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Evaluating the real-world implementation of the Family Nurse Partnership in England: a data linkage study. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-223. [PMID: 38784984 DOI: 10.3310/bvdw6447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Background/objectives The Family Nurse Partnership is an intensive home visiting programme for adolescent mothers. We aimed to evaluate the effectiveness of the Family Nurse Partnership on outcomes up to age 7 using national administrative data. Design We created a linked cohort of all mothers aged 13-19 using data from health, educational and children's social care and defined mothers enrolled in the Family Nurse Partnership or not using Family Nurse Partnership system data. Propensity scores were used to create matched groups for analysis. Setting One hundred and thirty-six local authorities in England with active Family Nurse Partnership sites between 2010 and 2017. Participants Mothers aged 13-19 at last menstrual period with live births between April 2010 and March 2019, living in a Family Nurse Partnership catchment area and their firstborn child(ren). Interventions The Family Nurse Partnership includes up to 64 home visits by a family nurse from early pregnancy until the child's second birthday and is combined with usual health and social care. Controls received usual health and social care. Main outcome measures Indicators of child maltreatment (hospital admissions for injury/maltreatment, referral to social care services); child health and development (hospital utilisation and education) outcomes and maternal hospital utilisation and educational outcomes up to 7 years following birth. Data sources Family Nurse Partnership Information System, Hospital Episode Statistics, National Pupil Database. Results Of 110,520 eligible mothers, 25,680 (23.2%) were enrolled in the Family Nurse Partnership. Enrolment rates varied across 122 sites (range: 11-68%). Areas with more eligible mothers had lower enrolment rates. Enrolment was higher among mothers aged 13-15 (52%), than 18-19 year-olds (21%). Indicators of child maltreatment: we found no evidence of an association between the Family Nurse Partnership and indicators of child maltreatment, except for an increased rate of unplanned admissions for maltreatment/injury-related diagnoses up to age 2 for children born to Family Nurse Partnership mothers (6.6% vs. 5.7%, relative risk 1.15; 95% confidence interval 1.07 to 1.24). Child health and developmental outcomes: there was weak evidence that children born to Family Nurse Partnership mothers were more likely to achieve a Good Level of Development at age 5 (57.5% vs. 55.4%, relative risk 1.05; 95% confidence interval 1.00 to 1.09). Maternal outcomes: There was some evidence that Family Nurse Partnership mothers were less likely to have a subsequent delivery within 18 months of the index birth (8.4% vs. 9.3%, relative risk 0.92; 95% confidence interval 0.88 to 0.97). Younger and more vulnerable mothers received higher numbers of visits and were more likely to achieve fidelity targets. Meeting the fidelity targets was associated with some outcomes. Limitations Bias by indication and variation in the intervention and usual care over time and between areas may have limited our ability to detect effects. Multiple testing may have led to spurious, significant results. Conclusions This study supports findings from evaluations of the Family Nurse Partnership showing no evidence of benefit for maltreatment outcomes measured in administrative data. Amongst all the outcomes measured, we found weak evidence that the Family Nurse Partnership was associated with improvements in child development at school entry, a reduction in rapid repeat pregnancies and evidence of increased healthcare-seeking in the mother and child. Future work Future evaluations should capture better measures of Family Nurse Partnership interventions and usual care, more information on maternal risk factors and additional outcomes relating to maternal well-being. Study registration The study is registered as NIHR CRN Portfolio (42900). Funding This award was funded by the National Institute of Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/99/19) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 11. See the NIHR Funding and Awards website for further award information.
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Watch Me Play!: protocol for a feasibility study of a remotely delivered intervention to promote mental health resilience for children (ages 0-8) across UK early years and children's services. Pilot Feasibility Stud 2024; 10:55. [PMID: 38576026 PMCID: PMC10993464 DOI: 10.1186/s40814-024-01491-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/26/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Half of mental health problems are established by the age of 14 years and 75% by 24 years. Early intervention and prevention of mental ill health are therefore vitally important. However, increased demand over recent years has meant that access to child mental health services is often restricted to those in severest need. Watch Me Play! (WMP) is an early intervention designed to support caregiver attunement and attention to the child to promote social-emotional well-being and thereby mental health resilience. Originally developed in the context of a local authority mental health service for children in care, it is now also delivered online as a low intensity, scalable, preventative intervention. Although WMP shows promise and is already used in some services, we do not yet know whether it is effective. METHODS A non-randomised single group feasibility study with embedded process evaluation. We propose to recruit up to 40 parents/carers of children aged 0-8 years who have been referred to early years and children's services in the UK. WMP involves a parent watching the child play and talking to their child about their play (or for babies, observing and following signals) for up to 20 min per session. Some sessions are facilitated by a trained practitioner who provides prompts where necessary, gives feedback, and discusses the child's play with the caregiver. Services will offer five facilitated sessions, and parents will be asked to do at least 10 additional sessions on their own with their child in a 5-week period. Feasibility outcomes examined are as follows: (i) recruitment, (ii) retention, (iii) adherence, (iv) fidelity of delivery, (v) barriers and facilitators of participation, (vi) intervention acceptability, (vii) description of usual care, and (viii) data collection procedures. Intervention mechanisms will be examined through qualitative interview data. Economic evaluation will be conducted estimating cost of the intervention and cost of service use for child and parents/carers quality-adjusted life years. DISCUSSION This study will address feasibility questions associated with progression to a future randomised trial of WMP. TRIAL REGISTRATION ISRCTN13644899 . Registered on 14th April 2023.
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Effects of increased grazing intensity during the early and late grazing periods on the welfare of spring-calving, pasture-based dairy cows. J Dairy Sci 2023; 106:6427-6443. [PMID: 37500449 DOI: 10.3168/jds.2022-22659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/12/2023] [Indexed: 07/29/2023]
Abstract
The objective of this study was to identify potential effects of increased grazing intensity, characterized by differing pasture availability and stocking rate, on indicators of welfare during both early and late grazing periods. Seventy spring-calving, pasture-based Holstein-Friesian and cross-bred dairy cows, averaging 35 ± 16 d in milk on the first day of data collection, were assigned to 3 treatments (20-26 cows/treatment) representing a range in grazing intensity: LO (high pasture availability, 980 kg DM/ha opening cover, 2.75 cows/ha, 90:10% pasture:concentrate diet), MOD (medium pasture availability, 720 kg DM/ha opening cover, 2.75 cows/ha, 90:10% pasture:concentrate diet), and HI (low pasture availability, 570 kg DM/ha opening cover, 3.25 cows/ha, 80:20% pasture:concentrate diet); representative of current, best practice and proposed production levels respectively for this system. Welfare indicators were locomotion score, digital dermatitis and white line disease, rumen fill, ocular and nasal discharge, integument damage to the neck-back and hock regions, and lying time. Data were collected during a 5-wk early grazing period in spring (EG) and a 7-wk late grazing period in autumn (LG). Average daily lying time was recorded for 8 to 10 focal cows per treatment. Results demonstrated only minor treatment effects. Cows on MOD [odds ratio (OR) = 3.11] and HI (OR = 1.95) were more likely to display nasal discharge compared with LO. Cows on MOD tended to have more damage to the skin on the neck-back region than LO (OR = 4.26). Total locomotion score (maximum = 25) was greater on LOW (7.1 ± 0.20) compared with HI (6.5 ± 0.19). Average lame cow prevalence for EG and LG respectively was 15.3 ± 3.12% and 39.2 ± 3.00% (LO), 20.0 ± 2.58% and 24.2 ± 5.69% (MOD), and 14.9 ± 4.79% and 17.0 ± 3.44% (HI). Cows on HI were less likely to have impaired walking speed than either LO (OR = 0.24) or MOD (OR = 0.29). Cows on both HI (OR = 0.36) and MOD (OR = 0.40) were less likely to display impaired abduction or adduction compared with those on LO. An interaction between treatment and period revealed longer lying times for cows on LO (10.6 h/d ± 0.39) compared with both MOD and HI (8.7 ± 0.43 and 8.4 ± 0.41 h/d) during EG only. The greatest effects were across grazing periods, with all indicators except rumen fill and locomotion score demonstrating improvements from EG to LG. This suggests cows were able to cope well with increasing levels of grazing intensity, and that regardless of treatment, a greater number of days on pasture led to improvements in welfare indicators.
