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Gohar B, Larivière M, Lightfoot N, Wenghofer E, Larivière C, Nowrouzi-Kia B. Meta-analysis of nursing-related organizational and psychosocial predictors of sickness absence. Occup Med (Lond) 2021; 70:593-601. [PMID: 33313909 DOI: 10.1093/occmed/kqaa144] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Nursing is a stressful occupation with high rates of sickness absence. To date, there are no meta-analyses that statistically determined the correlates of sickness absence in this population. AIMS This meta-analysis examined organizational and psychosocial predictors of sickness absence among nursing staff. METHODS As a registered systematic review (PROSPERO: CRD42017071040), which followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, five databases (CINAHL, PROQuest Allied, PROQuest database theses, PsycINFO, PubMed) were reviewed to examine predictors of sickness absence in nurses and nursing assistants between 1990 and 2019. The Population/Intervention/Comparison/Outcome tool was used to support our searches. Effect sizes were analysed using random-effects model. RESULTS Following critical appraisals using (i) National Institutes of Health's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and (ii) Strengthening the Reporting of Observational Studies in Epidemiology, 21 studies were included. Nursing assistants had greater odds of sickness absence than nurses. Working night shifts, in paediatrics or psychiatric units, experiencing poor mental health, and fatigue, also increased the odds of sickness absence. There was no evidence that job satisfaction or job strain influenced sickness absence; however, job demand increased the likelihood. Finally, work support reduced the odds of lost-time. CONCLUSIONS We synthesized three decades of research where several factors influenced sickness absence. Due to limited recent research, the results should be interpreted with caution as some practices may have changed overtime or between countries. Nevertheless, these findings could help in applying preventative strategies to mitigate lost-time in a vulnerable working population.
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Affiliation(s)
- B Gohar
- Psychology Department, University of Guelph, Guelph, Canada.,Centre for Research in Occupational Safety & Health, Laurentian University, Sudbury, Canada
| | - M Larivière
- School of Human Kinetics, Northern Ontario School of Medicine, Centre for Research in Occupational Safety & Health, Laurentian University, Sudbury, Canada
| | - N Lightfoot
- School of Rural & Northern Health, Centre for Research in Occupational Safety & Health, Laurentian University, Sudbury, Canada
| | - E Wenghofer
- School of Rural & Northern Health, Laurentian University, Sudbury, Canada
| | - C Larivière
- School of Human Kinetics, Centre for Research in Occupational Safety & Health, Laurentian University, Sudbury, Canada
| | - B Nowrouzi-Kia
- Centre for Research in Occupational Safety & Health, Laurentian University, Sudbury, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
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2
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Mongeau S, Lightfoot N, MacEwan L, Eger T. Union, employer and compensation system gaps and failures: Workers with injuries perceptions. Work 2021; 69:485-495. [PMID: 34120929 DOI: 10.3233/wor-213493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Workers who suffered a workplace injury and submitted a claim with the compensation board in Ontario often faced economic and non-economic costs that provoked depressive feelings, family strain, financial strain, and feelings of diminished self-worth. OBJECTIVE This qualitative descriptive study aimed to understand the perceived gaps and failures associated with the support systems (e.g., union, compensation and employer) that were in place to assist some male underground workers in Sudbury, Ontario, Canada, who had suffered a workplace injury and had a compensation claim. METHODS Twelve in-depth, in-person, individual, semi-structured interviews were conducted and data were transcribed verbatim and anonymized at the time of transcription. Data analysis followed Braun and Clarke's guidelines for thematic analysis. RESULTS Themes that emerged include: unfair and inadequate recognition of an injury; limited communication with stakeholders involved with their claim, including claim adjudicators, challenges when returning to work, and compensation claim system barriers. CONCLUSIONS Cooperation, collaboration, knowledge transfer, and decreased power imbalances could help to reduce the economic and non-economic strain felt by a worker with an injury. Additionally, a government-funded third-party advocate who knows the medical system, union contracts, the workers' compensation system, and employer policies and practices could act on behalf of an injured worker.
