1
|
Roberts C, Phillips L, Cooper C, Gray S, Soiza R, Allan J. Classifying the non-metabolic demands of different physical activity types: The Physical Activity Demand (PAD) typology. PLoS One 2023; 18:e0291782. [PMID: 37856505 PMCID: PMC10586621 DOI: 10.1371/journal.pone.0291782] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/05/2023] [Indexed: 10/21/2023] Open
Abstract
Different physical activity types vary in metabolic demand (intensity), but also in non-metabolic physical demand (balance, co-ordination, speed and flexibility), cognitive demand (attention, memory and decision making), and social demand (social interaction). Activity types with different combinations of demands may have different effects on health outcomes but this cannot be formally tested until such demands can be reliably quantified. The present Delphi expert consensus study aimed to objectively quantify the cognitive, physical and social demands of different core physical activity types and use these scores to create a formal Physical Activity Demand (PAD) typology. International experts (n = 40; experts in cognitive science, psychology, sports science and physiology; 7 different nationalities; 18 male/22 female; M = 13.75 years of disciplinary experience) systematically rated the intrinsic cognitive, physical and social demands of 61 common activity types over 2-rounds of a modified Delphi (expert consensus) study. Consensus (>70% agreement) was reached after 2 rounds on the demands of 59/61 activity types. Cognitive, physical and social demand scores were combined to create an overall non-metabolic demand rating for each activity type, and two-step cluster-analysis was used to identify groups of activities with comparable demand profiles. Three distinct clusters of activities were identified representing activity types with low (n = 12 activities; e.g. domestic cleaning), moderate (n = 23 activities; e.g. tai-chi) and high (n = 24 activities; e.g. football) total non-metabolic demands. These activity types were then organised into a formal typology. This typology can now be used to test hypotheses about if and why physical activity types with different combinations of cognitive, physical and social demands affect health outcomes in different ways.
Collapse
Affiliation(s)
- Christine Roberts
- Sport & Exercise Team, University of Aberdeen, Aberdeen, United Kingdom
| | - Louise Phillips
- School of Psychology, University of Aberdeen, Aberdeen, United Kingdom
| | - Clare Cooper
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Stuart Gray
- Institute of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Roy Soiza
- Institute of Medical Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Julia Allan
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| |
Collapse
|
2
|
Logan G, Somers C, Baker G, Connell H, Gray S, Kelly P, McIntosh E, Welsh P, Gray CM, Gill JMR. Benefits, risks, barriers, and facilitators to cycling: a narrative review. Front Sports Act Living 2023; 5:1168357. [PMID: 37795314 PMCID: PMC10546027 DOI: 10.3389/fspor.2023.1168357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023] Open
Abstract
There is large potential to increase cycling participation worldwide. Participation in cycling is associated with lower risk of mortality from any cause, and incidence of cardiovascular disease and type 2 diabetes, as well as positive mental health and well-being. The largest potential for health gains likely to come from increasing participation amongst those who do not currently cycle regularly, rather than encouraging those who already cycle regularly to cycle more. Replacing car journeys with cycling can lead to reductions in air pollution emissions and lower pollutant exposure to the general population. Important gaps and uncertainties in the existing evidence base include: the extent to which the health benefits associated with cycling participation are fully causal due to the observational nature of much of the existing evidence base; the real-world economic cost-benefits of pragmatic interventions to increase cycling participation; and the most effective (combination of) approaches to increase cycling participation. To address these uncertainties, large-scale, long-term randomised controlled trials are needed to: evaluate the effectiveness, and cost-effectiveness, of (combinations of) intervention approaches to induce sustained long-term increases in cycling participation in terms of increases in numbers of people cycling regularly and number of cycling journeys undertaken, across a range of population demographic groups; establish the effects of such interventions on relevant outcomes related to health and wellbeing, economic productivity and wider societal impacts; and provide more robust quantification of potential harms of increasing cycling participation, such as collision risks.
Collapse
Affiliation(s)
- Greig Logan
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Camilla Somers
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Graham Baker
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Hayley Connell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Stuart Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma McIntosh
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M. Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Jason M. R. Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| |
Collapse
|
3
|
Soltanisarvestani M, Lynskey N, Gray S, Gill JMR, Pell JP, Sattar N, Welsh P, Ho FK, Celis-Morales C, Peterman-Rocha F. Associations of grip strength and walking pace with mortality in stroke survivors: A prospective study from UK Biobank. Scand J Med Sci Sports 2023; 33:1190-1200. [PMID: 36932055 DOI: 10.1111/sms.14352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/19/2023]
Abstract
INTRODUCTION Although stroke is an emerging cause of disability and mortality globally, associations between physical capability markers and mortality in stroke survivors are elusive. This study investigated the individual and combined associations of walking pace and grip strength with all-cause and stroke mortality in stroke survivors. METHODS Individual and combined associations of walking pace and grip strength with stroke deaths and all-cause mortality were investigated using Cox proportional-hazard models adjusted for sociodemographic, lifestyle, and health-related variables. RESULTS Seven thousand four hundred eighty-six stroke survivors from the UK Biobank study (aged 40-70 years; 42.4% women) were included in this prospective study. Over a median follow-up of 12.6 (IQR: 11.9-13.3) years, 1490 (19.9%) participants died, of whom 222 (3.0%) died from stroke. After adjusting for confounding factors, and compared to individuals in the average/brisk walking pace category, those who reported a slow walking pace had 2.00 (95% CI: 1.50-2.68) and 1.99 (95% CI: 1.78-2.23) times higher risk of stroke mortality and all-cause mortality, respectively. Similar associations were identified for participants with low grip strength compared with those with normal levels. For combined associations, those with both slow walking pace and low grip strength showed the highest risk of stroke mortality (hazard ratio: 2.86 [95% CI: 1.93-4.22]). Similar results were found for all-cause mortality. CONCLUSIONS Low grip strength and slow walking pace were associated with a higher risk of stroke and all-cause mortality in stroke survivors. If these associations are causal, improving physical capability among stroke survivors might potentially prolong survival.
Collapse
Affiliation(s)
- Maryam Soltanisarvestani
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Nathan Lynskey
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Stuart Gray
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Jason M R Gill
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile
| | - Fanny Peterman-Rocha
- British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| |
Collapse
|
4
|
Jones C, Gray S, Brown M, Brown J, Mc Closkey E, Rai B, Clarke N, Sachdeva A. Fracture and fall risk in men with advanced or metastatic prostate cancer treated with novel androgen receptor signalling inhibitors: A systematic review and meta-analysis of randomised controlled trials. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01036-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
5
|
Gaal A, Shimchuk A, Gray S, Bloomquist D, Dillon J. Are postoperative antibiotics required after orthognathic surgery? Int J Oral Maxillofac Surg 2023; 52:211-218. [PMID: 35780069 DOI: 10.1016/j.ijom.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 01/11/2023]
Abstract
The aim of this study was to investigate and compare the frequency of surgical site infection (SSI) between orthognathic patients who received only intraoperative antibiotics and patients who received intraoperative antibiotics plus postoperative antibiotics. A retrospective study was performed of patients treated by a single surgeon over the years 2006-2012 and 2016-2019. The primary predictor variable was antibiotic exposure. The control group received no postoperative prophylactic antibiotics. The study group received postoperative antibiotics. Both groups received prophylactic intraoperative antibiotics and performed postoperative chlorhexidine rinses. The primary outcome was SSI frequency. Univariate, bivariate, and multiple logistic regression analyses were performed; statistical significance was set at P ≤ 0.05. The sample comprised 333 patients. Their mean age was 30.7 ± 11.8 years. The study group included 129 patients (38.7%); the control group included 204 patients (61.3%). The frequency of SSI was 17.1% in the study group and 26.5% in the control group (P = 0.048). In the multivariable logistic regression, only alcohol consumption was significantly associated with an increased risk of SSI (odds ratio 2.46, 95% confidence interval 1.36-4.44; P = 0.003). In patients undergoing orthognathic surgery, postoperative antibiotic exposure in addition to intraoperative prophylaxis approached but was not statistically significant for a decreased risk of SSI (P = 0.067).
Collapse
Affiliation(s)
- A Gaal
- Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA, USA.
| | - A Shimchuk
- Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA, USA.
| | - S Gray
- Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA, USA.
| | - D Bloomquist
- Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA, USA.
| | - J Dillon
- Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA, USA.
| |
Collapse
|
6
|
Thomas N, Stankard A, Cosgrave N, Conlon B, Monahan P, Halpin T, Britton D, Byrne P, McShane S, Sohail I, Grogan AM, Reilly A, Thapa A, Alsubaie N, Rane P, O'Connor J, Gray S, Kaja A, Gehani K, Kovalyshyn V, O'Brien H. 92 CONTINUING TO ‘BE HIP’: ORTHOGERIATRIC SERVICE IMPROVEMENTS IN 2021. Age Ageing 2022. [PMCID: PMC9620584 DOI: 10.1093/ageing/afac218.076] [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: 12/02/2022] Open
Abstract
Background Scotland first demonstrated that adherence to nationally agreed hip fracture standards improve patient survival, reduces the duration of admission, and reduces the need for high dependency care. Our study aims to assess adherence to the Irish Hip Fracture Standards (IHFS) in our hospital for 2021 amidst the COVID-19 pandemic, translating to improved clinical outcomes for our patients. Methods The IHF database was retrospectively analysed, comparing quarters 1-4 in 2021 with our 2020 results. Results IHFS1, patient time to the ward < 4hours, was maintained at 67% in 2021 versus 71% overall in 2020. There was improvement in IHFS2, time to surgery within 48 hours, up to 73% in 2021 versus 66% in 2020. IHFS3 was 4% in 2021 versus 3% overall in 2020. Further improvements were noted for IHFS4, with 95% of patients reviewed by a Geriatrician in 2021 versus 87% in 2020. IHFS5 also improved with 97% of patients receiving a bone health assessment in 2021 versus 87% in 2020. Moreover, IHFS6, improved with 97% of patients undergoing a specialised falls assessment in 2021 versus 87% in 2020. Conclusion The improvement in 2021 figures is reflective of the return of redeployed services during the COVID-19 pandemic inclusive of the Orthogeriatric Service, the Fracture Liaison Service Advanced Nurse Practitioner, the Trauma Co-ordinator, and the specialist Orthopaedic ward complete with its Orthopaedic nurses and Multi-Disciplinary Team, and improved Emergency Department pathways. These continued improvements in the IHFS further emphasise that success is dependent on a team that is joined at the hip
Collapse
Affiliation(s)
- N Thomas
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Stankard
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - N Cosgrave
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - B Conlon
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - P Monahan
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - T Halpin
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - D Britton
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - P Byrne
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - S McShane
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - I Sohail
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - AM Grogan
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Reilly
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Thapa
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - N Alsubaie
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - P Rane
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - J O'Connor
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - S Gray
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Kaja
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - K Gehani
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - V Kovalyshyn
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - H O'Brien
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| |
Collapse
|
7
|
Stankard A, Thomas N, Cosgrave N, Conlon B, Monaghan P, Halpin T, English D, Byrne P, McShane S, Sohail I, Grogan AM, Reilly A, Thapa A, Alsubaie N, Rane P, O'Connor J, Gray S, Kaja A, Gehani K, Kovalyshyn V, O'Brien H. 258 RISING TO THE CHALLENGE: ORTHOGERIATRIC SERVICE IMPROVEMENT AND COVID-19. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.227] [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
Nationally agreed hip fracture standards have contributed to the improvement of outcomes in hip fracture patients. In 2020, our hospital was awarded “The Golden Hip” for achieving highest compliance with Irish Hip Fracture Standards (IHFS) nationally for 2019.