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Lessons learned from using linked administrative data to evaluate the Family Nurse Partnership in England and Scotland. Int J Popul Data Sci 2023; 8:2113. [PMID: 37670953 PMCID: PMC10476150 DOI: 10.23889/ijpds.v8i1.2113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
Introduction "Big data" - including linked administrative data - can be exploited to evaluate interventions for maternal and child health, providing time- and cost-effective alternatives to randomised controlled trials. However, using these data to evaluate population-level interventions can be challenging. Objectives We aimed to inform future evaluations of complex interventions by describing sources of bias, lessons learned, and suggestions for improvements, based on two observational studies using linked administrative data from health, education and social care sectors to evaluate the Family Nurse Partnership (FNP) in England and Scotland. Methods We first considered how different sources of potential bias within the administrative data could affect results of the evaluations. We explored how each study design addressed these sources of bias using maternal confounders captured in the data. We then determined what additional information could be captured at each step of the complex intervention to enable analysts to minimise bias and maximise comparability between intervention and usual care groups, so that any observed differences can be attributed to the intervention. Results Lessons learned include the need for i) detailed data on intervention activity (dates/geography) and usual care; ii) improved information on data linkage quality to accurately characterise control groups; iii) more efficient provision of linked data to ensure timeliness of results; iv) better measurement of confounding characteristics affecting who is eligible, approached and enrolled. Conclusions Linked administrative data are a valuable resource for evaluations of the FNP national programme and other complex population-level interventions. However, information on local programme delivery and usual care are required to account for biases that characterise those who receive the intervention, and to inform understanding of mechanisms of effect. National, ongoing, robust evaluations of complex public health evaluations would be more achievable if programme implementation was integrated with improved national and local data collection, and robust quasi-experimental designs.
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The needs of children born preterm are too often overlooked. Lancet 2023; 401:1156. [PMID: 37030887 DOI: 10.1016/s0140-6736(23)00277-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 01/30/2023] [Indexed: 04/10/2023]
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A91 INTERACTIONS BETWEEN PREGNANCY, DELIVERY, AND ILEAL POUCH-ANAL ANASTOMOSIS FOR INFLAMMATORY BOWEL DISEASE: A RETROSPECTIVE CHART REVIEW. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991144 DOI: 10.1093/jcag/gwac036.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD) that affects people in their reproductive years of life. Surgical treatment for medically refractory UC involves surgery over 2-3 stages, which includes a subtotal colectomy followed by creation of an ileal pouch-anal anastomosis (IPAA), known as a “J pouch”. The IPAA allows preservation of fecal continence and avoids the psychosocial impacts of a stoma. The IPAA procedure is a deep pelvic surgery, which may impact pregnancy outcomes. Caesarean section (C-section) delivery is often performed to avoid anal sphincter and J pouch damage from vaginal delivery. However, literature demonstrates conflicting results regarding the risks of C-section compared to vaginal delivery, including the impact on pouch function. Surveys of clinicians also report varying delivery recommendations. Purpose To describe the delivery methods, pregnancy outcomes and postpartum course of IBD patients with IPAA at Mount Sinai Hospital. Method A retrospective chart review is being performed for female patients at Mount Sinai Hospital (Toronto, Ontario) with a diagnosis of IBD and an IPAA. Eligible patients completed a pregnancy from January 1, 2002-February 1, 2021 post-IPAA surgery and had variables of interest accessible in their electronic medical record. Variables of interest include demographics, pregnancy history, IBD characteristics, IPAA surgery details, pregnancy outcomes, mode of delivery and characteristics, and postpartum complications. Clinical data will be presented as means, medians and frequencies. Differences between variables of interest will be evaluated with Student’s t-test or chi-squared test. Result(s) Three avenues of patient identification yielded 1113 patients to be screened. Inclusion criteria were met for 71 patients and chart review is complete for 36 patients who had a total of 53 pregnancies and delivered 56 babies. Most patients (49%) had a two-stage IPAA surgery, 21% required a three-stage surgery and 30% were undocumented. Most patients’ (55%) IPAA was created through laparotomy, while 13% was through laparoscopic procedure and 32% was undocumented. Seventy-four percent of deliveries were through C-section (75% of primiparous), 69% of which were indicated to protect the patient’s J pouch and 31% for an obstetrical indication. The remaining 26% of deliveries were vaginal, 29% of which were assisted with forceps or vacuum, 57% had tears (37.5% first-, 37.5% second-, and 25% third-degree) and 50% had an episiotomy. Conclusion(s) At Mount Sinai Hospital, most IBD patients with an IPAA who completed a pregnancy had a history of laparotomy to create their IPAA. Most patients (74%) with IBD and an IPAA are delivering through C-section, and mainly to protect their J pouch, which is in line with reports in the literature. Most patients had a tear or episiotomy during vaginal delivery. Rates of third-degree tears may be higher than in the general population. Trends will be further elucidated with advancement of the study. Disclosure of Interest None Declared
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A85 ASSESSING THE IMPACT OF A DEDICATED RAPID INTERDISCIPLINARY IBD CLINIC ON PATIENT WAIT TIMES, REPORTED OUTCOMES, AND SATISFACTION OF CARE. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991230 DOI: 10.1093/jcag/gwac036.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Inflammatory bowel disease (IBD) is a chronic fluctuating condition where patients can experience periods of active disease and remission. Timely access to care has been shown to be impactful on important disease outcomes. In January 2020, we implemented a rapid assessment IBD program consisting of expedited access to interdisciplinary care and close monitoring of patients. Purpose To assess the impact of the rapid assessment program on access to care, disease activity, and patient satisfaction. Method Once informed consent was obtained, patients were enrolled into the RAPID IBD program. This program consisted of four close monitoring time points at baseline, 1, 2, and 3 months, as well as two follow up time points at 6 and 12 months. At each timepoint patients completed questionnaires that evaluated disease activity, using the Modified Harvey Bradshaw Index (mHBI) for Crohn’s disease (CD), partial Mayo (pMayo) score and Simple Clinical Colitis Activity Index (SCCAI) for ulcerative colitis patients. At baseline, 3, 6, and 12 months, patients were also assessed on mental health, using the Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7), and satisfaction of care, using the CACHE questionnaire. Result(s) Between January 2020 – August 2021, 216 patients were referred to the RAPID IBD program. The mean time from referral to clinical assessment was 8.1 days. Of those referred, 143 (71 CD, 62 UC, 6 IBDU, and 4 Query IBD) patients consented to and completed the 12-month RAPID IBD study. 34.9% of patients who had active disease at baseline achieved remission by 3 months (Table 1). At baseline 44.8% and 28.4% of patients experienced moderate to severe depression and anxiety, respectively. The greatest improvement in mental health was seen at 2 months where the proportion of patients experiencing moderate to severe depression and anxiety decreased to 27.5% and 18.3%, respectively (Table 2). Patient satisfaction, specific to clinical care, improved from a baseline score of 69.1% to 74.1% at 3 months (Table 3). Image ![]()
Conclusion(s) Implementation of a dedicated RAPID IBD clinic program reveals shorter wait times to be seen in clinic. By three months of enrollment, patients demonstrate improvements in clinical response, mental health, and satisfaction of care. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding; AMO Innovation Funding Disclosure of Interest None Declared
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The Tavistock First-Time Parent Study: a pilot randomised controlled feasibility trial of a brief couple-focused perinatal intervention to reduce inter-parental discord. Eur Child Adolesc Psychiatry 2023; 32:451-462. [PMID: 34546408 DOI: 10.1007/s00787-021-01862-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 08/13/2021] [Indexed: 10/20/2022]
Abstract
Numerous studies report that some first-time parents experience a decline in relationship quality and an increase in conflict after the birth of a first baby. Inter-parental discord that is frequent, intense, and poorly resolved increases the likelihood of relationship breakdown and adversely impacts child development. We investigated the feasibility of a brief preventative couple-focused psychotherapeutic intervention in the perinatal period in a general population sample. Sixty couples expecting their first baby were recruited from the Royal Free Hospital, London. Thirty were randomly assigned to treatment (TMT, a newly developed five-session couple-focused intervention), and 30 to usual care (TAU). Outcomes were collected at 28 weeks into pregnancy, 6-8 weeks after birth, and when the baby was 6 months old. The intervention was feasible and acceptable, evidenced by 100% attendance. However, no change in relationship quality or inter-parental discord was detected in either TMT or TAU groups across the transition to parenthood. The intervention did not improve outcomes vs. TAU. Depression assessed by the Hospital Anxiety and Depression Scale increased across the cohort and mood symptoms assessed by the Edinburgh Postnatal Depression Scale decreased in mothers but not fathers. The absence of a decline in relationship quality could reflect sample attributes: couples were older than average UK first-time parents, had high levels of educational qualifications, and low discord. Even in this low-risk sample, only 20 out of 30 TAU couples completed all three assessments, vs. 29 out of 30 TMT couples. Larger-scale RCTs of perinatal couple-focused psychosocial interventions may be hampered by selection effects and attrition. They may benefit from co-design with stakeholders and active control conditions.Trial registration: ISRCTN12258825; 1st May 2020 (retrospectively registered).