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Affiliation(s)
- S Mongeau
- School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada
| | - N Lightfoot
- School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada
| | - L MacEwan
- School of Social Work, Laurentian University, Sudbury, ON, Canada
| | - T Eger
- School of Human Kinetics, Laurentian University, Sudbury, ON, Canada
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3
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Lightfoot N, MacEwan L, Tufford L, Holness DL, Mayer C, Kramer DM. Who cares? The impact on caregivers of suspected mining-related lung cancer. ACTA ACUST UNITED AC 2019; 26:e494-e502. [PMID: 31548817 DOI: 10.3747/co.26.4635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background In the present study, we investigated the emotional, physical, financial, occupational, practical, and quality-of-life impacts on caregivers of patients with mining-related lung cancer. Methods This concurrent, embedded, mixed-methods study used individual in-depth qualitative interviews and the 36-item Short Form Health Survey (version 2: RAND Corporation, Santa Monica, CA, U.S.A.) quality-of-life measure with 8 caregivers of patients with suspected mining-related lung cancer who had worked in Sudbury or Elliot Lake (or both), and sometimes elsewhere. Individuals who assist workers in filing compensation claims were also interviewed in Sudbury and Elliot Lake. Interviews (n = 11) were transcribed and analyzed thematically. Results Caregiver themes focused on the long time to, and the shock of, diagnosis and dealing with lung cancer; not much of a life for caregivers; strong views about potential cancer causes; concerns about financial impacts; compensation experiences and long time to compensation; and suggestions for additional support. Quality-of-life scores were below the norm for most measures. Individuals who assist workers in preparing claims were passionate about challenges in the compensation journey; the requirement for more and better family support; the need to focus on compensation compared with cost control; the need for better exposure monitoring, controls, resources, and research; and job challenges, barriers, and satisfaction. Conclusions Caregivers expressed a need for more education about the compensation process and for greater support. Worker representatives required persistence, additional workplace monitoring and controls, additional research, and a focus on compensation compared with cost control. They also emphasized the need for more family support.
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Affiliation(s)
- N Lightfoot
- School of Rural and Northern Health, Laurentian University, Sudbury, ON
| | - L MacEwan
- School of Social Work, Laurentian University, Sudbury, ON
| | - L Tufford
- School of Social Work, Laurentian University, Sudbury, ON
| | - D L Holness
- Dalla Lana School of Public Health and Department of Medicine, University of Toronto, and Division of Occupational Medicine and Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON
| | - C Mayer
- Supportive Care Oncology Research Unit, Health Sciences North, Sudbury, ON
| | - D M Kramer
- School of Occupational and Public Health, Ryerson University, Toronto, ON
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4
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Lightfoot N, Tawfik B, Fox SB. Diagnostic issues with significant tumour displacement in breast biopsies. J Clin Pathol 2014; 67:1110-1. [PMID: 25214055 DOI: 10.1136/jclinpath-2014-202450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Nicole Lightfoot
- Department of Pathology, Peter MacCallum Cancer Centre, St. Andrew's Place, East Melbourne, Victoria, Australia
| | - Bassam Tawfik
- Department of Pathology, St. John of God Pathology, Geelong, Victoria, Australia
| | - Stephen B Fox
- Department of Pathology, Peter MacCallum Cancer Centre, St. Andrew's Place, East Melbourne, Victoria, Australia Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
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Hartley DM, Nelson NP, Arthur RR, Barboza P, Collier N, Lightfoot N, Linge JP, van der Goot E, Mawudeku A, Madoff LC, Vaillant L, Walters R, Yangarber R, Mantero J, Corley CD, Brownstein JS. An overview of internet biosurveillance. Clin Microbiol Infect 2013; 19:1006-13. [PMID: 23789639 DOI: 10.1111/1469-0691.12273] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Internet biosurveillance utilizes unstructured data from diverse web-based sources to provide early warning and situational awareness of public health threats. The scope of source coverage ranges from local media in the vernacular to international media in widely read languages. Internet biosurveillance is a timely modality that is available to government and public health officials, healthcare workers, and the public and private sector, serving as a real-time complementary approach to traditional indicator-based public health disease surveillance methods. Internet biosurveillance also supports the broader activity of epidemic intelligence. This overview covers the current state of the field of Internet biosurveillance, and provides a perspective on the future of the field.