Methods
Data from the Irish Hip Fracture Database (IHFD)was retrospectively analysed to assess our performance in 2020 versus 2019 in hip fracture patients over sixty. Multiple quality improvement interventions were put in place throughout 2019 to ensure improvement in IHFS1-6 compliance: Creation of the Hip Fracture Pathway Subgroup, IHFS 1 Breaches Audit, Orthogeriatric input at Orthopaedic inductions, weekly Multi-disciplinary Team meetings, a Nutritional Hip Fracture Pathway and addition of the Fracture Liaison Service Advanced Nurse Practitioner.
Results
There were 239 hip fracture patients in 2020 vs 249 in 2019. IHFS1 compliance improved with the percentage of patients admitted to the Orthopaedic ward within 4 hours increasing to 71% in 2020 from 56% in 2019. There was improvement in IHFS2-time to surgery <48 hours- 66% in 2020 vs 60% in 2019. IHFS3-pressure ulcer rate-was at the national average, 3% in 2020 vs 2% in 2019. IHFS4 (reviewed by a Geriatrician), IHFS5 (received a bone health assessment) and IHFS6 (received a specialised falls assessment) were lower overall; 87% in 2020 vs 98% in 2019. For all quarters (Q),43% of patients met all IHFS in our hospital in 2020 vs 32% in 2019, resulting in €90,000 in Best Practice Tariff funding.
Conclusion
Lower results for IHFS 4,5 and 6 reflect the arrival of the COVID-19 pandemic which led to redeployment of the Orthogeriatric Service and redeployment of the MDT from end of Q1 to Q3. When services in 2020 were preserved,1 in 2 hip fracture patients met all IHFS, vs 1 in 3 patients in 2019. Despite the pandemic, we continued to achieve the highest level of IHFS compliance nationally, being awarded a second consecutive “Golden Hip” for 2020.
Collapse
Affiliation(s)
- A Stankard
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - N Thomas
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - N Cosgrave
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - B Conlon
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - P Monaghan
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - T Halpin
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - D English
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - P Byrne
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - S McShane
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - I Sohail
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - AM Grogan
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Reilly
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Thapa
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - N Alsubaie
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - P Rane
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - J O'Connor
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - S Gray
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - A Kaja
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - K Gehani
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - V Kovalyshyn
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| | - H O'Brien
- Our Lady Of Lourdes Hospital , Drogheda, Ireland
| |
Collapse
|
8
|
Andemariam B, Inati A, Colombatti R, Minniti C, Brown C, Hottmann M, Gray S, Hoppe C, Montealegre-Golcher F, Yue P. TRIALS IN PROGRESS: THE THRIVE STUDIES EVALUATING THE EFFICACY, SAFETY, AND LONG-TERM TREATMENT WITH INCLACUMAB, A P-SELECTIN INHIBITOR, IN PATIENTS WITH SICKLE CELL DISEASE. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.046] [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: 11/06/2022] Open
|
9
|
Henderson B, Maguire P, Keartland S, Barr M, Crulhas B, Keating G, Fitzmaurice G, Gray S, Nicholson S, Finn S, Gately K. EP02.01-002 Development of Circulating and Tissue Biomarkers Predicting Immune Phenotype and Response to Immunotherapy in NSCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
10
|
Achebe M, Hassab H, Alkindi S, Brown C, Telfer P, Biemond B, Gordeuk V, Lipato T, Alfa Cissé O, Darson F, Tonda M, Gray S, Howard J. Sécurité et efficacité à long terme du voxelotor chez des patients atteints de drépanocytose : résultats d’une étude d’extension en ouvert de l’essai de phase 3 HOPE. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
11
|
Brookes O, Gray S, Bennett P, Burgess KV, Clark FE, Roberts E, Burghardt T. Evaluating Cognitive Enrichment for Zoo-Housed Gorillas Using Facial Recognition. Front Vet Sci 2022; 9:886720. [PMID: 35664848 PMCID: PMC9161820 DOI: 10.3389/fvets.2022.886720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
The use of computer technology within zoos is becoming increasingly popular to help achieve high animal welfare standards. However, despite its various positive applications to wildlife in recent years, there has been little uptake of machine learning in zoo animal care. In this paper, we describe how a facial recognition system, developed using machine learning, was embedded within a cognitive enrichment device (a vertical, modular finger maze) for a troop of seven Western lowland gorillas (Gorilla gorilla gorilla) at Bristol Zoo Gardens, UK. We explored whether machine learning could automatically identify individual gorillas through facial recognition, and automate the collection of device-use data including the order, frequency and duration of use by the troop. Concurrent traditional video recording and behavioral coding by eye was undertaken for comparison. The facial recognition system was very effective at identifying individual gorillas (97% mean average precision) and could automate specific downstream tasks (for example, duration of engagement). However, its development was a heavy investment, requiring specialized hardware and interdisciplinary expertise. Therefore, we suggest a system like this is only appropriate for long-term projects. Additionally, researcher input was still required to visually identify which maze modules were being used by gorillas and how. This highlights the need for additional technology, such as infrared sensors, to fully automate cognitive enrichment evaluation. To end, we describe a future system that combines machine learning and sensor technology which could automate the collection of data in real-time for use by researchers and animal care staff.
Collapse
Affiliation(s)
- Otto Brookes
- Department of Computer Science, Faculty of Engineering, University of Bristol, Bristol, United Kingdom
- *Correspondence: Otto Brookes
| | - Stuart Gray
- Centre for Entrepreneurship, Faculty of Engineering, University of Bristol, Bristol, United Kingdom
| | - Peter Bennett
- Department of Computer Science, Faculty of Engineering, University of Bristol, Bristol, United Kingdom
| | - Katy V. Burgess
- School of Psychological Science, Faculty of Life Sciences, University of Bristol, Bristol, United Kingdom
| | - Fay E. Clark
- School of Psychological Science, Faculty of Life Sciences, University of Bristol, Bristol, United Kingdom
- School of Life Sciences, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, United Kingdom
| | - Elisabeth Roberts
- Bristol Vet School, Faculty of Life Sciences, University of Bristol, Bristol, United Kingdom
| | - Tilo Burghardt
- Department of Computer Science, Faculty of Engineering, University of Bristol, Bristol, United Kingdom
| |
Collapse
|
12
|
Stevens K, Delles C, Mark P, Thomson P, Gill J, Gray S, Ho F, Rutherford E, Lees J. MO468: Moving More Associates With Reduced Risk of Cardiovascular Disease and Death Across All Stages of Chronic Kidney Disease: A UK Biobank Study. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac070.082] [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: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Physical activity (PA) is widely recommended for the prevention of chronic conditions including cardiovascular (CV) disease. In chronic kidney disease (CKD), it is unclear whether PA confers a similar benefit. We examined whether the duration and intensity of PA are associated with the risk of CV disease and mortality and whether the relationship differs in CKD.
METHOD
Participants were from UK Biobank: a prospective cohort study with over 500 000 participants. The estimated glomerular filtration rate was calculated using cystatin C (eGFRcys). CKD was defined according to the KDIGO guidelines and participants were categorized as no CKD (eGFRcys > 90mL/min/1.73m2), CKD G1-2 (eGFRcys 60–89mL/min/1.73m2) or CKD G3-5 (eGFRcys < 60mL/min/1.73m2). Exercise duration and intensity were self-reported using the international physical activity questionnaire (IPAQ) and participants were categorized into four groups: inactive (reference), low, moderate and vigorous PA, according to World Health Organisation (WHO) weekly PA recommendations. Cox proportional hazards models tested associations between PA category and a composite endpoint of CV disease (myocardial infarction or stroke) or all-cause mortality across CKD categories. Models were adjusted for other known risk factors for CV disease and death including age, smoking status, blood pressure, eGFRcys and albuminuria.
RESULTS
Of 502 460 participants in UK Biobank, 123 167 were excluded because of missing biochemistry or IPAQ data and a further 21 084 were excluded because of pre-existing CV disease: 358 209 participants were included in the analyses. Of these 182 457 (51.0%) were classed as no CKD, 162 621 (45.4%) as CKD G1-2 and 13 131 (3.7%) as CKD G3-5. A total of 48 369 (13.5%) of participants were classed as inactive and 211 591 (16.5%) as undertaking vigorous PA. In participants without CKD, any PA above inactivity was associated with a reduced risk of reaching the combined endpoint by approximately 20% (low: hazard ratio, HR 0.77, 95% confidence interval, CI 0.67–0.89; moderate: HR 0.80, 95%CI 0.70–0.91; vigorous: HR 0.81, 95%CI 0.73–0.90, P < 0.001). This relationship is maintained in CKD G1-2, but in CKD G3-5, moderate (HR 0.75, 95%CI 0.61–0.93) and vigorous (HR 0.77, CI 0.66–0.89, P < 0.001) activity are associated with reduced risk of the combined endpoint (Table 1). Interestingly across all categories of CKD, the majority of participants considered that they undertook more than the WHO minimum recommended PA per week.
CONCLUSION
Achieving the minimum weekly targets for PA set by WHO is associated with a significantly reduced risk of a combined endpoint of CV disease and death. This relationship is preserved in those with CKD G1-2, even when adjusted for other recognized risk factors. The benefit is seen in CKD G3-5 with increased intensity of PA, above the WHO minimum. PA data is self-reported which limits the accuracy and association does not prove causality. However, patients with CKD have a much higher risk of CVD and death and PA is a simple, low-cost intervention that warrants further study to improve CV morbidity and all-cause mortality amongst people with CKD.