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The cost-of-living crisis, poverty, and child maltreatment. THE LANCET. CHILD & ADOLESCENT HEALTH 2023; 7:5-6. [PMID: 36152648 DOI: 10.1016/s2352-4642(22)00252-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 11/19/2022]
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Evaluation of the real-world implementation of the Family Nurse Partnership in England: an observational cohort study using linked data from health, education, and children's social care. Lancet 2022; 400 Suppl 1:S29. [PMID: 36929972 DOI: 10.1016/s0140-6736(22)02239-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Family Nurse Partnership (FNP) is an early home visiting service supporting young mothers. A randomised controlled trial of FNP in England found no effect on short-term primary outcomes or maltreatment in children up to age 7 years, but positive impacts on some educational outcomes. We report preliminary results of a national evaluation of FNP using linked administrative data. METHODS We constructed a cohort of all mothers in England aged 13-19 years who gave birth between April 1, 2010, and March 31, 2019, to their firstborn child or children, using linked administrative data from hospital admissions (Hospital Episode Statistics) and education and social care (National Pupil Database). We evaluated differences in a range of policy relevant child and maternal outcomes, comparing mothers who were enrolled in FNP with those who were not, using propensity score matching. FINDINGS Of 110 960 mothers in our linked cohort, 26 290 (24%) were enrolled in FNP. FNP mothers were younger, more deprived, and more likely to have adversity or social care histories than mothers not enrolled. Compared with mothers not enrolled in FNP, those in FNP did not have fewer unplanned hospital admissions for injury or maltreatment in children by age 2 years, lower rates of children looked after in out-of-home care by age 7 years, or improved maternal outcomes, but were more likely to achieve a good level of development at school entry. We present findings among subgroups of younger maternal age (13-15 years), increased deprivation according to quintile of Index of Multiple Deprivation, and adversity and social care history. We also present sensitivity analyses that aim to minimise confounding. INTERPRETATION Our study supports findings from previous trials of FNP showing little benefit for measured child maltreatment and maternal outcomes, but some evidence of benefit for school readiness. Interpretation of results needs careful consideration of the impact of residual confounding due to unmeasured or undisclosed factors (eg, family violence) linked to targeting of FNP to higher risk mothers, and surveillance bias. FUNDING National Institute for Health and Care Research.
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Challenges and lessons learned from Scotland and England using linked administrative data to evaluate the Family Nurse Partnership: two administrative data cohort studies. Lancet 2022; 400 Suppl 1:S28. [PMID: 36929971 DOI: 10.1016/s0140-6736(22)02238-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Family Nurse Partnership (FNP) is an early intervention aiming to support adolescent mothers and their children. The FNP has been evaluated in England and Scotland in two separate studies using linked administrative data from health, education, and social care. We aimed to make recommendations for studies using linked administrative data to evaluate public health interventions. METHODS We constructed two cohorts of all mothers aged 13-19 years giving birth in NHS hospitals between 2010 and 2016-17 using data from Hospital Episode Statistics (England) and Maternity Inpatient and Day Case (Scotland). FNP participation was identified through linkage to FNP programme data. We also linked to health, educational, and social care data for mothers and their babies (data from the National Pupil Database and electronic Data Research and Innovation Service). Ethical approval was obtained but no consent was required because we used secondary data. We used these data to evaluate the effect of the FNP on maternal and child outcomes. FINDINGS Key challenges included characterising the intervention and usual care, understanding quality of multi-sector data linkage, data access delays, constructing appropriate comparator groups, and interpreting outcomes captured in administrative data. Lessons learned included that evaluations required detailed data on intervention activity (dates and geography) and assessment of usual care, which are rarely readily available and are time-consuming to gather; data linkage quality information was variable or not available, making defining denominators challenging; data access delays impeded on data analysis time; and unmeasured confounders not captured in administrative data possibly prevented the generation of an appropriate comparator group. We recommend that characteristics informing targeting should be explicitly documented, and could be enhanced by using linked primary care data and information on household members (eg, fathers). Process evaluation and qualitative research could help to provide a better understanding of mechanisms of effect. INTERPRETATION Linkage of administrative data presents opportunities for efficient evaluation of large-scale, complex public health interventions. However, sufficient information is needed on programme metadata, targeting, and important confounders to generate meaningful results. Our findings should help to stimulate exploration by practitioners about how such programmes can be improved. FUNDING National Institute for Health and Care Research.
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326 USE OF A PHARMACY PRIORITISATION TOOLKIT IN FRAIL OLDER ADULTS PRESENTING TO THE EMERGENCY DEPARTMENT. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A Pharmacy Prioritisation Toolkit (PPT) was adapted for use by a front door frailty multidisciplinary team to direct pharmacist review.
Methods
Over a 4-week period pharmacist referrals based on a toolkit used by the team were reviewed. Data was recorded in Excel including age, reason for referral and outcome of Medicines Optimisation Review (MOR). Pharmacy-identified patients were also analysed.
Results
Forty-Five patients were referred by the team using the PPT and 25 were pharmacist-identified for review. Reason for referral were use of high-risk medication (20/45), suspected medication related admission (9/45), chronic kidney disease or acute kidney injury (7/45), specific pharmaceutical concerns (5/45) >10 regular medications (4/45). Of those reviewed, 29 MORs were made. Of patients who were pharmacist identified, 10 MORs were made (53% of patients). The toolkit was retrospectively applied to these patients and would have selected all but 3.
Conclusion
The PPT was successfully used by the team to generate 45 referrals for pharmacist review over a 4-week period. As a result of analysis of these recommendations, antimicrobial prophylaxis for urinary tract infections will be added to the high-risk medicines list on the PPT. Development of the toolkit is ongoing using a plan, do, study, act model with input from all members of the team to further improve both its efficacy and utility.
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Thinking Time, Shifting Goalposts and Ticking Time Bombs: Experiences of Waiting on the Gender Identity Development Service Waiting List. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13883. [PMID: 36360763 PMCID: PMC9657771 DOI: 10.3390/ijerph192113883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
LOGiC-Q is a prospective longitudinal qualitative study that explores the experiences of children and young people, and their families, who have been referred to the Gender Identity Development Service (GIDS) in the UK. This paper describes the experiences of children and young people and their parents while they are on the waiting list to be seen. Semi-structured interviews were undertaken with 39 families who had been referred to GIDS and were waiting for their first appointment with the service. Both parent and child/young person were interviewed. Analysis of the anonymised interview transcripts was informed by both narrative and thematic approaches, and three predominant narratives around waiting were identified: 1. Positive experiences attached to waiting; 2. Feelings of distress and stuckness; 3. Suggestions for support while waiting. Findings from this study indicate variations in how waiting is experienced depending on the age of the child, and how distressed their body makes them feel. Young people and their parents offered suggestions for how the service could support families on the waiting list. These suggestions related primarily to ways of checking in and providing reassurance that they were at least still on the list as well as ideas about how to make the wait less distressing, rather than necessarily making the wait shorter, which was more spoken about in terms of an ideal rather than a realistic option.
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Establishing intersectoral ‘Schools Teams’ to mitigate SARS-CoV-2 school transmission, 2020/2021. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
The SARS-CoV-2 pandemic disrupted the lives of up to 100,000 school-going children in Ireland. Consequently, intersectoral ‘Schools Teams’ were established for the 2020/2021 school year to reduce SARS-CoV-2 transmission in school settings. This novel public health intervention provides learning to inform future cross-sectoral collaborative work in Public Health in responding to infectious disease threats. For the 2020/2021 school year in Ireland, intersectoral Schools Teams were formed within each of eight regional Departments of Public Health to manage mitigation of SARS-CoV-2 transmission in school settings. These teams comprised of staff from Departments of Public Health and redeployed staff from the Department of Education. A nationally agreed schools process was followed by Schools Teams to manage SARS-CoV-2 cases and outbreaks in schools. Relevant cases were referred to the regional Schools Team for a public health risk assessment (PHRA). Close contacts were determined using appropriate definitions of close contact within a school setting through the PHRA. This model with centralised procedures and linked health/education teams was novel and adaptable to additional settings. Results from the East region of Ireland showed testing of close contacts of COVID-19 was conducted in 71.8% (676/942) of schools, with 43881 tests completed. Most Schools Team members reported efficient communication within the team (88.7%), a positive team culture (96.3%) and feeling comfortable in their roles following training (82.7%). The majority of members felt the team was able to effectively support schools to reduce COVID-19 transmission (92.5%). Lessons learnt include the synergistic working of educational and health professionals towards a common goal, maximising the skills of all, ensuring a better outcome for school children. Involving educational teams in active contact tracing of COVID-19 cases in schools maximised engagement of the educational sector in the COVID-19 response.