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Affiliation(s)
- D M Hartley
- Imaging Science and Information Systems Center, Georgetown University School of Medicine, Washington, DC, USA; Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, USA
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Abstract
Objective The aim of the present study was to survey human resources personnel about how their northeastern Ontario workplaces assist employees with cancer. Study Design and Setting This cross-sectional study was conducted from December 2007 to April 2008. Surveys were sent to 255 workplaces in northeastern Ontario with 25 or more employees, and 101 workplaces responded (39.6% response rate). Logistic regression modelling was used to identify factors associated with more or less workplace support. More or less workplace support was defined by provision of paid time to employees with medical appointments and an offer of a return-to-work meeting and reduced hours for employees with cancer. Factors considered in the model included organization size, geographic location (urban, rural), and workplace type (private sector, public sector). Results Most of the human resources staff who completed the surveys were women (67.4%), and respondents ranged in age from 25 to 70 years (mean: 45.30 ± 8.10 years). Respondents reported working for organizations that ranged in size from 25 to more than 9000 employees. In the logistic regression model, large organization size [odds ratio (or): 6.97; 95% confidence interval (ci): 1.34 to 36.2] and public sector (or: 4.98; 95% ci: 1.16 to 21.3) were associated with employer assistance. Public sector employers provided assistance at a rate 5 times that of private sector employers, and large organizations (>50 employees) provided assistance at a rate 7 times that of smaller organizations. Conclusions In the population studied, employees with cancer benefit from working in larger and public sector organizations. The data suggest a need for further support for employees with cancer in some other organizations.
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Affiliation(s)
- B Nowrouzi
- Master of Public Health Program, Lakehead University, Thunder Bay, ON.
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7
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Lightfoot N, Santos P, Nikfarjam M. Paraganglioma mimicking a pancreatic neoplasm. JOP 2011; 12:259-261. [PMID: 21546704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
CONTEXT Paragangliomas are rare tumours of neural crest origin. Extra-adrenal pancreatic paragangliomas are exceptionally rare. CASE REPORT A 66-year-old man with abdominal pain was noted to have a complex pancreatic head and uncinate process mass on imaging. He underwent complete resection by pancreaticoduodenectomy with final pathology confirming a 6 cm paraganglioma without evidence of metastases. On histology the tumour was arising from the retroperitoneum and abutting the pancreas. The patient was disease free at 14-month follow-up. CONCLUSION Pancreatic paragangliomas represent in many cases the retroperitoneal extension of a paraganglioma into the pancreas rather than a true pancreatic neoplasm. Although generally benign, the risk of malignant transformation justifies aggressive management.
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Affiliation(s)
- Nicole Lightfoot
- Department of Pathology, University of Melbourne, Austin Health, Heidelberg, VIC, Australia
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8
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Holmes NE, Gordon CL, Lightfoot N, Crowley P, Buchanan RR, Smith CL, Johnson PDR. Intravascular large B cell lymphoma: an elusive cause of pyrexia of unknown origin diagnosed postmortem. Clin Infect Dis 2010; 51:e61-4. [PMID: 20868278 DOI: 10.1086/656684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Intravascular large B cell lymphoma (IVLBCL) is a rare cause of pyrexia of unknown origin. Because of its protean clinical manifestations, diagnosis is elusive and is often made postmortem. We report here a case of IVLBCL that evaded diagnosis despite multiple investigations in vivo for pyrexia of unknown origin over a 5‐month period.
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Affiliation(s)
- N E Holmes
- Department of Infectious Diseases, Austin Health, Heidelberg, Australia.
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9
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Hartley DM, Nelson NP, Walters R, Arthur R, Yangarber R, Madoff L, Linge JP, Mawudeku A, Collier N, Brownstein JS, Thinus G, Lightfoot N. Landscape of international event-based biosurveillance. Emerg Health Threats J 2010; 3:e3. [PMID: 22460393 PMCID: PMC3167659 DOI: 10.3134/ehtj.10.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Revised: 11/17/2009] [Accepted: 01/12/2010] [Indexed: 11/18/2022]
Abstract
Event-based biosurveillance is a scientific discipline in which diverse sources of data, many of which are available from the Internet, are characterized prospectively to provide information on infectious disease events. Biosurveillance complements traditional public health surveillance to provide both early warning of infectious disease events and situational awareness. The Global Health Security Action Group of the Global Health Security Initiative is developing a biosurveillance capability that integrates and leverages component systems from member nations. This work discusses these biosurveillance systems and identifies needed future studies.