Collapse
Affiliation(s)
| | | | | | | | - Jason Gill
- University of Glasgow, ICAMS, Glasgow, UK
| | | | | | | | | |
Collapse
|
13
|
Dagnone JD, Brooks J, Mann M, Cameron B, Gray S, Poonja Z, Lim R. Reconceptualizing ER physician wellness in the midst of the pandemic: survival through the lens of personal agency. CAN J EMERG MED 2022; 24:16-19. [PMID: 34928492 PMCID: PMC8686091 DOI: 10.1007/s43678-021-00253-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/10/2021] [Indexed: 11/06/2022]
Affiliation(s)
- J D Dagnone
- Emergency Medicine, Queen's University, Kingston, ON, Canada.
| | - J Brooks
- College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - M Mann
- Emergency Medicine, Stratford General Hospital, Stratford, ON, Canada
| | - B Cameron
- Michael Garron Hospital, Toronto, ON, Canada
| | - S Gray
- St. Michael's Hospital, Toronto, ON, Canada
| | - Z Poonja
- Emergency Medicine, Vancouver General Hospital, Vancouver, BC, Canada
| | - R Lim
- Paediatric Emergency Medicine, Western University, London, ON, Canada
| |
Collapse
|
14
|
Affiliation(s)
| | - S Gray
- University of the West of England, UK
| |
Collapse
|
15
|
Scheper J, Bruner S, Flume P, McCoy L, Gray S, Bullington W. 241: The impact of implementing specialty pharmacy services within a cystic fibrosis clinic. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01666-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
16
|
Gray S. The Impact of Online Nutrition Education on WIC Client Retention and Redemption of the Cash Value Benefit of Fruit/Vegetables. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
17
|
Ho F, Gray S, Petermann-Rocha F, Mathers J, Pell J, Celis-Morales C. 194Nonlinear isocaloric substitution analysis in nutritional epidemiology: An example using the UK Biobank data. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.280] [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
Intake of macronutrients and its components are associated with mortality and morbidity. Isocaloric substitution analysis is a tool to examine how changing the source of energy intake (e.g. from saturated to monounsaturated fat) is associated with health. However, conventional methods assume linearity, which may be untrue in many cases. This paper presents a nonlinear alternative, using UK Biobank data as an example data set.
Methods
Nonlinear isocaloric substitution analysis was conducted using penalised cubic splines in Cox proportional hazard models. In the UK Biobank, 195,658 participants completed at least one dietary questionnaire and were included in the analyses. Diet was assessed using the Oxford WebQ, a web-based 24-hour recall questionnaire. Prospective all-cause mortality was derived from on linked death records.
Results
More than half of the associations between macronutrient intake and all-cause mortality were nonlinear. Nonlinear isocaloric substitution analysis provides effect sizes conditional on the current intake, while conventional analysis provides an average over the whole range of intake. For example, conventional isocaloric substitution estimated no effect of replacing sugar with starch. However, the nonlinear method revealed that replacing sugar with starch was associated with a higher risk when the current starch intake was greater than 30% of total energy, and with a lower risk when current intake was less than 25%.
Conclusions
Nonlinear isocaloric substitution provides an alternative to conventional isocaloric substitution analysis when the underlying association is nonlinear.
Key messages
Nonlinear associations are common in nutritional epidemiology. In such cases, nonlinear isocaloric substitution analyses should be used.
Collapse
Affiliation(s)
| | - Stuart Gray
- University of Glasgow, Glasgow, United Kingdom
| | | | - John Mathers
- University of Newcastle, Newcastle upon Tyne, Newcastle upon Tyne
| | - Jill Pell
- University of Glasgow, Glasgow, United Kingdom
| | | |
Collapse
|
18
|
Altinoluk-Davis F, Gray S, Bray I. Measuring the effectiveness of catch-up MMR delivered by school nurses compared to signposting to general practice on improving MMR coverage. J Public Health (Oxf) 2021; 42:416-422. [PMID: 32052033 DOI: 10.1093/pubmed/fdaa004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/03/2020] [Accepted: 01/03/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study assesses whether increased coverage of the measles, mumps and rubella (MMR) vaccination differs between areas where school nurses deliver catch-up MMR doses to adolescents in school settings, compared to signposting to general practice. METHODS A retrospective cohort study was conducted using Child Health Information Services records within the NHS England South (South Central) commissioning boundary. The sample population included children born 1 September 2000-31 August 2001, in school year 9 during the 2014-15 academic year. RESULTS The primary outcome findings show an increase in coverage of at least one dose of MMR by 1.6% (n = 334) in the cohort receiving catch-up MMR, compared to 0.2% (n = 12) in the cohort signposted to general practice. Over time, the difference in increase between the two cohorts was 1.4%, analysed using the chi-squared comparison of proportions test, providing strong evidence (P < 0.0001) that school nurse delivery of catch-up MMR is effective at increasing coverage. The findings also suggest that school nurse delivery of catch-up MMR may benefit Black, Asian and minority ethnic children and those from more deprived backgrounds. CONCLUSIONS It is recommended that commissioners of school-aged immunization services incorporate the delivery of catch-up MMR doses in their contracts with school nurses.
Collapse
Affiliation(s)
- F Altinoluk-Davis
- Health & Wellbeing Team, South West Centre, Public Health England, Bristol BS1 6EH, UK
| | - S Gray
- Centre for Public Health and Wellbeing, University of the West of England, Bristol BS16 1QY, UK
| | - I Bray
- Centre for Public Health and Wellbeing, University of the West of England, Bristol BS16 1QY, UK
| |
Collapse
|
19
|
Petermann-Rocha F, Parra-Soto S, Gray S, Anderson J, Welsh P, Gill J, Sattar N, Ho FK, Celis-Morales C, Pell JP. Vegetarians, fish, poultry, and meat-eaters: who has higher risk of cardiovascular disease incidence and mortality? A prospective study from UK Biobank. Eur Heart J 2021; 42:1136-1143. [PMID: 33313747 PMCID: PMC7982287 DOI: 10.1093/eurheartj/ehaa939] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/30/2020] [Accepted: 10/30/2020] [Indexed: 12/17/2022] Open
Abstract
AIMS To compare the incidence and mortality risk for cardiovascular diseases (CVD) [CVD and also ischaemic heart disease (IHD), myocardial infarction (MI), stroke, and heart failure (HF)] among people with different types of diets-including vegetarians, fish eaters, fish and poultry eaters, and meat-eaters-using data from UK Biobank. METHODS AND RESULTS A total of 422 791 participants (55.4% women) were included in this prospective analysis. Using data from a food frequency questionnaire, four types of diets were derived. Associations between types of diets and health outcomes were investigated using Cox proportional hazard models. Meat-eaters comprised 94.7% of the cohort and were more likely to be obese than other diet groups. After a median follow-up of 8.5 years, fish eaters, compared with meat-eaters, had lower risks of incident CVD {hazard ratios (HR): 0.93 [95% confidence intervals (CI): 0.88-0.97]}, IHD [HR: 0.79 (95% CI: 0.70-0.88)], MI [HR: 0.70 (95% CI: 0.56-0.88)], stroke [HR: 0.79 (95% CI: 0.63-0.98)] and HF [HR: 0.78 (95% CI: 0.63-0.97)], after adjusting for confounders. Vegetarians had lower risk of CVD incidence [HR: 0.91 (95% CI: 0.86-0.96)] relative to meat-eaters. In contrast, the risk of adverse outcomes was not different in fish and poultry eaters compared with meat-eaters. No associations were identified between types of diets and CVD mortality. CONCLUSION Eating fish rather than meat or poultry was associated with a lower risk of a range of adverse cardiovascular outcomes. Vegetarianism was only associated with a lower risk of CVD incidence.
Collapse
Affiliation(s)
- Fanny Petermann-Rocha
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Solange Parra-Soto
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Stuart Gray
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jana Anderson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Paul Welsh
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Jason Gill
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Carlos Celis-Morales
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Centre of Exercise Physiology Research (CIFE), Universidad Mayor, Santiago, Chile
- Research Group in Education, Physical Activity and Health, University Catolica del Maule, Talca, Chile
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| |
Collapse
|
20
|
Gray S. ES15.03 Effective and Interpretable Reporting of Genotyping Results. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.035] [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]
|
21
|
Welsh P, Welsh C, Celis-Morales C, Brown R, Ferguson L, Gray S, Mark P, Lewsey J, Lyall D, Gill J, Pell J, Jhund P, De Lemos J, Willeit P, Sattar N. Lipoprotein(a) and cardiovascular disease: prediction, attributable risk fraction and estimating benefits from novel interventions. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2833] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Lipoprotein (a) (Lp(a)) measurement may help guide CVD risk prediction, is thought to be causal in several CVD outcomes, and phase 3 intervention trials of Lp(a) lowering agents are underway. We aimed to investigate the population attributable fraction due to elevated Lp(a) and its utility in CVD risk prediction.
Methods
In 413,724 participants from UK Biobank, associations of serum Lp(a) with composite fatal/nonfatal CVD (n=10,065 events), fatal CVD (n=3247), coronary heart disease (n=16,649), ischaemic stroke (n=3191), and peripheral vascular disease (n=2716) were compared using Cox models. Predictive utility was determined by C-index changes. The population attributable fraction was estimated.
Results
Median Lp(a) was 19.7nmol/L (interquartile interval 7.6–75.3nmol/L). 20.8% had Lp(a) values >100nmol/L; 9.2% had values >175nmol/L. After adjustment for classical risk factors, in participants with no baseline CVD and not taking a statin, 1 standard deviation increment in log Lp(a) was associated with a HR for fatal/nonfatal CVD of 1.09 (95% CI 1.07–1.11). Associations were similar for fatal CVD, coronary heart disease, and peripheral vascular disease. Adding Lp(a) to a prediction model containing traditional CVD risk factors improved the C-index by +0.0017 (95% CI 0.0009, 0.0026). We estimated that having Lp(a) values >100nmol/L accounts for 5.7% of CVD events in the whole cohort. We modelled that an ongoing trial to lower Lp(a) in patients with CVD and Lp(a) above ∼175nmol/L may be expected to reduce CVD risk by 20.3%, assuming causality, and an achieved Lp(a) reduction of 80%.
Conclusions
Population screening for elevated Lp(a) may help to predict CVD and target Lp(a) lowering drugs to those with markedly elevated levels, if such drugs prove efficacious.