Key messages
• Establishing intersectoral ‘Schools Teams’ pooled skills, resources and expertise, enabling development of synergistic solutions to a complex problem.
• This exemplifies a large national cross-sectoral collaborative working process involving education and public health sectors, providing a model for future responses to infectious disease threats.
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Characteristics of enrolment in an intensive home-visiting programme among eligible first-time adolescent mothers in England: a linked administrative data cohort study. J Epidemiol Community Health 2022; 76:991-998. [PMID: 36198485 DOI: 10.1136/jech-2021-217986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/24/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Intensive home visiting for adolescent mothers may help reduce health disparities. Given limited resources, such interventions need to be effectively targeted. We evaluated which mothers were enrolled in the Family Nurse Partnership (FNP), an intensive home-visiting service for first-time young mothers commissioned in >130 local authorities in England since 2007. METHODS We created a population-based cohort of first-time mothers aged 13-19 years giving birth in English National Health Service hospitals between 1 April 2010 and 31 March 2017, using administrative hospital data linked with FNP programme, educational and social care data. Mothers living in a local authority with an active FNP site were eligible. We described variation in enrolment rates across sites, and identified maternal and FNP site characteristics associated with enrolment. RESULTS Of 110 520 eligible mothers, 25 680 (23.2% (95% CI: 23.0% to 23.5%)) were enrolled. Enrolment rates varied substantially across 122 sites (range: 11%-68%), and areas with greater numbers of first-time adolescent mothers achieved lower enrolment rates. Mothers aged 13-15 years were most likely to be enrolled (52%). However, only 26% of adolescent mothers with markers of vulnerability (including living in the most deprived areas and ever having been looked after as a child) were enrolled. CONCLUSION A substantial proportion of first-time adolescent mothers with vulnerability markers were not enrolled in FNP. Variation in enrolment across sites indicates insufficient commissioning of places that is not proportional to level of need, with mothers in areas with large numbers of other adolescent mothers least likely to receive support.
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Risk factors associated with indicators of dairy cow welfare during the housing period in Irish, spring-calving, hybrid pasture-based systems. Prev Vet Med 2022; 208:105760. [PMID: 36181750 DOI: 10.1016/j.prevetmed.2022.105760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 10/31/2022]
Abstract
In a dairy production system where cows are grazing for a large portion of their lactation, little attention has been afforded to investigating multiple indicators of welfare for risk factors associated with the housing period. Yet regardless of the length of the housing period, cows still experience the positive and negative welfare impacts of both indoor and outdoor environments in a hybrid system. Thus, the objective of this study was to identify risk factors for indicators of dairy cow welfare during the housing period in a spring-calving, hybrid pasture-based system. Herd-level scores for seven indicators of welfare (locomotion, body condition, ocular and nasal discharge, integument damage, tail injury and human avoidance response) were collected from 82 Irish dairy farms during the housing period (October - February). Data were analysed using multiple beta regression or zero-inflated beta regression to identify associations between these welfare indicators and measured herd-level housing, resource and management factors. Thirty-six unique risk factors were associated with one or more welfare indicators (P < 0.05). Analyses identified two risk factors for body condition < 3.0 and four for body condition > 3.5, the target range during the housing period. Four risk factors were identified for each of ocular discharge, nasal discharge and avoidance response of > 1 m from human approach. Six risk factors each were associated with the proportion of lame cows and integument damage to the head-neck-back or hindquarter regions. The greatest number of risk factors, 12, were associated with tail injury (broken, lacerated or incomplete tails). Risk factors associated with multiple indicators of welfare were cow comfort index (tail lacerations and hindquarter integument damage), cubicle width (broken and incomplete tails), shed floor slipperiness (lameness and head-neck-back integument damage), shed light-level (tail lacerations, avoidance response and below target body condition), shed passage width (broken tails and head-neck-back integument damage) and presence (incomplete tails) or absence (broken tails) of a collecting yard backing gate. With the large number of risk factors associated with tail injury, continued research is necessary to identify causes and determine prevention methods to contribute to improved overall welfare of dairy cows. Housing features meeting recommended guidelines from the literature were frequently associated with greater negative indicators of welfare. In light of this, housing guidelines may benefit from regular re-evaluation to ensure facilities meet the welfare needs of cows during the housing period.
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Evaluation of the real-world implementation of the Family Nurse Partnership in England: an observational cohort study using linked data from health, education and children’s social care. Int J Popul Data Sci 2022. [DOI: 10.23889/ijpds.v7i3.1831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
ObjectivesThe Family Nurse Partnership (FNP) is an early home visiting service supporting young mothers. A randomised controlled trial of FNP in England found no effect on short-term primary outcomes or maltreatment up to age seven, but positive impacts on educational outcomes by age 7. We report preliminary results of an evaluation of FNP using linked administrative data.
ApproachWe constructed a cohort of all mothers aged 13-19 and their firstborn child(ren) giving birth between 2010 and 2017, using linked administrative data from hospital admissions (Hospital Episode Statistics) and education and social care (National Pupil Database). We evaluated differences in a range of policy relevant child and maternal outcomes, comparing mothers who were enrolled in FNP with those who were not using propensity score matching.
ResultsOf 110,960 mothers in our linked cohort, 26,290 (24%) were enrolled in FNP. FNP mothers were younger, more deprived, and more likely to have adversity or social care histories than mothers not enrolled. Preliminary results suggest that FNP was not associated with fewer unplanned hospital admissions for injury / maltreatment by age two, improved child development at age 4, persistent school absence or children looked after in out-of-home care by age 7, or improved maternal outcomes. Some adverse outcomes appeared to be increased in the FNP group. We will present findings amongst subgroups of younger maternal age (13-15 years), increased deprivation according to quintile of Index of Multiple Deprivation, and adversity and social care history. We also present sensitivity analyses that aim to minimise confounding.
ConclusionOur study supports findings from previous trials of FNP showing little benefit for measured child and maternal outcomes. Interpretation of results needs careful consideration of the impact of residual confounding due to unmeasured or undisclosed factors (e.g. family violence) linked to targeting of FNP to higher risk mothers, and surveillance bias.
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Challenges and lessons learned from two countries using linked administrative data to evaluate the Family Nurse Partnership. Int J Popul Data Sci 2022. [DOI: 10.23889/ijpds.v7i3.1833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
ObjectivesWe describe the challenges and lessons learned from two studies using linked administrative data from health, education and social care sectors to evaluate the Family Nurse Partnership (FNP), an intervention supporting adolescent mothers in England(E) and Scotland(S). We present recommendations for studies using linked administrative data to evaluate complex interventions.
ApproachWe constructed two cohorts of all mothers aged 13-19 giving birth in NHS hospitals in England and Scotland between 2010-2016/17 using linkage of mothers and babies in hospital admissions data (E:Hospital Episode Statistics/S:Maternity Inpatient and Day Case), and identified FNP participation through linkage to FNP programme data. We additionally linked to health, educational and social care data for mothers and their babies (E:National Pupil Database/S:eDRIS). We used these data to identify key risk factors for enrolment in the FNP, assess the effect of the FNP on maternal and child outcomes, and determine programme characteristics modifying the effect of the FNP.
ResultsKey challenges: characterising the intervention and usual care, understanding quality of multi-sector data linkage, data access delays, constructing appropriate comparator groups and interpreting outcomes captured in administrative data. Lessons learned: evaluations require detailed data on intervention activity (dates/geography), and assessment of usual care, which are rarely readily available and are time-consuming to gather; data linkage quality is variable/not available, making defining denominators challenging; data access delays impeded on data analysis time; unmeasured confounders not captured in administrative data may prevent generation of an appropriate comparator group. Recommendations: Characteristics informing targeting should be explicitly documented, and could be enhanced using linked primary care data and information on household members (e.g. fathers). Process evaluation and qualitative research could help to provide better understanding of mechanisms of effect.
ConclusionLinkage of administrative data presents exciting opportunities for efficient evaluation of large-scale, complex public health interventions. However, sufficient information is needed on programme meta-data, targeting and important confounders in order to generate meaningful results. Study findings should help stimulate exploration with practitioners about how programmes can be improved.