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Affiliation(s)
- DM Hartley
- Imaging Science and Information Systems Center, Georgetown University School of Medicine, Washington, DC, USA
| | - NP Nelson
- Georgetown University School of Medicine, Washington, DC, USA
| | - R Walters
- Pacific Northwest National Laboratory, Richland, WA, USA
| | - R Arthur
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - R Yangarber
- Department of Computer Science, University of Helsinki, Helsinki, Finland
| | - L Madoff
- University of Massachusetts Medical School, Worcester, MA, USA
| | - JP Linge
- Joint Research Centre, European Commission, Ispra, Italy
| | - A Mawudeku
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - N Collier
- National Institute of Informatics, Tokyo, Japan
| | - JS Brownstein
- Children's Hospital Boston, Harvard Medical School, Boston, MA, USA
| | - G Thinus
- Imaging Science and Information Systems Center, Georgetown University School of Medicine, Washington, DC, USA
| | - N Lightfoot
- Georgetown University School of Medicine, Washington, DC, USA
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10
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Abstract
BACKGROUND Previous studies of nickel workers have primarily noted significant early increases in lung and nasal cancers and for various types of accidents. AIMS To examine cancer incidence and mortality, concurrently, for a cohort of male nickel workers at a major nickel and copper producer in Sudbury, Ontario, Canada. METHODS From January 1964 to December 2001, nominal roll and work history information were linked to Ontario health data and mortality and cancer incidence were compared to the Ontario population. RESULTS There were 1984 (19%) deaths and 1127 (11%) incident cancers (n = 10,253). Significant elevations in mortality were observed for accidents, poisoning and violence; for possibly job-related accidents among those with <15 years since first hire [standardized mortality ratio (SMR) = 133, 95% CI: 111-158; SMR = 241, 95% CI: 159-351, respectively] and for accidents in those with > or =15 years since first hire (SMR = 123, 95% CI: 104-144). Significant elevations were also observed for accidents, poisoning and violence for those with 6 months to 14 years work experience and for lung cancer incidence and mortality for those with 15-29 years work experience (SMR = 128, 95% CI: 107-153). Incident lung cancers were significantly elevated for those hired in the 1940s and 1960s. CONCLUSIONS Significant lung cancer mortality and incidence elevations were observed for the cohort and underground workers with increased time since first hire, for those hired during early periods of operation and for those with longer durations of employment. Further aetiological study is required as occupational aetiology could not be ascertained.
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Affiliation(s)
- N Lightfoot
- School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada.
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11
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Anaraki S, Addiman S, Nixon G, Krahé D, Ghosh R, Brooks T, Lloyd G, Spencer R, Walsh A, McCloskey B, Lightfoot N. Investigations and control measures following a case of inhalation anthrax in East London in a drum maker and drummer, October 2008. Euro Surveill 2008; 13:19076. [PMID: 19094916] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
The patient is believed to have acquired the infection from making animal hide drums. Environmental investigations identified one drum and two pieces of animal skins contaminated with anthrax spores.
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Affiliation(s)
- S Anaraki
- North East and North Central London Health Protection Unit, Health Protection Agency, London, United Kingdom
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12
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Anaraki S, Addiman S, Nixon G, Krahé D, Ghosh R, Brooks T, Lloyd G, Spencer R, Walsh A, McCloskey B, Lightfoot N. Investigations and control measures following a case of inhalation anthrax in East London in a drum maker and drummer, October 2008. Euro Surveill 2008. [DOI: 10.2807/ese.13.51.19076-en] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We discuss the investigations and control measures undertaken following the notification of a fatal case of inhalation anthrax in East London. The patient is believed to have acquired the infection from making animal hide drums. Environmental investigations identified one drum and two pieces of animal skins contaminated with anthrax spores.