Population attributable fractions: Lp(a)
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): Chest, Heart, and Stroke Association Scotland and British Heart Foundation
Collapse
Affiliation(s)
- P Welsh
- University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - C Welsh
- University of Newcastle, Newcastle Upon Tyne, United Kingdom
| | - C.A.C Celis-Morales
- University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - R Brown
- University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - L.D Ferguson
- University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - S Gray
- University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - P Mark
- University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - J Lewsey
- University of Glasgow, Glasgow, United Kingdom
| | - D.M Lyall
- University of Glasgow, Glasgow, United Kingdom
| | - J.M.R Gill
- University of Glasgow, Glasgow, United Kingdom
| | - J Pell
- University of Glasgow, Glasgow, United Kingdom
| | - P.S Jhund
- University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - J.A De Lemos
- University of Texas Southwestern Medical Center, Texas, United States of America
| | - P Willeit
- Medical University of Innsbruck, Innsbruck, Austria
| | - N Sattar
- University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| |
Collapse
|
22
|
Saade D, Bharucha-Goebel D, Zein W, Norato G, Rybin D, Cheung K, Charnas L, Paredes E, Inati S, Foley A, Gray S, Bönnemann C. HEREDITARY NEUROPATHIES & ALS. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.111] [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: 10/23/2022]
|
23
|
Lim M, Greene J, Baird AM, Gray S, McNevin C, McDermott R, Finn S. 1972P Circular RNA is associated with enzalutamide resistant prostate cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1364] [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: 10/23/2022] Open
|
24
|
Gray S, Clough T, Mcgee Y, Murphy T, Poulikakos D. Increased risk of COVID-19 in haemodialysis healthcare workers in a tertiary centre in the North West of England. J Hosp Infect 2020; 106:390-391. [PMID: 32763332 PMCID: PMC7403103 DOI: 10.1016/j.jhin.2020.07.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 01/19/2023]
Affiliation(s)
- S Gray
- Renal Services, Salford Royal NHS Foundation Trust, UK
| | - T Clough
- Renal Services, Salford Royal NHS Foundation Trust, UK
| | - Y Mcgee
- Renal Services, Salford Royal NHS Foundation Trust, UK
| | - T Murphy
- Renal Services & Tertiary Medicine, Salford Royal NHS Foundation Trust, UK
| | - D Poulikakos
- Renal Services, Salford Royal NHS Foundation Trust, UK.
| |
Collapse
|
25
|
Hayes S, Forbes JF, Celis-Morales C, Anderson J, Ferguson L, Gill JMR, Gray S, Hastie C, Iliodromoti S, Lyall D, Pellicori P, Sattar N, Welsh CE, Pell J. Association Between Walking Pace and Stroke Incidence: Findings From the UK Biobank Prospective Cohort Study. Stroke 2020; 51:1388-1395. [PMID: 32299326 DOI: 10.1161/strokeaha.119.028064] [Citation(s) in RCA: 9] [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: 11/16/2022]
Abstract
Background and Purpose- Stroke incidence in younger and middle-aged people is growing. Despite this, its associations in this subset of the stroke population are unknown, and prevention strategies are not tailored to meet their needs. This study examined the association between self-reported walking pace and incident stroke. Methods- Data from the UK Biobank were used in a prospective population-based study. Three hundred and sixty-three thousand, one hundred and thirty-seven participants aged 37 to 73 years (52% women) were recruited. The associations of self-reported walking pace with stroke incidence over follow-up were investigated using Cox proportional-hazard models. Results- Among 363,137 participants, 2705 (0.7%) participants developed a fatal or nonfatal stroke event over the mean follow-up period of 6.1 years (interquartile range, 5.4-6.7). Slow walking pace was associated with a higher hazard for stroke incidence (hazard ratio [HR], 1.45 [95% CI, 1.26-1.66]; P<0.0001). Stroke incidence was not associated with walking pace among people <65 years of age. However, slow walking pace was associated with a higher risk of stroke among participants aged ≥65 years (HR, 1.42 [95% CI, 1.17-1.72]; P<0.0001). A higher risk for stroke was observed on those with middle (HR, 1.28 [95% CI, 1.01-1.63]; P=0.039) and higher (HR, 1.29 [95% CI, 1.05-1.69]; P=0.012) deprivation levels but not in the least deprived individuals. Similarly, overweight (HR, 1.30 [95% CI, 1.04-1.63]; P=0.019) and obese (HR, 1.33 [95% CI, 1.09-1.63]; P=0.004) but not normal-weight individuals had a higher risk of stroke incidence. Conclusions- Slow walking pace was associated with a higher risk of stroke among participants over 64 years of age in this population-based cohort study. The addition of the measurement of self-reported walking pace to primary care or public health clinical consultations may be a useful screening tool for stroke risk.
Collapse
Affiliation(s)
- Sara Hayes
- From the School of Allied Health, Ageing Research Centre (S.H.), Health Research Institute, University of Limerick, Ireland
| | - John F Forbes
- Graduate Entry Medical School (J.F.F.), Health Research Institute, University of Limerick, Ireland
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences (C.C.-M., L.F., J.M.R.G., S.G., S.I., N.S.), University of Glasgow, Scotland.,Centre for Research in Exercise Physiology, University Mayor, Santiago, Chile (C.C.-M.)
| | - Jana Anderson
- Institute of Health and Wellbeing (J.A., C.H., D.L., P.P., J.P.), University of Glasgow, Scotland
| | - Lyn Ferguson
- Institute of Cardiovascular and Medical Sciences (C.C.-M., L.F., J.M.R.G., S.G., S.I., N.S.), University of Glasgow, Scotland
| | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences (C.C.-M., L.F., J.M.R.G., S.G., S.I., N.S.), University of Glasgow, Scotland
| | - Stuart Gray
- Institute of Cardiovascular and Medical Sciences (C.C.-M., L.F., J.M.R.G., S.G., S.I., N.S.), University of Glasgow, Scotland
| | - Claire Hastie
- Institute of Health and Wellbeing (J.A., C.H., D.L., P.P., J.P.), University of Glasgow, Scotland
| | - Stamatina Iliodromoti
- Institute of Cardiovascular and Medical Sciences (C.C.-M., L.F., J.M.R.G., S.G., S.I., N.S.), University of Glasgow, Scotland
| | - Donald Lyall
- Institute of Health and Wellbeing (J.A., C.H., D.L., P.P., J.P.), University of Glasgow, Scotland
| | - Pierpaolo Pellicori
- Institute of Health and Wellbeing (J.A., C.H., D.L., P.P., J.P.), University of Glasgow, Scotland
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences (C.C.-M., L.F., J.M.R.G., S.G., S.I., N.S.), University of Glasgow, Scotland
| | - Claire E Welsh
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom (C.E.W.)
| | - Jill Pell
- Institute of Health and Wellbeing (J.A., C.H., D.L., P.P., J.P.), University of Glasgow, Scotland
| |
Collapse
|
26
|
Cheung SM, Keenan K, Senn N, Hutcheon G, Chan K, Erwig L, Schrepf A, Dospinescu P, Gray S, Waiter G, He J, Basu N. Metabolic and Structural Skeletal Muscle Health in Systemic Lupus Erythematosus-Related Fatigue: A Multimodal Magnetic Resonance Imaging Study. Arthritis Care Res (Hoboken) 2020; 71:1640-1646. [PMID: 30629805 DOI: 10.1002/acr.23833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 01/08/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate the potential structural and metabolic role of skeletal muscle in systemic lupus erythematosus (SLE)-related fatigue. METHODS A case-control, multimodal magnetic resonance imaging (MRI) study was conducted. Cases were patients with inactive SLE who reported chronic fatigue. Controls were age- and sex-matched healthy members of the general population. Patients were clinically characterized and then underwent a 3T whole-body MRI scan. Resting and dynamic 31 P MRI spectroscopy of the calf muscles was applied, from which phosphocreatine (PCr) recovery halftime, a marker of mitochondrial dysfunction, was computed. In addition, microstructural sequences (T1-weighted anatomic images, T2 mapping, and diffusion tensor imaging) were acquired. Descriptive statistics evaluated group differences and within-case physical fatigue correlations were explored. RESULTS Of the 37 recruits (mean age 43.8 years, 89.2% female), cases (n = 19) reported higher levels of physical fatigue, pain, depression, and sleep disturbance compared to the control group (P < 0.0001). PCr was greater (P = 0.045) among cases (mean ± SD 33.0 ± 9.0 seconds) compared to controls (mean ± SD 27.1 ± 6.6 seconds). No microstructural group differences were observed. Within cases, physical fatigue did not correlate with PCr (r = -0.28, P = 0.25). CONCLUSION We report preliminary data demonstrating greater skeletal muscle mitochondrial dysfunction among fatigued patients with SLE compared to healthy controls.
Collapse
Affiliation(s)
| | | | | | | | | | - Lars Erwig
- University of Aberdeen, Aberdeen, and GlaxoSmithKline, Stevenage, UK
| | | | | | | | | | - Jiabao He
- University of Aberdeen, Aberdeen, UK
| | | |
Collapse
|
27
|
Dial J, Chan F, Mezger C, Parker H, Zangla K, Wong D, Gray S. Comprehensive Vocational Evaluation System for Visually Impaired and Blind Persons. Journal of Visual Impairment & Blindness 2020. [DOI: 10.1177/0145482x9108500404] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to validate the appropriateness of the Comprehensive Vocational Evaluation System (CVES) for evaluating the work potential and independent living levels of visually impaired and blind individuals. The CVES was administered to 237 clients of the Texas Commission for the Blind (TCB), and the results were used to predict the vocational placement and independent living levels of these clients as determined by the TCB staff. The results indicated that the CVES is significantly related to work and independent living outcomes for visually impaired and blind people.