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A modified video-feedback intervention for carers of foster children aged 6 years and under with reactive attachment disorder: a feasibility study and pilot RCT. Health Technol Assess 2022; 26:1-106. [PMID: 35959710 DOI: 10.3310/sliz1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Looked-after children are at risk of suboptimal attachment patterns and reactive attachment disorder. However, access to interventions varies widely and there are no evidence-based interventions for this disorder. OBJECTIVES (1) To adapt an existing video-feedback intervention to meet the specific needs of foster children in the UK with reactive attachment symptoms, (2) to conduct a case series to road-test the treatment manual and study procedures, (3) to conduct a scoping study of the key hurdles in a pilot trial and (4) to conduct a pilot randomised controlled trial of the adapted intervention to determine the feasibility of a future full-scale trial. DESIGN This was a mixed-methods study. The adapted treatment manual was developed with expert input and tested on a small case series. Qualitative interviews with key stakeholders were used in the scoping study in preparation for the trial and later with foster carers who received the new intervention. The final stage was a feasibility and pilot randomised controlled trial of the new intervention, compared with usual care. Researchers assessing the outcomes were blinded to group assignment. SETTING The study was set in outpatient child and adolescent mental health services and partner social services departments. Sites included urban and rural/semirural areas. PARTICIPANTS Participants were foster carers with children aged ≤ 6 years presenting with difficulties in the domain of reactive attachment disorder. Key stakeholders included children's services managers and mental health service practitioners in the scoping study. Foster carers who received the modified intervention participated in qualitative interviews. INTERVENTION The video-feedback intervention to promote positive parenting and sensitive discipline is an extensively evaluated and effective treatment approach. This intervention was modified (based on the adapted version for foster care in the Netherlands) to suit the needs of young children with reactive attachment symptoms in foster care in the UK and was delivered to improve the sensitive responding of foster carers, foster carer-child relationships and child outcomes. The modified intervention was delivered in-home by trained mental health professionals over a period of 4-6 months. MAIN OUTCOME MEASURE The main outcome was reactive attachment symptom scores on the Disturbances of Attachment Interview. RESULTS A series of minor changes to the intervention programme were introduced, which focused on improving its suitability for the UK foster care context. Challenges in recruitment meant that, despite numerous modifications to the protocol and the inclusion of additional sites, only 30 families (target, n = 40) were recruited to the randomised controlled trial (15 allocated to each group). However, most other trial parameters were deemed feasible and acceptable, particularly the high levels of data and treatment completeness. All randomised families were available for baseline analyses, but two in the treatment arm were not available for post-treatment analyses. The revised intervention was positively received by practitioners and foster carers. LIMITATIONS Only three-quarters of the target sample size was recruited. Furthermore, the sites' own exclusion of potential participants and the low return rates of screening questionnaires raise the possibility of non-randomness of non-responses. CONCLUSION A larger-scale trial may be feasible, but only if recruitment barriers can be overcome. Dedicated resources to support recruitment within local authorities and wider inclusion criteria are recommended. Central resourcing of intervention capacity to supplement NHS staff is also recommended. TRIAL REGISTRATION This trial is registered as ISRCTN18374094. FUNDING This project was funded by the National Institute for Health and Care Research ( NIHR ) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 35. See the NIHR Journals Library website for further project information.
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Children in foster care with symptoms of reactive attachment disorder: feasibility randomised controlled trial of a modified video-feedback parenting intervention. BJPsych Open 2022; 8:e134. [PMID: 35848060 PMCID: PMC9347233 DOI: 10.1192/bjo.2022.538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Looked-after children are at risk of suboptimal attachment patterns and reactive attachment disorder (RAD). However, access to interventions varies widely, and there are no evidence-based interventions for RAD. AIMS To modify an existing parenting intervention for children with RAD in the UK foster care setting, and test the feasibility of conducting a randomised controlled trial (RCT) of the modified intervention. METHOD The intervention was modified with expert input and tested on a case series. A feasibility and pilot RCT compared the new intervention with usual care. Foster carers and children in their care aged ≤6 years were recruited across nine local authorities, with 1:1 allocation and blind post-treatment assessments. The modified intervention was delivered in-home by trained mental health professionals over 4-6 months. Children were assessed for RAD symptoms, attachment quality and emotional/behavioural difficulties, and foster carers were assessed for sensitivity and stress. RESULTS Minimal changes to the intervention programme were necessary, and focused on improving its suitability for the UK foster care context. Recruitment was challenging, and remained below target despite modifications to the protocol and the inclusion of additional sites. Thirty families were recruited to the RCT; 15 were allocated to each group. Most other feasibility outcomes were favourable, particularly high numbers of data and treatment completeness. The revised intervention was positively received by practitioners and foster carers. CONCLUSIONS A large-scale trial may be feasible, but only if recruitment barriers can be overcome. Dedicated resources to support recruitment within local authorities and wider inclusion criteria are recommended.
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Lameness prevalence and management practices on Irish pasture-based dairy farms. Ir Vet J 2022; 75:14. [PMID: 35672794 PMCID: PMC9175467 DOI: 10.1186/s13620-022-00221-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background Lameness is a painful disease, which negatively impacts dairy cow production and welfare. The aim of this observational study was to determine herd lameness prevalence, describe current lameness management practices and identify the presence of established risk factors for lameness on Irish pasture-based dairy farms. Farms were visited once during grazing (99 farms) and again during housing (85 farms). Lameness scoring was carried out at each visit (AHDB 0–3 scale); cows were classified as lame if they scored two or three. Farm management practices and infrastructure characteristics were evaluated via farmer questionnaires and direct measurements of farm infrastructure. Results Median herd-level lameness prevalence was 7.9% (interquartile range = 5.6 – 13.0) during grazing and 9.1% (interquartile range = 4.9 – 12.0) during housing; 10.9% of cows were lame at a single visit and 3.5% were lame at both visits (chronically lame or had a repeat episode of lameness). Fifty-seven percent of farmers were not familiar with lameness scoring and only one farm carried out lameness scoring. Only 22% of farmers kept records of lame cows detected, and 15% had a lameness herd health plan. Twenty-eight percent of farmers waited more than 48 h to treat a lame cow, and 21% waited for more than one cow to be identified as lame before treating. Six percent of farmers carried out routine trimming and 31% regularly footbathed (> 12 times per year). Twelve percent put severely lame cows in a closer paddock and 8% stated that they used pain relief to treat severely lame cows. Over 50% of farms had at least one cow track measurement that was classified as rough or very rough, and cow tracks were commonly narrow for the herd size. On 6% of farms, all cubicle beds were bare concrete (no matting or bedding) and on a further 6% of farms, there was a combination of cubicles with and without matting or bedding. On 56% of farms, all pens contained less than 1.1 cubicles per cow and on 28% of farms, a proportion of pens contained less than 1.1 cubicles per cow. Conclusions Overall, this study identified infrastructure and management practices which could be improved upon. The comparatively low lameness prevalence demonstrated, compared to fully housed systems, also highlights the benefits of a pasture-based system for animal welfare; however, there remains scope for improvement.