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Affiliation(s)
- S Anaraki
- North East and North Central London Health Protection Unit, Health Protection Agency, London, United Kingdom
| | - S Addiman
- North East and North Central London Health Protection Unit, Health Protection Agency, London, United Kingdom
| | - G Nixon
- North East and North Central London Health Protection Unit, Health Protection Agency, London, United Kingdom
| | - D Krahé
- Homerton University Hospital, London, United Kingdom
| | - R Ghosh
- Homerton University Hospital, London, United Kingdom
| | - T Brooks
- Laboratory for Novel and Dangerous Pathogens, Health Protection Agency, London, United Kingdom
| | - G Lloyd
- Laboratory for Novel and Dangerous Pathogens, Health Protection Agency, London, United Kingdom
| | - R Spencer
- Laboratory for Novel and Dangerous Pathogens, Health Protection Agency, London, United Kingdom
| | - A Walsh
- Centre for Infections, Health Protection Agency, London, United Kingdom
| | - B McCloskey
- London Regional Director’s Office, Health Protection Agency, London, United Kingdom
| | - N Lightfoot
- Health Protection Agency, Central Office, London, United Kingdom
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Kraut AG, Venables KM, Allender S, McNamee R, Carder M, Chen Y, Agius R, Ilg AGS, Imbernon E, Rolland P, Ducamp S, De Quillacq A, Frenay C, Chammings S, Launoy G, Pairon JC, Astoul P, Galateau-Salle F, Brochard P, Goldberg M, Geoffroy-Perez B, Julliard S, Fouquet A, Goldberg M, Imbernon E, Lo SH, Wang JD, Liau CS, Carosi A, Lightfoot N, Alkema K, Driscoll TR, Hogan A, Kearney G. Surveillance and health care. Occup Environ Med 2007. [DOI: 10.1136/oem.64.12.e44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Behrens T, Schill W, Wild P, Frentzel-Beyme R, Ahrens W, Iwatsubo Y, Benezet L, Boutou-Kempf O, Chabault E, Fevotte J, Garras L, Goldberg M, Luce D, Imbernon E, Peplonska B, Wilczynska U, Sobala W, Szeszenia-Dabrowska N, Thuret A, Geoffroy-Perez B, Luce D, Goldberg M, Imbernon E, Won JU, Koh DH, Roh JH, Kim KS, Canu IG, Molina G, Collomb P, Goldberg M, Perez P, Paquet F, Acker A, Tirmarche M, Berriault C, Lightfoot N, Conlon M, Bissett R, Gottfred B, Robinson CF, Sestito JP, Wood J, Walker JT, Brooks C, Linsell L, Keegan TJ, Langdon T, Beral V, Doyle P, Fletcher T, Maconochie N, Nieuwenhuijsen MJ, Carpenter LM, Venables KM. Industry based cohorts 1. Occup Environ Med 2007. [DOI: 10.1136/oem.64.12.e10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Monteith SJ, Winder MJ, Lightfoot N, Mee E. NS05 PENETRATING HEAD INJURY FROM NAILGUNS: THE NEW ZEALAND EXPERIENCE. A CASE SERIES. ANZ J Surg 2007. [DOI: 10.1111/j.1445-2197.2007.04124_5.x] [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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Nguyen-Van-Tam JS, Nair P, Acheson P, Baker A, Barker M, Bracebridge S, Croft J, Ellis J, Gelletlie R, Gent N, Ibbotson S, Joseph C, Mahgoub H, Monk P, Reghitt TW, Sundkvist T, Sellwood C, Simpson J, Smith J, Watson JM, Zambon M, Lightfoot N. Outbreak of low pathogenicity H7N3 avian influenza in UK, including associated case of human conjunctivitis. ACTA ACUST UNITED AC 2006; 11:E060504.2. [PMID: 16816456 DOI: 10.2807/esw.11.18.02952-en] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
On 26 April 2006, the veterinary authorities in the United Kingdom reported that there had been an outbreak of avian influenza type A/H7 among a 35 000-bird housed poultry flock in eastern England, United Kingdom.
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17
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Harling R, Twisselmann B, Asgari-Jirhandeh N, Morgan D, Lightfoot N, Reacher M, Nicoll A. Deliberate releases of biological agents: initial lessons for Europe from events in the United States. Euro Surveill 2001; 6:166-71. [PMID: 11891387 DOI: 10.2807/esm.06.11.00384-en] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The experience of autumn 2001, when anthrax spores were released in the postal system, had considerable consequences in the United States and in Europe. The threat of covert deliberate releases against civilians has become a reality. In Europe, despite the growing number of criminal hoaxes, no cases of anthrax linked to deliberate releases have been reported, and the only contaminated letters were addressed to American embassies abroad. Nevertheless, the time has come for Europe to set up efficient and timely plans to respond to bioterrorism, under the coordination of the European Commission.