Collapse
Affiliation(s)
- J.G. Dial
- Department of Rehabilitation Science, University of Texas Southwestern Medical Center, Dallas
| | - F. Chan
- Rehabilitation Counseling–Psychology area; Department of Psychology, Illinois Institute of Technology
| | - C. Mezger
- Vocational Diagnostic Unit, Texas Commission for the Blind, Austin
| | - H.J. Parker
- Physical medicine and rehabilitation, and rehabilitation science, University of Texas Southwestern Medical Center, Dallas
| | - K. Zangla
- Department of Public Service Training, New Orleans, Louisiana
| | - D.W. Wong
- Center for Rehabilitation Studies, University of North Texas
| | - S. Gray
- Clinical neuropsychologist in private practice, Arlington, Texas
| |
Collapse
|
28
|
Green B, Wong E, Andrews S, Hampshire-Jones K, McKinnon S, Brooks C, McAdam R, Gray S, Vickers C, Blake Y, Sekhon G, Merrick S, Faerber J, Mather P, Gilbert E, McBride R, Coombes A, Walker M, Owen A, Davies J, Richardson S, Carr S, Mapson R, Spivey J, Draper S, Kendall F, Hubbard G, Stratton R. Increased protein intake is associated with improved hand grip strength and quality of life in home enterally tube fed adults using a high-energy, high-protein feed. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2019.12.005] [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: 11/27/2022]
|
29
|
Lee X, Nagarajan T, Evison M, Grundy S, Al-Najjar H, Brockelsby C, Randles V, Rice M, Dildar B, King J, Chlerigh R, Allen R, Sundar R, Gray S. Clinical effectiveness of routine brain imaging in the management of lung cancer prior to curative treatments. Lung Cancer 2020. [DOI: 10.1016/s0169-5002(20)30070-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
30
|
Welsh CE, Welsh P, Jhund P, Delles C, Celis-Morales C, Lewsey JD, Gray S, Lyall D, Iliodromiti S, Gill JMR, Sattar N, Mark PB. Urinary Sodium Excretion, Blood Pressure, and Risk of Future Cardiovascular Disease and Mortality in Subjects Without Prior Cardiovascular Disease. Hypertension 2019; 73:1202-1209. [PMID: 31067194 DOI: 10.1161/hypertensionaha.119.12726] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [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: 12/18/2022]
Abstract
Hypertension is a risk factor for cardiovascular disease. Increased urinary sodium excretion, representing dietary sodium intake, is associated with hypertension. Low sodium intake has been associated with increased mortality in observational studies. Further studies should assess whether confounding relationships explain associations between sodium intake and outcomes. We studied UK Biobank participants (n=457 484; mean age, 56.3 years; 44.7% men) with urinary electrolytes and blood pressure data. Estimated daily urinary sodium excretion was calculated using Kawasaki formulae. We analyzed associations between sodium excretion and blood pressure in subjects without cardiovascular disease, treated hypertension, or diabetes mellitus at baseline (n=322 624). We tested relationships between sodium excretion, incidence of fatal and nonfatal cardiovascular disease, heart failure, and mortality. Subjects in higher quintiles of sodium excretion were younger, with more men and higher body mass index. There was a linear relationship between increasing urinary sodium excretion and blood pressure. During median follow-up of 6.99 years, there were 11 932 deaths (1125 cardiovascular deaths) with 10 717 nonfatal cardiovascular events. There was no relationship between quintile of sodium excretion and outcomes. These relationships were unchanged after adjustment for comorbidity or excluding subjects with events during the first 2 years follow-up. No differing risk of incident heart failure (1174 events) existed across sodium excretion quintiles. Urinary sodium excretion correlates with elevated blood pressure in subjects at low cardiovascular risk. No pattern of increased cardiovascular disease, heart failure, or mortality risk was demonstrated with either high or low sodium intake.
Collapse
Affiliation(s)
- C E Welsh
- From the Institute of Cardiovascular and Medical Sciences (C.E.W., P.W., P.J., C.D., C.C.-M., S.G., J.M.R.G., N.S., P.B.M.)
| | - Paul Welsh
- From the Institute of Cardiovascular and Medical Sciences (C.E.W., P.W., P.J., C.D., C.C.-M., S.G., J.M.R.G., N.S., P.B.M.)
| | - Pardeep Jhund
- From the Institute of Cardiovascular and Medical Sciences (C.E.W., P.W., P.J., C.D., C.C.-M., S.G., J.M.R.G., N.S., P.B.M.)
| | - Christian Delles
- From the Institute of Cardiovascular and Medical Sciences (C.E.W., P.W., P.J., C.D., C.C.-M., S.G., J.M.R.G., N.S., P.B.M.)
| | - C Celis-Morales
- From the Institute of Cardiovascular and Medical Sciences (C.E.W., P.W., P.J., C.D., C.C.-M., S.G., J.M.R.G., N.S., P.B.M.)
| | - J D Lewsey
- Institute of Health and Wellbeing (J.D.L., D.L.), University of Glasgow, United Kingdom
| | - S Gray
- From the Institute of Cardiovascular and Medical Sciences (C.E.W., P.W., P.J., C.D., C.C.-M., S.G., J.M.R.G., N.S., P.B.M.)
| | - D Lyall
- Institute of Health and Wellbeing (J.D.L., D.L.), University of Glasgow, United Kingdom
| | - S Iliodromiti
- Women's Health Research Division, Queen Mary University of London, United Kingdom (S.I.)
| | - J M R Gill
- From the Institute of Cardiovascular and Medical Sciences (C.E.W., P.W., P.J., C.D., C.C.-M., S.G., J.M.R.G., N.S., P.B.M.)
| | - Naveed Sattar
- From the Institute of Cardiovascular and Medical Sciences (C.E.W., P.W., P.J., C.D., C.C.-M., S.G., J.M.R.G., N.S., P.B.M.)
| | - Patrick B Mark
- From the Institute of Cardiovascular and Medical Sciences (C.E.W., P.W., P.J., C.D., C.C.-M., S.G., J.M.R.G., N.S., P.B.M.)
| |
Collapse
|
31
|
Celis-Morales CA, Gray S, Petermann F, Iliodromiti S, Welsh P, Lyall DM, Anderson J, Pellicori P, Mackay DF, Pell JP, Sattar N, Gill JMR. Walking Pace Is Associated with Lower Risk of All-Cause and Cause-Specific Mortality. Med Sci Sports Exerc 2019; 51:472-480. [PMID: 30303933 DOI: 10.1249/mss.0000000000001795] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE Walking pace is associated with all-cause and cardiovascular disease (CVD) mortality. Whether this association extends to other health outcomes and whether it is independent of total amount of time walked are currently unknown. Therefore, the aim of this study was to investigate whether usual walking pace is associated with a range of health outcomes. METHODS UK Biobank participants (318,185 [54%] women) age 40 to 69 yr were included. Walking pace and total walking time were self-reported. The outcomes comprised: all-cause mortality as well as incidence and mortality from CVD, respiratory disease and cancer. The associations were investigated using Cox proportional hazard models. RESULTS Over a mean of 5.0 yr [ranging from 3.3 to 7.8], 5890 participants died, 18,568 developed CVD, 5430 respiratory disease and 19,234 cancer. In a fully adjusted model, compared to slow pace walkers, men and women, respectively, with a brisk pace having lower risk of mortality from all-causes (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.69-0.90 and HR, 0.73; 95% CI, 0.62-0.85), CVD (HR, 0.62; 95% CI, 0.50-0.76 and HR, 0.80; 95% CI, 0.73-0.88), respiratory disease (HR, 0.58; 95% CI, 0.43-0.78 and HR, 0.66; 95% CI, 0.57-0.77), chronic obstructive pulmonary disease (HR, 0.26; 95% CI, 0.12-0.56 and HR, 0.28; 95% CI, 0.16-0.49). No associations were found for all-cause cancer, colorectal, and breast cancer. However, brisk walking was associated with a higher risk of prostate cancer. CONCLUSIONS Walking pace is associated with lower risk of a wide range of important health conditions, independently of overall time spent walking.
Collapse
Affiliation(s)
- Carlos A Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Stuart Gray
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Fanny Petermann
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Stamatina Iliodromiti
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Paul Welsh
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Donald M Lyall
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Jana Anderson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Pierpaolo Pellicori
- Robertson Centre for Biostatistics & Clinical Trials, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Daniel F Mackay
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Jason M R Gill
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| |
Collapse
|
32
|
Scariati P, Knapp H, Gray S. A Comparison of One- and Four-Open-Chart Access: No Change in Computerized Provider Order Entry Error Rates. Appl Clin Inform 2019; 10:804-809. [PMID: 31645077 DOI: 10.1055/s-0039-1697599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To assess changes in computerized provider order entry error rates among providers who with less than 24-hour notice were switched from four-chart access to one-chart-only access. METHODS An interrupted time series analysis of emergency medicine providers, hospitalists, and maternal child health providers was performed with pairwise comparison of computerized provider order entry error rates within and between specialties. This retrospective snapshot consisted of four phases. Phase 1 was the baseline 2 weeks where providers were privileged to work with up to four charts open. Phase 2 was the 2-week period where providers were limited to one-chart access. Phase 3 was the 2-week period where providers were returned to four-chart access. And phase 4 was a 2-week period 3 months following the end of phase 3. RESULTS Analysis of the overall and specialty-stratified cohorts revealed no statistically significant differences in median computerized provider order entry error rates across the four phases (Wilcoxon signed-rank test, α = 0.05). However, statistically significant differences in median computerized provider order entry error rates were detected between the three specialties within each phase of the study (Kruskal-Wallis, p < 0.001). CONCLUSION Allowing providers in select specialties to have access to four charts simultaneously does not increase their computerized provider order entry error rates. Significant differences in error rates between specialties suggest the need for further study of the use of standardized order sets, charting, and workflow variations.
Collapse
Affiliation(s)
- Paula Scariati
- Health Informatics, Dignity Health, San Francisco, California, United States
| | - Herschel Knapp
- Nursing Research & Analytics, Dignity Health, Phoenix, Arizona, United States
| | - Stuart Gray
- Nursing Research & Analytics, Dignity Health, Phoenix, Arizona, United States
| |
Collapse
|
33
|
Pellicori P, Stanley B, Iliodromiti S, Celis-Morales CA, Lyall DM, Anderson J, Gray S, Mackay DF, Nelson SM, Welsh P, Pell JP, Gill JMR, Sattar N, Cleland JGF. P3823Body mass index or waist and hip circumference as predictors of outcome in the UK biobank. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0665] [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: 11/14/2022] Open
Abstract
Abstract
Background
Controversies exist about the relationship between body habitus and mortality, especially for patients with cardiovascular disease.
Purpose
We evaluated the relations between different anthropometric indices and mortality amongst participants with and without cardiovascular (CV) risk factors, or established CV disease (stroke, myocardial infarction and/or heart failure), enrolled in the UK Biobank.
Methods
The UK Biobank is a large prospective study which, between 2006 and 2010, enrolled 502,620 participants aged 38–73 years. Participants filled questionnaires and had a medical history recorded, physical measurements done and biological samples taken. The UK Biobank is routinely linked to national death registries and updated on a quarterly basis. Data on death were coded according to the International Classification of Diseases, 10th Revision (ICD-10). The primary end-point was all-cause mortality (ACM) across three subgroups of men and women: those with, or without, one or more CV risk factors (smoking, diabetes and/or hypertension), and those with CV disease (history of stroke, myocardial infarction and/or heart failure) at recruitment. Presence, or absence, of CV risk factors and diagnoses of CV disease were self-reported by participants at enrolment. Associations between anthropometric indices (body mass index (BMI), waist circumference (WC), waist to hip ratio (WHiR), and waist to height ratio (WHeR)) and the risk of all-cause mortality were analysed using Cox regression models.