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Risk factors associated with the welfare of grazing dairy cows in spring-calving, hybrid pasture-based systems. Prev Vet Med 2022; 204:105640. [DOI: 10.1016/j.prevetmed.2022.105640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 03/22/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
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The effect of weaning age and post-weaning feeding regime on growth and fertility of pasture-based Holstein-Friesian and Jersey dairy heifers. Livest Sci 2022. [DOI: 10.1016/j.livsci.2021.104812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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2021 Canadian Surgery Forum01. Design and validation of a unique endoscopy simulator using a commercial video game03. Is ethnicity an appropriate measure of health care marginalization?: A systematic review and meta-analysis of the outcomes of diabetic foot ulceration in the Aboriginal population04. Racial disparities in surgery — a cross-specialty matched comparison between black and white patients05. Starting late does not increase the risk of postoperative complications in patients undergoing common general surgical procedures06. Ethical decision-making during a health care crisis: a resource allocation framework and tool07. Ensuring stability in surgical training program leadership: a survey of program directors08. Introducing oncoplastic breast surgery in a community hospital09. Leadership development programs for surgical residents: a review of the literature10. Superiority of non-opioid postoperative pain management after thyroid and parathyroid operations: a systematic review and meta-analysis11. Timing of ERCP relative to cholecystectomy in patients with ductal gallstone disease12. A systematic review and meta-analysis of randomized controlled trials comparing intraoperative red blood cell transfusion strategies13. Postoperative outcomes after frail elderly preoperative assessment clinic: a single-institution Canadian perspective14. Selective opioid antagonists following bowel resection for prevention of postoperative ileus: a systematic review and meta-analysis15. Peer-to-peer coaching after bile duct injury16. Laparoscopic median arcuate ligament release: a video abstract17. Retroperitoneoscopic approach to adrenalectomy19. Endoscopic Zenker diverticulotomy: a video abstract20. Variability in surgeons’ perioperative management of pheochromocytomas in Canada21. The contribution of surgeon and hospital variation in transfusion practice to outcomes for patients undergoing elective gastrointestinal cancer surgery: a population-based analysis22. Perioperative transfusions for gastroesophageal cancers: risk factors and short- and long-term outcomes23. The association between frailty and time alive and at home after cancer surgery among older adults: a population-based analysis24. Psychological and workplace-related effects of providing surgical care during the COVID-19 pandemic in British Columbia, Canada25. Safety of venous thromboembolism prophylaxis in endoscopic retrograde cholangiopancreatography: a systematic review26. Complications and reintervention following laparoscopic subtotal cholecystectomy: a systematic review and meta-analysis27. Synchronization of pupil dilations correlates with team performance in a simulated laparoscopic team coordination task28. Receptivity to and desired design features of a surgical peer coaching program: an international survey9. Impact of the COVID-19 pandemic on rates of emergency department utilization due to general surgery conditions30. The impact of the current COVID-19 pandemic on the exposure of general surgery trainees to operative procedures31. Association between academic degrees and research productivity: an assessment of academic general surgeons in Canada32. Laparoscopic endoscopic cooperative surgery (LECS) for subepithelial gastric lesion: a video presentation33. Effect of the COVID-19 pandemic on acute care general surgery at an academic Canadian centre34. Opioid-free analgesia after outpatient general surgery: a pilot randomized controlled trial35. Impact of neoadjuvant immunotherapy or targeted therapies on surgical resection in patients with solid tumours: a systematic review and meta-analysis37. Surgical data recording in the operating room: a systematic review of modalities and metrics38. Association between nonaccidental trauma and neighbourhood socioeconomic status during the COVID-19 pandemic: a retrospective analysis39. Laparoscopic repair of a transdiaphragmatic gastropleural fistula40. Video-based interviewing in medicine: a scoping review41. Indocyanine green fluorescence angiography for prevention of anastomotic leakage in colorectal surgery: a cost analysis from the hospital payer’s perspective43. Perception or reality: surgical resident and faculty assessments of resident workload compared with objective data45. When illness and loss hit close to home: Do health care providers learn how to cope?46. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial47. The evolving use of robotic surgery: a population-based analysis48. Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies49. Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study on anastomotic complications50. A lay of the land — a description of Canadian academic acute care surgery models51. Emergency general surgery in Ontario: interhospital variability in structures, processes and models of care52. Trauma 101: a virtual case-based trauma conference as an adjunct to medical education53. Assessment of the National Surgical Quality Improvement Program Surgical Risk Calculator for predicting patient-centred outcomes of emergency general surgery patients in a Canadian health care system54. Sustainability of a narcotic reduction initiative: 1 year following the Standardization of Outpatient Procedure (STOP) Narcotics Study55. Barriers to transanal endoscopic microsurgery referral56. Geospatial analysis of severely injured rural patients in a geographically complex landscape57. Implementation of an incentive spirometry protocol in a trauma ward: a single-centre pilot study58. Impostor phenomenon is a significant risk factor for burnout and anxiety in Canadian resident physicians: a cross-sectional survey59. Understanding the influence of perioperative education on performance among surgical trainees: a single-centre experience60. The effect of COVID-19 pandemic on current and future endoscopic personal protective equipment practices: a national survey of 77 endoscopists61. Case report: delayed presentation of perforated sigmoid diverticulitis as necrotizing infection of the lower limb62. Investigating disparities in surgical outcomes in Canadian Indigenous populations63. Fundoplication is superior to medical therapy for Barrett esophagus disease regression and progression: a systematic review and meta-analysis64. Development of a novel online general surgery learning platform and a qualitative preimplementation analysis65. Hagfish slime exudate as a potential novel hemostatic agent: developing a standardized assessment protocol66. The effect of the first wave of the COVID-19 pandemic on surgical oncology case volumes and wait times67. Safety of same-day discharge in high-risk patients undergoing ambulatory general surgery68. External validation of the Codman score in colorectal surgery: a pragmatic tool to drive quality improvement69. Improved morbidity and gastrointestinal restoration rates without compromising survival rates for diverting loop ileostomy with colonic lavage versus total abdominal colectomy for fulminant Clostridioides difficile colitis: a multicentre retrospective cohort study70. Potential access to emergency general surgical care in Ontario71. Immersive virtual reality (iVR) improves procedural duration, task completion and accuracy in surgical trainees: a systematic review01. Clinical validation of the Canada Lymph Node Score for endobronchial ultrasound02. Venous thromboembolism in surgically treated esophageal cancer patients: a provincial population-based study03. Venous thromboembolism in surgically treated lung cancer patients: a population-based study04. Is frailty associated with failure to rescue after esophagectomy? A multi-institutional comparative analysis of outcomes05. Routine systematic sampling versus targeted sampling of lymph nodes during endobronchial ultrasound: a feasibility randomized controlled trial06. Gastric ischemic conditioning reduces anastomotic complications in patients undergoing esophagectomy: a systematic review and meta-analysis07. Move For Surgery, a novel preconditioning program to optimize health before thoracic surgery: a randomized controlled trial08. In case of emergency, go to your nearest emergency department — Or maybe not?09. Does preoperative SABR increase the risk of complications from lung cancer resection? A secondary analysis of the MISSILE trial10. Segmental resection for lung cancer: the added value of near-infrared fluorescence mapping diminishes with surgeon experience11. Toward competency-based continuing professional development for practising surgeons12. Stereotactic body radiotherapy versus surgery in older adults with NSCLC — a population-based, matched analysis of long-term dependency outcomes13. Role of adjuvant therapy in esophageal cancer patients after neoadjuvant therapy and curative esophagectomy: a systematic review and meta-analysis14. Evaluation of population characteristics on the incidence of thoracic empyema: an ecological study15. Determining the optimal stiffness colour threshold and stiffness area ratio cut-off for mediastinal lymph node staging using EBUS elastography and AI: a pilot study16. Quality assurance on the use of sequential compression stockings in thoracic surgery (QUESTs)17. The relationship between fissureless technique and prolonged air leak for patients undergoing video-assisted thoracoscopic lobectomy18. CXCR2 inhibition as a candidate for immunomodulation in the treatment of K-RAS-driven lung adenocarcinoma19. Assessment tools for evaluating competency in video-assisted thoracoscopic lobectomy: a systematic review20. Understanding the current practice on chest tube management following lung resection among thoracic surgeons across Canada21. Effect of routine jejunostomy tube insertion in esophagectomy: a systematic review and meta-analysis22. Recurrence of primary spontaneous pneumothorax following bullectomy with pleurodesis or pleurectomy: a retrospective analysis23. Surgical outcomes following chest wall resection and reconstruction24. Outcomes following surgical management of primary mediastinal nonseminomatous germ cell tumours25. Does robotic approach offer better nodal staging than thoracoscopic approach in anatomical resection for non–small cell lung cancer? A single-centre propensity matching analysis26. Competency assessment for mediastinal mass resection