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Affiliation(s)
- R Harling
- Public Health Laboratory Service, London, England
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19
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Abstract
BACKGROUND This study was performed to assess radiotherapy education among family physicians. METHODS A questionnaire evaluating radiotherapy training and knowledge was given to participants of a palliative care conference. RESULTS Thirty-four physicians completed the survey (71% response rate). Major deficiencies in radiotherapy education were identified and 88% of respondents stated that they did not have adequate knowledge. Only 33% had received formal training in radiotherapy and the majority (77%) thought that they would benefit considerably from continuing medical education. CONCLUSIONS Better education about radiotherapy is required for family physicians and could lead to increased patient referral for such treatment.
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Affiliation(s)
- R Samant
- Northeastern Ontario RegionaL Cancer Centre, Sudbury, Ontario, Canada.
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20
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Lightfoot N, Conlon M, Kreiger N, Bissett R, Desai M, Warde P, Prichard HM. Impact of noninvasive imaging on increased incidental detection of renal cell carcinoma. Eur Urol 2000; 37:521-7. [PMID: 10765089 DOI: 10.1159/000020188] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the impact of non-invasive imaging, specifically ultrasound imaging and computed tomography, on the incidental detection of renal cell carcinoma during two consecutive time periods, one prior and one subsequent to the acquisition of imaging equipment. METHODS All located patient charts (83% of 207) of renal cell carcinoma cases (n = 172) were reviewed, and categorized by presentation method as 'incidental' or 'nonincidental' cases, based on defined criteria. Clinical information was recorded, cases were staged, and survival estimates were calculated. RESULTS More than a third of the 172 cases were categorized as incidentally detected, most of which (82.5%) were detected during the latter time period. Either ultrasound or CT imaging was credited with detecting over 80% of the incidentally detected tumors. CONCLUSION Ultrasound and CT imaging have contributed to the incidental detection of renal cell carcinomas during the two time periods. Stage significantly predicted survival (p<0.001) in a Cox proportional hazard model that also controlled for presentation, sex, and age.
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Affiliation(s)
- N Lightfoot
- Epidemiology Research Unit, Northeastern Ontario Regional Cancer Centre (NEORCC), Sudbury, Canada.
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21
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Willocks L, Crampin A, Milne L, Seng C, Susman M, Gair R, Moulsdale M, Shafi S, Wall R, Wiggins R, Lightfoot N. A large outbreak of cryptosporidiosis associated with a public water supply from a deep chalk borehole. Outbreak Investigation Team. Commun Dis Public Health 1998; 1:239-43. [PMID: 9854881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Three hundred and forty-five confirmed cases were reported in a large waterborne outbreak of cryptosporidiosis in North Thames in the spring of 1997. The descriptive epidemiology, attack rates, a case control study, and the detection of oocysts in the water suggested strongly that the outbreak was associated with drinking unboiled tap water that originated from one deep chalk borehole. The 746,000 people living in the water distribution area were advised to boil their drinking water. Investigations did not reveal how oocysts entered the borehole. This is the first published report of a cryptosporidium outbreak caused by filtered borehole water and we believe it to be the largest outbreak due to groundwater to have been reported. Borehole supplies are regarded as relatively pure sources of water and this outbreak has implications for the future monitoring and treatment of drinking water extracted from boreholes.
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Affiliation(s)
- L Willocks
- Department of Public Health and Epidemiology, King's College School of Medicine and Dentistry.
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22
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Blain P, Lightfoot N, Bannister B. Practicalities of warfare required service personnel to be vaccinated against anthrax. BMJ 1998; 317:1077-8. [PMID: 9774304 PMCID: PMC1114073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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23
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24
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Steggles S, Lightfoot N, Sellick SM. Psychological distress associated with organized breast cancer screening. Cancer Prev Control 1998; 2:213-20. [PMID: 10093635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Regular breast cancer screening with the use of mammography for asymptomatic women is the most effective method for the early detection of breast cancer. Although the health and economic implications of breast cancer screening have received a great deal of attention, the psychological consequences of attending a breast screening program that includes mammography have been largely ignored. This article briefly reviews 10 studies that have examined the psychological distress associated with organized breast cancer screening. Anxiety appears to be the most prevalent consequence of mammography and seems to affect certain subgroups, with the most significant effects being among those women requiring further investigation because of abnormal results. The results of these studies, the research methods used and future directions in this area are discussed.