Results
After excluding those with history of cancer at baseline (n=45,222), 453,046 participants were included (median age: 58 (interquartile range: 50 - 63) years; 53% women), of whom 150,732 had at least one CV risk factor, and 17,884 established CV disease.
During a median follow-up of 5 years, 6,319 participants died. Baseline BMI had a U-shaped relationship with ACM, with higher nadir-values for those with CV risk factors or CV disease, for both sexes (figure). WC, WHiR and WHeR (measures of central distribution of body fat) had more linear associations with ACM, regardless of CV risk factors, CV disease and sex.
Conclusions
For adults with or without CV risk factors or established CV disease, measures of central distribution of body fat are more strongly and more linearly associated with ACM than BMI. WC, or WHiR, rather than BMI, appear to be more appropriate variables for risk stratification.
Collapse
Affiliation(s)
- P Pellicori
- University of Glasgow, Glasgow, United Kingdom
| | - B Stanley
- University of Glasgow, Glasgow, United Kingdom
| | | | | | - D M Lyall
- University of Glasgow, Glasgow, United Kingdom
| | - J Anderson
- University of Glasgow, Glasgow, United Kingdom
| | - S Gray
- University of Glasgow, Glasgow, United Kingdom
| | - D F Mackay
- University of Glasgow, Glasgow, United Kingdom
| | - S M Nelson
- University of Glasgow, Glasgow, United Kingdom
| | - P Welsh
- University of Glasgow, Glasgow, United Kingdom
| | - J P Pell
- University of Glasgow, Glasgow, United Kingdom
| | - J M R Gill
- University of Glasgow, Glasgow, United Kingdom
| | - N Sattar
- University of Glasgow, Glasgow, United Kingdom
| | | |
Collapse
|
34
|
Baird A, Wright M, Mccarra L, Thirstrup H, Schønau A, Cuffe S, Finn S, Gray S. P2.09-16 Assessment of PD-L1 and CD8 Expression in Lung Cancer Using RNA in Situ Hybridisation. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
35
|
Mezincescu AM, Ahearn T, Rudd AE, Cheyne L, Scally C, Horgan G, Philip S, Delibegovic M, Lobley G, Thies F, Gray S, Henning A, Dawson DK. P6203Intramyocellular lipid saturation as a new metabolic biomarker. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0808] [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] Open
Abstract
Abstract
Background
Endurance trained athletic healthy volunteers (Athl-HV) and type 2 diabetes patients (T2D) have higher levels of lipids in their skeletal myocytes compared to healthy controls. Despite apparently similar metabolic storage, they are at opposite ends of insulin sensitivity and cardio-metabolic risk.
Purpose
We investigated if the degree of saturation of the IntraMyoCellular Lipids (IMCL) will differentiate Athl-HV from T2D; and explored if an exercise intervention will induce changes in the IMCL saturation.
Methods
Male, age matched Athl-HV and T2D were enrolled (n=25/group). Athl-HV had ≥5 years endurance training, T2D were sedentary. Subjects were studied at baseline and after an exercise intervention (4 week deconditioning in Athl-HV and supervised bike training at ≥65% of peakVO2, 5 hours/week x 8 weeks in T2D). All subjects underwent cardio-pulmonary exercise testing (CPET), blood sampling for insulin sensitivity (QUICKI*) and single voxel 1H-magnetic resonance spectroscopy (1H-MRS) of the right vastus lateralis. 1H-MRS was acquired on 3T Philips Achieva with a 16-channel coil, point-resolved spectroscopy, variable pulse power and optimized relaxation delay water suppression and analysed in LCModel. We derived fractional lipid mass (fLM) and fractions of saturated (fSL) and unsaturated (fUL) lipids. Data were analysed by t tests, shown as mean±SEM, statistical significance p<0.05.
Results
CPET and insulin sensitivity are presented in Table 1. T2D had higher fLM in the skeletal muscle compared to Athl-HV, at baseline (p=0.003) and after the exercise intervention (p=0.009), Figure 1A. At baseline, T2D had a different phenotype with a lower fSL and higher fUL compared to Athl-HV (82±3 vs 88±1% and 18±3 vs 12±1%, p=0.02 for both). Whilst deconditioning did not attract any significant changes in either fSL or fUL in Athl-HV (88±1 to 86±1% and 12±1 to 14±1, p=0.2), in contrast, with exercise training T2D significantly increased fSL (82±3 to 88±1%) and decreased their fUL (18±3 to 12±1%) (both p=0.01). Figure 1B and 1C.
CPET and insulin sensitivity results Athl-HV Baseline Athl-HV Deconditioning p value T2D Baseline T2D After Training p value VO2 peak, (mL/kg/min) 45.0±0.9† 41.7±0.9‡ <0.0001 23.6±0.6† 30.3±0.6‡ <0.0001 QUICKI* 0.346±0.002† 0.343±0.003‡ 0.2 0.308±0.004† 0.317±0.004‡ 0.02 *QUICKI: Quantitative Insulin Sensitivity Check Index; †Athl-HV vs T2D at baseline p≤0.001, ‡Athl-HV vs T2D after exercise intervention p≤0.001.
Figure 1
Conclusion
We demonstrate for the first time, in vivo, significant differences in the IMCL amount and saturation between Athl-HV and T2D. IMCL saturation was changed by exercise training in T2D to mirror the phenotype seen in Athl-HV uncovering a new, independent biomarker of improved cardio-metabolic health.
Acknowledgement/Funding
British Heart Foundation Project Grant no. PG/15/88/31780
Collapse
Affiliation(s)
| | - T Ahearn
- University of Aberdeen, Aberdeen, United Kingdom
| | - A E Rudd
- University of Aberdeen, Aberdeen, United Kingdom
| | - L Cheyne
- University of Aberdeen, Aberdeen, United Kingdom
| | - C Scally
- University of Aberdeen, Aberdeen, United Kingdom
| | - G Horgan
- University of Aberdeen, Aberdeen, United Kingdom
| | - S Philip
- University of Aberdeen, Aberdeen, United Kingdom
| | | | - G Lobley
- University of Aberdeen, Aberdeen, United Kingdom
| | - F Thies
- University of Aberdeen, Aberdeen, United Kingdom
| | - S Gray
- Cardiovascular Research Centre of Glasgow, Glasgow, United Kingdom
| | - A Henning
- Max Planck Institute for Biological Cybernetics, Tubingen, Germany
| | - D K Dawson
- University of Aberdeen, Aberdeen, United Kingdom
| |
Collapse
|
36
|
Hyde AJ, Nassabein R, AlShareef A, Armstrong D, Babak S, Berry S, Bossé D, Chen E, Colwell B, Essery C, Goel R, Goodwin R, Gray S, Hammad N, Jeyakuymar A, Jonker D, Karanicolas P, Lamond N, Letourneau R, Michael J, Patil N, Powell E, Ramjeesingh R, Saliba W, Singh R, Snow S, Stuckless T, Tadros S, Tehfé M, Thana M, Thirlwell M, Vickers M, Virik K, Welch S, Asmis T. Eastern Canadian Gastrointestinal Cancer Consensus Conference 2018. Curr Oncol 2019; 26:e665-e681. [PMID: 31708660 PMCID: PMC6821113 DOI: 10.3747/co.26.5193] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference was held in Halifax, Nova Scotia, 20-22 September 2018. Experts in radiation oncology, medical oncology, surgical oncology, and pathology who are involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics in the management of pancreatic cancer, pancreatic neuroendocrine tumours, hepatocellular cancer, and rectal and colon cancer, including ■ surgical management of pancreatic adenocarcinoma,■ adjuvant and metastatic systemic therapy options in pancreatic adenocarcinoma,■ the role of radiotherapy in the management of pancreatic adenocarcinoma,■ systemic therapy in pancreatic neuroendocrine tumours,■ updates in systemic therapy for patients with advanced hepatocellular carcinoma,■ optimum duration of adjuvant systemic therapy for colorectal cancer, and■ sequence of therapy in oligometastatic colorectal cancer.
Collapse
Affiliation(s)
- A J Hyde
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - R Nassabein
- Quebec-McGill University Health Centre, Montreal (Thirlwell); Centre Hospitalier de l'Université de Montréal, Montreal (Letourneau, Nassabein, Tehfé)
| | - A AlShareef
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - D Armstrong
- Newfoundland and Labrador-Dr. H. Bliss Murphy Cancer Centre, St. John's (Armstrong, Powell, Stuckless)
| | - S Babak
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - S Berry
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - D Bossé
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - E Chen
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - B Colwell
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - C Essery
- New Brunswick-Saint John Regional Hospital, Saint John (Gray, Michael)
| | - R Goel
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - R Goodwin
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - S Gray
- British Columbia-Penticton Regional Hospital, Penticton (Essery)
| | - N Hammad
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - A Jeyakuymar
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - D Jonker
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - P Karanicolas
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - N Lamond
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - R Letourneau
- Quebec-McGill University Health Centre, Montreal (Thirlwell); Centre Hospitalier de l'Université de Montréal, Montreal (Letourneau, Nassabein, Tehfé)
| | - J Michael
- British Columbia-Penticton Regional Hospital, Penticton (Essery)
| | - N Patil
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - E Powell
- Newfoundland and Labrador-Dr. H. Bliss Murphy Cancer Centre, St. John's (Armstrong, Powell, Stuckless)
| | - R Ramjeesingh
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - W Saliba
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - R Singh
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - S Snow
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - T Stuckless
- Newfoundland and Labrador-Dr. H. Bliss Murphy Cancer Centre, St. John's (Armstrong, Powell, Stuckless)
| | - S Tadros
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - M Tehfé
- Quebec-McGill University Health Centre, Montreal (Thirlwell); Centre Hospitalier de l'Université de Montréal, Montreal (Letourneau, Nassabein, Tehfé)
| | - M Thana
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - M Thirlwell
- Quebec-McGill University Health Centre, Montreal (Thirlwell); Centre Hospitalier de l'Université de Montréal, Montreal (Letourneau, Nassabein, Tehfé)
| | - M Vickers
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - K Virik
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - S Welch
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - T Asmis
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| |
Collapse
|
37
|
Bahji A, Cheng B, Gray S, Stuart H. Reduction in mortality risk with opioid agonist therapy: a systematic review and meta-analysis. Acta Psychiatr Scand 2019; 140:313-339. [PMID: 31419306 DOI: 10.1111/acps.13088] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/12/2019] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Opioid agonist therapies are effective medications that can greatly improve the quality of life of individuals with opioid use disorder. However, there is significant uncertainty about the risks of cause-specific mortality in and out of treatment. OBJECTIVE This systematic review and meta-analysis explored the association between methadone and buprenorphine with cause-specific mortality among opioid-dependent persons. METHODS We searched six online databases to identify relevant cohort studies, calculating all-cause and overdose-specific mortality rates during periods in and out of treatment. We pooled mortality estimates using multivariate random effects meta-analysis of the crude mortality rate per 1000 person-years of follow-up as well as relative risks comparing mortality in vs. out of treatment. RESULTS A total of 32 cohort studies (representing 150 235 participants, 805 423.6 person-years, and 9112 deaths) met eligibility criteria. Crude mortality rates were substantially higher among methadone cohorts than buprenorphine cohorts. Relative risk reduction was substantially higher with methadone relative to buprenorphine when time in-treatment was compared to time out-of-treatment. Furthermore, the greatest mortality reduction was conferred during the first 4 weeks of treatment. Mortality estimates were substantially heterogeneous and varied significantly by country, region, and by the nature of the treatment provider. CONCLUSION Precautions are necessary for the safer implementation of opioid agonist therapy, including baseline assessments of opioid tolerance, ongoing monitoring during the induction period, education of patients about the risk of overdose, and coordination within healthcare services.