and thymectomy: design and Delphi process27. The contemporary significance of venous thromboembolism (deep venous thrombosis [DVT] and pulmonary embolus [PE]) in patients undergoing esophagectomy: a prospective, multicentre cohort study to evaluate the incidence and clinical outcomes of VTE after major esophageal resections28. Esophageal cancer: symptom severity at the end of life29. The impact of pulmonary artery reconstruction on postoperative and oncologic outcomes: a systematic review30. Association with surgical technique and recurrence after laparoscopic repair of paraesophageal hernia: a single-centre experience31. Enhanced recovery after surgery (ERAS) in esophagectomy32. Surgical treatment of esophageal cancer: trends in surgical approach and early mortality at a single institution over the past 18 years34. Adverse events and length of stay following minimally invasive surgery in paraesophageal hernia repair35. Long-term symptom control comparison of Dor and Nissen fundoplication following laparoscopic para-esophageal hernia repair: a retrospective analysis36. Willingness to pay: a survey of Canadian patients’ willingness to contribute to the cost of robotic thoracic surgery37. Radiomics in early-stage lung adenocarcinoma: a prediction tool for tumour immune microenvironments38. Effectiveness of intraoperative pyloric botox injection during esophagectomy: how often is endoscopic intervention required?39. An artificial intelligence algorithm for predicting lymph node malignancy during endobronchial ultrasound40. The effect of major and minor complications after lung surgery on length of stay and readmission41. Measuring cost of adverse events following thoracic surgery: a scoping review42. Laparoscopic paraesophageal hernia repair: characterization by hospital and surgeon volume and impact on outcomes43. NSQIP 5-Factor Modified Frailty Index predicts morbidity but not mortality after esophagectomy44. Trajectory of perioperative HRQOL and association with postoperative complications in thoracic surgery patients45. Variation in treatment patterns and outcomes for resected esophageal cancer at designated thoracic surgery centres46. Patient-reported pretreatment health-related quality of life (HRQOL) predicts short-term survival in esophageal cancer patients47. Analgesic efficacy of surgeon-placed paravertebral catheters compared with thoracic epidural analgesia after Ivor Lewis esophagectomy: a retrospective noninferiority study48. Rapid return to normal oxygenation after lung surgery49. Examination of local and systemic inflammatory changes during lung surgery01. Implications of near-infrared imaging and indocyanine green on anastomotic leaks following colorectal surgery: a systematic review and meta-analysis02. Repeat preoperative endoscopy after regional implementation of electronic synoptic endoscopy reporting: a retrospective comparative study03. Consensus-derived quality indicators for operative reporting in transanal endoscopic surgery (TES)04. Colorectal lesion localization practices at endoscopy to facilitate surgical and endoscopic planning: recommendations from a national consensus Delphi process05. Black race is associated with increased mortality in colon cancer — a population-based and propensity-score matched analysis06. Improved survival in a cohort of patients 75 years and over with FIT-detected colorectal neoplasms07. Laparoscopic versus open loop ileostomy reversal: a systematic review and meta-analysis08. Posterior mesorectal thickness as a predictor of increased operative time in rectal cancer surgery: a retrospective cohort study09. Improvement of colonic anastomotic healing in mice with oral supplementation of oligosaccharides10. How can we better identify patients with rectal bleeding who are at high risk of colorectal cancer?11. Assessment of long-term bowel dysfunction in rectal cancer survivors: a population-based cohort study12. Observational versus antibiotic therapy for acute uncomplicated diverticulitis: a noninferiority meta-analysis based on a Delphi consensus13. Radiotherapy alone versus chemoradiotherapy for stage I anal squamous cell carcinoma: a systematic review and meta-analysis14. Is the Hartmann procedure for diverticulitis obsolete? National trends in colectomy for diverticulitis in the emergency setting from 1993 to 201515. Sugammadex in colorectal surgery: a systematic review and meta-analysis16. Sexuality and rectal cancer treatment: a qualitative study exploring patients’ information needs and expectations on sexual dysfunction after rectal cancer treatment17. Video-based interviews in selection process18. Impact of delaying colonoscopies during the COVID-19 pandemic on colorectal cancer detection and prevention19. Opioid use disorder associated with increased anastomotic leak and major complications after colorectal surgery20. Effectiveness of a rectal cancer education video on patient expectations21. Robotic-assisted rectosigmoid and rectal cancer resection: implementation and early experience at a Canadian tertiary centre22. An online educational app for rectal cancer survivors with low anterior resection syndrome: a pilot study23. The effects of surgeon specialization on the outcome of emergency colorectal surgery24. Outcomes after colorectal cancer resections in octogenarians and older in a regional New Zealand setting — What are the predictors of mortality?25. Long-term outcomes after seton placement for perianal fistulae with and without Crohn disease26. A survey of patient and surgeon preference for early ileostomy closure following restorative proctectomy for rectal cancer — Why aren’t we doing it?27. Crohn disease independently associated with longer hospital admission after surgery28. Short-stay (≤ 1 d) diverting loop ileostomy closure can be selectively implemented without an increase in readmission and complication rates: an ACS-NSQIP analysis29. A comparison of perineal stapled rectal prolapse resection and the Altemeier procedure at 2 Canadian academic hospitals30. Mental health and substance use disorders predict 90-day readmission and postoperative complications following rectal cancer surgery31. Early discharge after colorectal cancer resection: trends and impact on patient outcomes32. Oral antibiotics without mechanical bowel preparation prior to emergency colectomy reduces the risk of organ space surgical site infections: a NSQIP propensity score matched study33. The impact of robotic surgery on a tertiary care colorectal surgery program, an assessment of costs and short-term outcomes — a Canadian perspective34. Should we scope beyond the age limit of guidelines? Adenoma detection rates and outcomes of screening and surveillance colonoscopies in patients aged 75–79 years35. Emergency department admissions for uncomplicated diverticulitis: a nationwide study36. Obesity is associated with a complicated episode of acute diverticulitis: a nationwide study37. Green indocyanine angiography for low anterior resection in patients with rectal cancer: a prospective before-and-after study38. The impact of age on surgical recurrence of fibrostenotic ileocolic Crohn disease39. A qualitative study to explore the optimal timing and approach for the LARS discussion01. Racial, ethnic and socioeconomic disparities in diagnosis, treatment and survival of patients with breast cancer: a SEER-based population analysis02. First-line palliative chemotherapy for esophageal and gastric cancer: practice patterns and outcomes in the general population03. Frailty as a predictor for postoperative outcomes following pancreaticoduodenectomy04. Synoptic electronic operative reports identify practice variation in cancer surgery allowing for directed interventions to decrease variation05. The role of Hedgehog signalling in basal-like breast cancer07. Clinical and patient-reported outcomes in oncoplastic breast conservation surgery from a single surgeon’s practice in a busy community hospital in Canada08. Upgrade rate of atypical ductal hyperplasia: 10 years of experience and predictive factors09. Time to first adjuvant treatment after oncoplastic breast reduction10. Preparing to survive: improving outcomes for young women with breast cancer11. Opioid prescription and consumption in patients undergoing outpatient breast surgery — baseline data for a quality improvement initiative12. Rectal anastomosis and hyperthermic intraperitoneal chemotherapy: Should we avoid diverting loop ileostomy?13. Delays in operative management of early-stage, estrogen-receptor positive breast cancer during the COVID-19 pandemic — a multi-institutional matched historical cohort study14. Opioid prescribing practices in breast oncologic surgery15. Oncoplastic breast reduction (OBR) complications and patient-reported outcomes16. De-escalating breast cancer surgery: Should we apply quality indicators from other jurisdictions in Canada?17. The breast cancer patient experience of telemedicine during COVID-1918. A novel ex vivo human peritoneal model to investigate mechanisms of peritoneal metastasis in gastric adenocarcinoma (GCa)19. Preliminary uptake and outcomes utilizing the BREAST-Q patient-reported outcomes questionnaire in patients following breast cancer surgery20. Routine elastin staining improves detection of venous invasion and enhances prognostication in resected colorectal cancer21. Analysis of exhaled volatile organic compounds: a new frontier in colon cancer screening and surveillance22. A clinical pathway for radical cystectomy leads to a shorter hospital stay and decreases 30-day postoperative complications: a NSQIP analysis23. Fertility preservation in young breast cancer patients: a population-based study24. Investigating factors associated with postmastectomy unplanned emergency department visits: a population-based analysis25. Impact of patient, tumour and treatment factors on psychosocial outcomes after treatment in women with invasive breast cancer26. The relationship between breast and axillary pathologic complete response in women receiving neoadjuvant chemotherapy for breast cancer01. The association between bacterobilia and the risk of postoperative complications following pancreaticoduodenectomy02. Surgical outcome and quality of life following exercise-based prehabilitation for hepatobiliary surgery: a systematic review and meta-analysis03. Does intraoperative frozen section and revision of margins lead to improved survival in patients undergoing resection of perihilar cholangiocarcinoma? A systematic review and meta-analysis04. Prolonged kidney procurement time is associated with worse graft survival after transplantation05. Venous thromboembolism following hepatectomy for colorectal metastases: a population-based retrospective cohort study06. Association between resection approach and transfusion exposure in liver resection for gastrointestinal cancer07. The association between surgeon volume and use of laparoscopic liver resection for gastrointestinal