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Affiliation(s)
- S Steggles
- Supportive Care Program, Northeastern Ontario Regional Cancer Centre.
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25
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Steggles S, Damore-Petingola S, Maxwell J, Lightfoot N. Hypnosis for children and adolescents with cancer: an annotated bibliography, 1985-1995. J Pediatr Oncol Nurs 1997; 14:27-32. [PMID: 9019041 DOI: 10.1177/104345429701400105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
This annotated bibliography reviews the professional literature published in English, from 1985 to 1995 inclusive, on the subject of the use of hypnosis with pediatric cancer patients. Books, chapters, and journal articles are included; dissertation, theses, and unpublished material are not. This bibliography contains 37 items organized into three categories: (1) General Discussions; (2) Case Reports or Case Studies: and (3) Experimental and Nonexperimental Group Designs. The brief annotations provided are not intended to be reviews or to be evaluative, but, rather, to inform the reader about the content and focus of the publication. This is an update of a previously published annotated bibliography, also presented in this Journal, which explored the relationship between hypnosis and pediatric cancer in journal articles published from 1960 to 1985.
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Affiliation(s)
- S Steggles
- Department of Psychosocial Resources, Northeastern Ontario Regional Cancer Centre, Sudbury, Canada
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Abstract
In many radiotherapy facilities radiotherapy portal verification is currently a subjective process based on the visual comparison of a treatment or portal image with a prescription or simulation image. The reliability of this process is unknown. We describe here a study in which 16 observers (oncologists, physicists and therapists) independently evaluated the geometric accuracy of 530 treatment fields on 45 patients. The treatment images were acquired by the BEAMVIEW on-line portal imaging system (Siemens Medical Laboratories, Concord, CA, USA). Illustrative examples of the large variation in observers' assessments of the same field are given. The kappa statistic is used to evaluate the degree of agreement between observers and between on-line (at the treatment unit) and off-line (in a quiet viewing room) assessments. The best interobserver agreement was between the four oncologists contributing to the study although this level of agreement was rated only as "fair". Comparison of on-line and off-line decisions made by therapists exhibited "poor" agreement. This study has provided statistical confirmation of the suspicions of many workers in the field of radiotherapy portal verification, viz that the subjective evaluation of field accuracy is unreliable. However, the degree of unreliability is surprisingly large. The inconsistencies between observers documented in this study need to be clearly acknowledged in the development of protocols for the clinical use of on-line portal imaging systems. Acceptable reliability in radiotherapy portal verification will only be achieved when subjective decision making is eliminated.
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Affiliation(s)
- R Bissett
- Department of Radiation Oncology, Northeastern Ontario Regional Cancer Centre, Sudbury, Canada
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27
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Hofbeck M, Sunnegårdh JT, Burrows PE, Moes CA, Lightfoot N, Williams WG, Trusler GA, Freedom RM. Analysis of survival in patients with pulmonic valve atresia and ventricular septal defect. Am J Cardiol 1991; 67:737-43. [PMID: 2006624 DOI: 10.1016/0002-9149(91)90532-p] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.1] [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: 12/29/2022]
Abstract
This study reviews the clinical course of 104 consecutive patients with pulmonic valve atresia and ventricular septal (VSD) defect who were diagnosed in the first year of life and followed for a mean period of 4.95 years (range 2 days to 13.75 years). Specific attention was paid to the nature of the pulmonary blood supply and to its influence on patient outcome. Confluent pulmonary arteries supplied by a single ductus arteriosus were present in 72 patients (69%, group I), whereas 32 patients (31%, group II) had a pulmonary blood supply that was partially or exclusively dependent on systemic collateral arteries. An estimate of the probability of survival for 10 years was 69% in the entire cohort, with no different between patients in group I and group II. Definitive surgical repair was performed in 33 of 72 group I patients (46%), compared with 5 of 32 group II patients (16%). Arborization and distribution abnormalities of the pulmonary arteries as well as intrapulmonary stenoses that were exclusively present in patients with systemic collateral arteries (p less than 0.00001) accounted for the significantly lower probability of undergoing corrective surgery in group II patients.