Collapse
Affiliation(s)
- A Bahji
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.,Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Substance Treatment and Recovery Team, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - B Cheng
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - S Gray
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - H Stuart
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| |
Collapse
|
38
|
Lenny C, Gray S, Moore-Gillon J. EP1.06-05 The British Lung Foundation Mesothelioma Research Network: An International Collaborative Research Platform. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
39
|
Sillars A, Ho FK, Pell GP, Gill JMR, Sattar N, Gray S, Celis-Morales C. Sex differences in the association of risk factors for heart failure incidence and mortality. Heart 2019; 106:203-212. [PMID: 31366573 DOI: 10.1136/heartjnl-2019-314878] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/28/2019] [Accepted: 07/03/2019] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND There are known risk factors associated with the development of heart failure (HF), but it is not fully understood whether these differ by sex. OBJECTIVES To investigate sex differences in risk factors for HF incidence and mortality. METHODS 468 941 participants (55.9% women, age range 37-73 years) were included. Established CVD risk factors (hypertension, hypercholesterolaemia, diabetes type 1 and 2, adiposity, smoking, physical activity and poor diet) and novel risk factors (grip strength, fitness, TV viewing and sleep duration) were the exposures of interest. HF incidence and mortality were the outcomes. RESULTS Over a mean follow-up of 9.0 years, 1812 participants developed HF and 763 died due to HF. Women with type 1 diabetes (T1DM), type 2 diabetes (T2DM), hypertension, hypercholesterolaemia, low levels of physical activity and fitness, low strength, high levels of TV viewing, sleep duration <7 hours/day, smokers; those who were underweight and who were obese, had high body surface area and those who drink >14 units of alcohol were at higher risk of HF incidence. However, in women T2DM, hypercholesterolaemia, >3 hours/day of TV and sleep <7 hours/day, low level of physical activity and high level of TV viewing were more strongly associated with HF incidence compared with men. CONCLUSION Several modifiable risk factors (in particular diabetes) appear more strongly associated with HF in women compared with men. The relevance of these findings to HF characteristics and future outcomes needs to be established.
Collapse
Affiliation(s)
- Anne Sillars
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Frederick K Ho
- Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Gill P Pell
- Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jason M R Gill
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Stuart Gray
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|
40
|
Crowther K, Osman S, O'Hare S, Gray S, Holland D, Vennard H, Hanna G. OC-0098 Gated vs coached DIBH treatment in left sided breast cancer radiotherapy: a single centre study. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30518-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
41
|
Abstract
BACKGROUND In the era of global surgery, there are limited data regarding the available surgical workforce in South Africa. METHODS This aim of this study was to determine the orthopaedic surgeon density in South Africa. This involved a quantitative descriptive analysis of all registered specialist orthopaedic surgeons in South Africa, using data collected from various professional societal national databases. RESULTS The results showed 1.63 orthopaedic surgeons per 100,000 population. The vast majority were male (95%) with under two-thirds (65%) being under the age of 55 years. The majority of the orthopaedic surgeons were found in Gauteng, followed by the Western Cape and Kwa-Zulu Natal. The majority of specialists reportedly worked either full time or part time in the private sector (95%), and the orthopaedic surgeon density per uninsured population (0.36) was far below that of the private sector (8.3). CONCLUSION Interprovincial differences as well as intersectoral differences were marked indicating geographic and socio-economic maldistribution of orthopaedic surgeons. This parallels previous studies which looked at other surgical sub-disciplines in South Africa. Addressing this maldistribution requires concerted efforts to expand public sector specialist posts as well as quantifying the burden of orthopaedic disease in both private and public sectors before recommendations can be made regarding workforce allocation in the future. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- A J Dell
- Department of Surgery, University of Cape Town Health Sciences Faculty, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, 7925, South Africa.
| | - S Gray
- Medical Intern, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - R Fraser
- Busamed Hillcrest Private Hospital, Durban, South Africa
| | - M Held
- Orthopaedic Research Unit, Division of Orthopaedic Surgery, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - R Dunn
- Orthopaedic Research Unit, Division of Orthopaedic Surgery, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| |
Collapse
|
42
|
Burgess J, Bolderson E, Adams M, Zhang S, Fox S, Wright G, Young R, Solomon B, Gray S, Richard D, O’Byrne K. Chloropyramine increases NSCLC sensitivity to cisplatin in a SASH1 dependent manner. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30046-7] [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]
|
43
|
Boucher D, Ashton N, Suraweera A, Burgess J, Bolderson E, Barr M, Gray S, Gately K, Adams M, Croft L, Richard D, O’Byrne K. Human single-stranded DNA protein 1 (hSSB1): a prognostic factor and target for non-small cell lung cancer (NSCLC) treatment. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30084-4] [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: 10/27/2022]
|
44
|
Saade D, Bharucha-Goebel D, Norato G, Foley A, Waite M, Jain M, Debs S, Vasavada R, Nichols C, Kaur R, Donkervoort S, Neuhaus S, Hu Y, Lehky T, Gray S, Fink M. CMT AND NEUROGENIC DISEASE. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.385] [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]
|
45
|
Saade D, Bharucha-Goebel D, Jain M, Waite M, Norato G, Cheung K, Foley A, Soldatos A, Rybin D, Lehky T, Ying H, Whitehead M, Calcedo Del Hoyo R, Jacobson S, Leibovitch E, Nath A, Grieger J, Samulski R, Gray S, Bönnemann C. NEW THERAPEUTIC APPROACHES AND THEIR READOUT. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.242] [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]
|
46
|
Moore THM, Kesten JM, López-López JA, Ijaz S, McAleenan A, Richards A, Gray S, Savović J, Audrey S. The effects of changes to the built environment on the mental health and well-being of adults: Systematic review. Health Place 2018; 53:237-257. [PMID: 30196042 DOI: 10.1016/j.healthplace.2018.07.012] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 06/01/2018] [Accepted: 07/17/2018] [Indexed: 10/28/2022]
Abstract
There is increasing interest in the influence of place on health, and the need to distinguish between environmental and individual level factors. For environmental-level factors, current evidence tends to show associations through cross-sectional and uncontrolled longitudinal analyses rather than through more robust study designs that can provide stronger causal evidence. We restricted this systematic review to randomised (or cluster) randomised controlled trials and controlled before-and-after studies of changes to the built environment. Date of search was December 2016. We identified 14 studies. No evidence was found of an effect on mental health from 'urban regeneration' and 'improving green infrastructure' studies. Beneficial effects on quality-of-life outcomes from 'improving green infrastructure' were found in two studies. One 'improving green infrastructure' study reported an improvement in social isolation. Risk-of-bias assessment indicated robust data from only four studies. Overall, evidence for the impact of built environment interventions on mental health and quality-of-life is weak. Future research requires more robust study designs and interdisciplinary research involving public health, planning and urban design experts.
Collapse
Affiliation(s)
- T H M Moore
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK; Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK.
| | - J M Kesten
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK; The National Institute for Health Research Health Protection Research Unit in Evaluation of Interventions, Bristol Medical School, University of Bristol, UK
| | - J A López-López
- Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK
| | - S Ijaz
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK; Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK
| | - A McAleenan
- Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK
| | - A Richards
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK
| | - S Gray
- Department of Health and Applied Social Science, University of the West of England, Bristol BS16 1QY, UK
| | - J Savović
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK; Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK
| | - S Audrey
- Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK
| |
Collapse
|
47
|
Frankel AH, Kazempour-Ardebili S, Bedi R, Chowdhury TA, De P, El-Sherbini N, Game F, Gray S, Hardy D, James J, Kong MF, Ramlan G, Southcott E, Winocour P. Management of adults with diabetes on the haemodialysis unit: summary of guidance from the Joint British Diabetes Societies and the Renal Association. Diabet Med 2018; 35:1018-1026. [PMID: 30152585 DOI: 10.1111/dme.13676] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2018] [Indexed: 12/29/2022]
Abstract
Diabetic nephropathy remains the principal cause of end-stage renal failure in the UK and its prevalence is set to increase. People with diabetes and end-stage renal failure on maintenance haemodialysis are highly vulnerable, with complex comorbidities, and are at high risk of adverse cardiovascular outcomes, the leading cause of mortality in this population. The management of people with diabetes receiving maintenance haemodialysis is shared between diabetes and renal specialist teams and the primary care team, with input from additional healthcare professionals providing foot care, dietary support and other aspects of multidisciplinary care. In this setting, one specialty may assume that key aspects of care are being provided elsewhere, which can lead to important components of care being overlooked. People with diabetes and end-stage renal failure require improved delivery of care to overcome organizational difficulties and barriers to communication between healthcare teams. No comprehensive guidance on the management of this population has previously been produced. These national guidelines, the first in this area, bring together in one document the disparate needs of people with diabetes on maintenance haemodialysis. The guidelines are based on the best available evidence, or on expert opinion where there is no clear evidence to inform practice. We aim to provide clear advice to clinicians caring for this vulnerable population and to encourage and improve education for clinicians and people with diabetes to promote empowerment and self-management.