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Affiliation(s)
- M Hofbeck
- Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
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28
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Lightfoot N. A GP antibiotic formulary. Practitioner 1990; 234:1060, 1062. [PMID: 2075168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- N Lightfoot
- Public Health Laboratory, Newcastle upon Tyne
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Rowe RD, Rose V, Wilson GJ, Lightfoot N. Kawasaki disease: a measles cover-up? CMAJ 1987; 136:1146. [PMID: 3567773 PMCID: PMC1492163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Frank RJ, Ronald K, Lightfoot N. Parturition in the Hooded Seal, Cystophora cristata (Erxleben). J Mammal 1985. [DOI: 10.2307/1380935] [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: 11/10/2022] Open
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31
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Gledhill T, Leicester RJ, Addis B, Lightfoot N, Barnard J, Viney N, Darkin D, Hunt RH. Epidemic hypochlorhydria. Br Med J (Clin Res Ed) 1985; 290:1383-6. [PMID: 3922503 PMCID: PMC1415635 DOI: 10.1136/bmj.290.6479.1383] [Citation(s) in RCA: 71] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
During a study of gastric secretion four out of six previously healthy subjects developed hypochlorhydria after a transient illness with nausea, vomiting, and abdominal pain. Mean basal and peak acid outputs were 0 and 2.3 mmol (84 mg)/h one month after the onset of illness and 1.5 and 27.0 mmol/h (55 and 984 mg/h) at eight months' follow up. Two of the subjects were followed up at 18 months, when mean basal and peak acid outputs were 3.9 and 33.5 mmol/h (142 and 1221 mg/h). No endoscopic abnormality was seen at one and eight months, but biopsies showed active superficial gastritis, which resolved in one subject and became chronic in two. Schilling tests performed in three subjects at eight months showed diminished retention of vitamin B12. During hypochlorhydria a 24 hour intragastric analysis was performed for total and nitrate reducing bacteria, pH, and concentrations of nitrite and total and stable N-nitroso compounds. Of the 48 samples of gastric juice examined, 47 had bacterial growth of more than 10(6) organisms/ml and 46 had growth of nitrate reducing bacteria of more than 10(5) organisms/ml. Mean intragastric nitrite concentrations were 10 times higher than in a group of eight healthy controls. Both mean total and mean stable N-nitroso compound concentrations, however, were not appreciably different from those in controls. Although community transmission was a possibility, serological screening and electron microscopy of gastric biopsy specimens failed to show an infective cause. Transmission of an unidentified enteric pathogen via a contaminated pH electrode was therefore suspected. Thus gastric juice should not be returned to the stomach after contact with a contaminated glass electrode as this is a possible cause of atrophic gastritis.
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Nichols G, Goad RF, Page B, Lightfoot N. A pilot study of skin disinfection in the hyperbaric environment. Undersea Biomed Res 1981; 8:239-43. [PMID: 7324256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
An opportunity was taken to carry out a pilot on human skin disinfection during a recent long-term saturation dive at extremely high pressure. Despite a number of difficulties, results were sufficiently encouraging to suggest that, given ideal conditions, sterilization of the skin in preparation for surgical or anesthetic procedures, or both, in a hyperbaric environment is possible.
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Preston PJ, Lightfoot N, Clarke P. A retrospective serological suvey of Royal Marines previously exposed to Pseudomonas pseudomallei in South East Asia. Trans R Soc Trop Med Hyg 1976; 70:335-7. [PMID: 1006764 DOI: 10.1016/0035-9203(76)90092-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Following the suggestion that it was possible that cases of melioidosis amongst those who had been exposed abroad in the past, might be escaping notice, 487 Royal Marines were examined by indirect haemagglutination studies. Four hundred and eleven of these subjects had served for variable times in areas where melioidosis has been known to occur in Indonesia and Malaya, between 1960 and 1974, occupied in activities in the jungle and paddy fields during which exposure to the disease was to be expected. No evidence of residual subclinical melioidosis was found and it seems unlikely that recrudescent disease will prove to be a problem in the future for English servicemen who have been in South East Asia.
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