Collapse
Affiliation(s)
- A H Frankel
- Imperial College Healthcare NHS Trust, London, UK
| | - S Kazempour-Ardebili
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Iran
| | - R Bedi
- Imperial College Healthcare NHS Trust, London, UK
| | | | - P De
- Birmingham City Hospital (Sandwell and West Birmingham Hospitals NHS Trust), Birmingham, UK
| | | | - F Game
- Derby Teaching Hospitals NHS Foundation Trust and University of Nottingham, UK
| | - S Gray
- East and North Herts NHS Trust, UK
| | - D Hardy
- East and North Herts NHS Trust, UK
| | - J James
- University Hospitals of Leicester NHS Trust, UK
| | - M-F Kong
- University Hospitals of Leicester NHS Trust, UK
| | - G Ramlan
- North Middlesex University Hospital NHS Trust, UK
| | | | - P Winocour
- Queen Elizabeth II Hospital, Welwyn Garden City, UK
| |
Collapse
|
48
|
McGee S, AlGhareeb W, Ahmad C, Armstrong D, Babak S, Berry S, Biagi J, Booth C, Bossé D, Champion P, Colwell B, Finn N, Goel R, Gray S, Green J, Harb M, Hyde A, Jeyakumar A, Jonker D, Kanagaratnam S, Kavan P, MacMillan A, Muinuddin A, Patil N, Porter G, Powell E, Ramjeesingh R, Raza M, Rorke S, Seal M, Servidio-Italiano F, Siddiqui J, Simms J, Smithson L, Snow S, St-Hilaire E, Stuckless T, Tate A, Tehfe M, Thirlwell M, Tsvetkova E, Valdes M, Vickers M, Virik K, Welch S, Marginean C, Asmis T. Eastern Canadian Colorectal Cancer Consensus Conference 2017. Curr Oncol 2018; 25:262-274. [PMID: 30111967 PMCID: PMC6092057 DOI: 10.3747/co.25.4083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2017 was held in St. John's, Newfoundland and Labrador, 28-30 September. Experts in radiation oncology, medical oncology, surgical oncology, and cancer genetics who are involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics in the management of gastric, rectal, and colon cancer, including ■ identification and management of hereditary gastric and colorectal cancer (crc);■ palliative systemic therapy for metastatic gastric cancer;■ optimum duration of preoperative radiation in rectal cancer-that is, short- compared with long-course radiation;■ management options for peritoneal carcinomatosis in crc;■ implications of tumour location for treatment and prognosis in crc; and■ new molecular markers in crc.
Collapse
Affiliation(s)
- S.F. McGee
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - W. AlGhareeb
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - C.H. Ahmad
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - D. Armstrong
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - S. Babak
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - S. Berry
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - J. Biagi
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - C. Booth
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - D. Bossé
- Dana–Farber Cancer Institute, Boston, MA, U.S.A
| | - P. Champion
- Prince Edward Island—Prince Edward Island Cancer Treatment Centre, Charlottetown
| | - B. Colwell
- Nova Scotia—qeii Health Sciences Centre, Dalhousie University, Halifax
| | - N. Finn
- New Brunswick—Saint John Regional Hospital, Saint John (Gray); Centre hospitalier universitaire Dr-Georges-L.-Dumont, Moncton (Finn, St-Hilaire); Dr. Everett Chalmers Hospital, Fredericton (Raza); Moncton City Hospital (Harb)
| | - R. Goel
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - S. Gray
- New Brunswick—Saint John Regional Hospital, Saint John (Gray); Centre hospitalier universitaire Dr-Georges-L.-Dumont, Moncton (Finn, St-Hilaire); Dr. Everett Chalmers Hospital, Fredericton (Raza); Moncton City Hospital (Harb)
| | - J. Green
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - M. Harb
- New Brunswick—Saint John Regional Hospital, Saint John (Gray); Centre hospitalier universitaire Dr-Georges-L.-Dumont, Moncton (Finn, St-Hilaire); Dr. Everett Chalmers Hospital, Fredericton (Raza); Moncton City Hospital (Harb)
| | - A. Hyde
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - A. Jeyakumar
- Nova Scotia—qeii Health Sciences Centre, Dalhousie University, Halifax
| | - D. Jonker
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - S. Kanagaratnam
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - P. Kavan
- Quebec—McGill University Health Centre, Montreal (Kavan, Thirlwell); Centre hospitalier de l’Université de Montréal, Montreal (Tehfé)
| | - A. MacMillan
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - A. Muinuddin
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - N. Patil
- Nova Scotia—qeii Health Sciences Centre, Dalhousie University, Halifax
| | - G. Porter
- Nova Scotia—qeii Health Sciences Centre, Dalhousie University, Halifax
| | - E. Powell
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - R. Ramjeesingh
- Nova Scotia—qeii Health Sciences Centre, Dalhousie University, Halifax
| | - M. Raza
- New Brunswick—Saint John Regional Hospital, Saint John (Gray); Centre hospitalier universitaire Dr-Georges-L.-Dumont, Moncton (Finn, St-Hilaire); Dr. Everett Chalmers Hospital, Fredericton (Raza); Moncton City Hospital (Harb)
| | - S. Rorke
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - M. Seal
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - F. Servidio-Italiano
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - J. Siddiqui
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - J. Simms
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - L. Smithson
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - S. Snow
- Nova Scotia—qeii Health Sciences Centre, Dalhousie University, Halifax
| | - E. St-Hilaire
- New Brunswick—Saint John Regional Hospital, Saint John (Gray); Centre hospitalier universitaire Dr-Georges-L.-Dumont, Moncton (Finn, St-Hilaire); Dr. Everett Chalmers Hospital, Fredericton (Raza); Moncton City Hospital (Harb)
| | - T. Stuckless
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - A. Tate
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - M. Tehfe
- Quebec—McGill University Health Centre, Montreal (Kavan, Thirlwell); Centre hospitalier de l’Université de Montréal, Montreal (Tehfé)
| | - M. Thirlwell
- Quebec—McGill University Health Centre, Montreal (Kavan, Thirlwell); Centre hospitalier de l’Université de Montréal, Montreal (Tehfé)
| | - E. Tsvetkova
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - M. Valdes
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - M. Vickers
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - K. Virik
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - S. Welch
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - C. Marginean
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - T. Asmis
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| |
Collapse
|
49
|
Gray S, Cheetham T, McConachie H, Mann KD, Parr JR, Pearce MS, Colver A. A longitudinal, observational study examining the relationships of patient satisfaction with services and mental well-being to their clinical course in young people with Type 1 diabetes mellitus during transition from child to adult health services. Diabet Med 2018; 35:1216-1222. [PMID: 29852520 PMCID: PMC6099219 DOI: 10.1111/dme.13698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/29/2018] [Indexed: 12/25/2022]
Abstract
AIM We hypothesized that participant well-being and satisfaction with services would be positively associated with a satisfactory clinical course during transition from child to adult health care. METHODS Some 150 young people with Type 1 diabetes mellitus from five diabetes units in England were recruited to a longitudinal study of transition. Each young person was visited at home four times by a research assistant; each visit was 1 year apart. Satisfaction with services (Mind the Gap; MTG) and mental well-being (Warwick-Edinburgh Mental Well-being Scale; WEMWBS) were captured. Change in HbA1c , episodes of ketoacidosis, clinic and retinal screening attendance were used to assess clinical course. In total, 108 of 150 (72%) young people had sufficient data for analysis at visit 4. RESULTS Mean age at entry was 16 years. By visit 4, 81.5% had left paediatric healthcare services. Median HbA1c increased significantly (P = 0.01) from 69 mmol/mol (8.5%) at baseline to 75 mmol/mol (9.0%) at visit 4. WEMWBS scores were comparable with those in the general population at baseline and were stable over the study period. MTG scores were also stable. By visit 4, some 32 individuals had a 'satisfactory' and 76 a 'suboptimal' clinical course. There were no significant differences in average WEMWBS and MTG scores between the clinical course groups (P = 0.96, 0.52 respectively); nor was there a significant difference in transfer status between the clinical course groups. CONCLUSIONS The well-being of young people with diabetes and their satisfaction with transition services are not closely related to their clinical course. Investigating whether innovative psycho-educational interventions can improve the clinical course is a research priority.
Collapse
Affiliation(s)
- S. Gray
- Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
| | - T. Cheetham
- Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
- Institute of Genetic MedicineNewcastle upon TyneUK
| | - H. McConachie
- Institute of Health and SocietyNewcastle upon TyneUK
| | - K. D. Mann
- Institute of Health and SocietyNewcastle upon TyneUK
| | - J. R. Parr
- Newcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
- Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneUK
| | - M. S. Pearce
- Institute of Health and SocietyNewcastle upon TyneUK
| | - A. Colver
- Institute of Health and SocietyNewcastle upon TyneUK
- Northumbria Healthcare NHS Foundation TrustNorth ShieldsUK
| |
Collapse
|
50
|
Basu N, Cheung G, Senn N, Keenan K, Hutcheon G, Erwig L, Schrepf A, Dospinescu P, Gray S, Waiter G, He J. 129 Does skeletal muscle mitochondrial dysfunction explain SLE related physical fatigue? Rheumatology (Oxford) 2018. [DOI: 10.1093/rheumatology/key075.353] [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)
- Neil Basu
- Aberdeen Centre for Arthritis & Musculoskeletal Health, University of Aberdeen, Aberdeen, UNITED KINGDOM
| | - Gabe Cheung
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UNITED KINGDOM
| | - Nicholas Senn
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UNITED KINGDOM
| | - Karen Keenan
- Aberdeen Centre for Arthritis & Musculoskeletal Health, University of Aberdeen, Aberdeen, UNITED KINGDOM
| | - Gayle Hutcheon
- Aberdeen Centre for Arthritis & Musculoskeletal Health, University of Aberdeen, Aberdeen, UNITED KINGDOM
| | - Lars Erwig
- Aberdeen Centre for Arthritis & Musculoskeletal Health, University of Aberdeen, Aberdeen, UNITED KINGDOM
- Experimental Medicine, GSK, Stevenage, UNITED KINGDOM
| | - Andrew Schrepf
- Chronic Pain & Fatigue Research Center, University of Michigan, Ann Arbor, MI, USA
| | - Paula Dospinescu
- Aberdeen Centre for Arthritis & Musculoskeletal Health, University of Aberdeen, Aberdeen, UNITED KINGDOM
| | - Stuart Gray
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UNITED KINGDOM
| | - Gordon Waiter
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UNITED KINGDOM
| | - Jiabao He
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UNITED KINGDOM
| |
Collapse
|