cancer08. Immune suppression through TIGIT in colorectal cancer liver metastases09. “The whole is greater than the sum of its parts” — a combined strategy to reduce postoperative pancreatic fistula after pancreaticoduodenectomy10. Laparoscopic versus open synchronous colorectal and hepatic resection for metastatic colorectal cancer11. Identifying prognostic factors for overall survival in patients with recurrent disease following liver resection for colorectal cancer metastasis12. Modified Blumgart pancreatojejunostomy with external stenting in laparoscopic Whipple reconstruction13. Laparoscopic versus open pancreaticoduodenectomy: a single centre’s initial experience with introduction of a novel surgical approach14. Neoadjuvant chemotherapy versus upfront surgery for borderline resectable pancreatic cancer: a single-centre cohort analysis15. Thermal ablation and telemedicine to reduce resource utilization during the COVID-19 pandemic16. Cost-utility analysis of normothermic machine perfusion compared with static cold storage in liver transplantation in the Canadian setting17. Impact of adjuvant therapy on overall survival in early-stage ampullary cancers: a single-centre retrospective review18. Presence of biliary anaerobes enhances response to neoadjuvant chemotherapy in pancreatic ductal adenocarcinoma19. How does tumour viability influence the predictive capability of the Metroticket model? Comparing predicted-to-observed 5-year survival after liver transplant for hepatocellular carcinoma20. Does caudate resection improve outcomes in patients undergoing curative resection for perihilar cholangiocarcinoma? A systematic review and meta-analysis21. Appraisal of multivariable prognostic models for postoperative liver decompensation following partial hepatectomy: a systematic review22. Predictors of postoperative liver decompensation events following resection in patients with cirrhosis and hepatocellular carcinoma: a population-based study23. Characteristics of bacteriobilia and impact on outcomes after Whipple procedure01. Inverting the y-axis: the future of MIS abdominal wall reconstruction is upside down02. Progressive preoperative pneumoperitoneum: a single-centre retrospective study03. The role of radiologic classification of parastomal hernia as a predictor of the need for surgical hernia repair: a retrospective cohort study04. Comparison of 2 fascial defect closure methods for laparoscopic incisional hernia repair01. Hypoalbuminemia predicts serious complications following elective bariatric surgery02. Laparoscopic adjustable gastric band migration inducing jejunal obstruction associated with acute pancreatitis: aurgical approach of band removal03. Can visceral adipose tissue gene expression determine metabolic outcomes after bariatric surgery?04. Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: a systematic review and meta-analysis05. A prediction model for delayed discharge following gastric bypass surgery06. Experiences and outcomes of Indigenous patients undergoing bariatric surgery: a mixed-methods scoping review07. What is the optimal common channel length in revisional bariatric surgery?08. Laparoscopic management of internal hernia in a 34-week pregnant woman09. Characterizing timing of postoperative complications following elective Roux-en-Y gastric bypass and sleeve gastrectomy10. Canadian trends in bariatric surgery11. Common surgical stapler problems and how to correct them12. Management of choledocholithiasis following Roux-en-Y gastric bypass: a systematic review and meta-analysis. Can J Surg 2021; 64:S80-S159. [PMID: 35483046 PMCID: PMC8677574 DOI: 10.1503/cjs.021321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Safety and activity of alectinib plus bevacizumab in patients with advanced ALK-rearranged non-small-cell lung cancer: a phase I/II study. ESMO Open 2021; 7:100342. [PMID: 34896762 PMCID: PMC8666648 DOI: 10.1016/j.esmoop.2021.100342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 12/20/2022] Open
Abstract
Background Alectinib, a second-generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor (TKI), is highly effective in advanced ALK-rearranged non-small-cell lung cancer and represents a standard first-line therapy. New strategies are needed, however, to delay resistance. We conducted a phase I/II study to assess the safety and efficacy of combining alectinib with bevacizumab, a monoclonal antibody against vascular endothelial growth factor. Patients and methods Patients with advanced ALK-rearranged non-squamous non-small-cell lung cancer were enrolled. The phase I portion employed a dose de-escalation strategy with alectinib and bevacizumab starting at the individual standard doses. The primary objective was to determine the recommended phase II dose (RP2D). In phase II, the primary objective was to evaluate the safety of the combination at the RP2D; the secondary objective was to determine extracranial and intracranial efficacy. Results Eleven patients were enrolled between September 2015 and February 2020. Most patients (82%) had baseline brain metastases. Six patients (55%) were treatment-naive; five (46%) had received prior ALK TKIs (crizotinib, n = 3; ceritinib, n = 1; crizotinib then brigatinib, n = 1). No dose-limiting toxicities occurred. RP2D was determined as alectinib 600 mg orally twice daily plus bevacizumab 15 mg/kg intravenously every 3 weeks. Three patients experienced grade 3 treatment-related adverse events: pneumonitis related to alectinib, proteinuria related to bevacizumab, and hypertension related to bevacizumab. Treatment-related intracranial hemorrhage was not observed. Six (100%) of six treatment-naive patients and three (60%) of five ALK TKI-pretreated patients had objective responses; median progression-free survival was not reached (95% confidence interval, 9.0 months-not reached) and 9.5 months (95% confidence interval, 4.3 months-not reached), respectively. Intracranial responses occurred in four (100%) of four treatment-naive and three (60%) of five TKI-pretreated patients with baseline brain metastases. The study was stopped prematurely because of slow accrual. Conclusions Alectinib plus bevacizumab was well tolerated without unanticipated toxicities or dose-limiting toxicities. Alectinib plus bevacizumab is safe in patients with advanced ALK-rearranged non-small-cell lung cancer. Bevacizumab combined with alectinib does not increase risk of intracranial hemorrhage in patients with brain metastases. Enrollment challenges with this trial highlight important considerations for future studies of ALK inhibitor combinations.
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Cow- and herd-level risk factors for lameness in partly housed pasture-based dairy cows. J Dairy Sci 2021; 105:1418-1431. [PMID: 34802737 DOI: 10.3168/jds.2021-20767] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/02/2021] [Indexed: 12/16/2022]
Abstract
Lameness in dairy cows is a major animal welfare concern and has substantial economic impact through reduced production and fertility. Previous risk factor analyses have focused on housed systems, rather than those where cows were grazed for the majority of the year and housed only for the winter period. Therefore, the aim of this observational study was to identify a robust set of cow-level and herd-level risk factors for lameness in a pasture-based system, based on predictors from the housing and grazing periods. Ninety-nine farms were visited during the grazing period (April 2019-September 2019), and 85 farms were revisited during the housing period (October 2019-February 2020). At each visit, all lactating cows were scored for lameness (0 = good mobility, 1 = imperfect mobility, 2 = impaired mobility, 3 = severely impaired mobility), and potential herd-level risk factors were recorded through questionnaires and infrastructure measurements. Routine cow-level management data were also collected. Important risk factors for lameness were derived though triangulation of results from elastic net regression, and from logistic regression model selection using modified Bayesian information criterion. Both selection methods were implemented using bootstrapping. This novel approach has not previously been used in a cow-level or herd-level risk factor analysis in dairy cows, to the authors' knowledge. The binary outcome variable was lameness status, whereby cows with a lameness score of 0 or 1 were classed as non-lame and cows with a score of 2 or 3 were classed as lame. Cow-level risk factors for increased lameness prevalence were age and genetic predicted transmitting ability for lameness. Herd-level risk factors included farm and herd size, stones in paddock gateways, slats on cow tracks near the collecting yard, a sharper turn at the parlor exit, presence of digital dermatitis on the farm, and the farmers' perception of whether lameness was a problem on the farm. This large-scale study identified the most important associations between risk factors and lameness, based on the entire year (grazing and housing periods), providing a focus for future randomized clinical trials.
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Longitudinal Outcomes of Gender Identity in Children (LOGIC): study protocol for a retrospective analysis of the characteristics and outcomes of children referred to specialist gender services in the UK and the Netherlands. BMJ Open 2021; 11:e054895. [PMID: 34758999 PMCID: PMC8587379 DOI: 10.1136/bmjopen-2021-054895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Specialist gender services for children and young people (CYP) worldwide have experienced a significant increase in referrals in recent years. As rates of referrals increase, it is important to understand the characteristics and profile of CYP attending these services in order to inform treatment pathways and to ensure optimal outcomes. METHODS AND ANALYSIS A retrospective observational study of clinical health records from specialist gender services for CYP in the UK and the Netherlands. The retrospective analysis will examine routinely collected clinical and outcome measures data including demographic, clinical, gender identity-related and healthcare resource use information. Data will be reported for each service and also compared between services. This study forms part of a wider programme of research investigating outcomes of gender identity in children (the Longitudinal Outcomes of Gender Identity in Children study). ETHICS AND DISSEMINATION The proposed study has been approved by the Health Research Authority and London-Hampstead Research Ethics Committee as application 19/LO/0181. The study findings will be published in peer-reviewed journals and presented at both conferences and stakeholder events.
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Effect of feeding single-dam or pooled colostrum on maternally derived immunity in dairy calves. J Dairy Sci 2021; 105:560-571. [PMID: 34763911 DOI: 10.3168/jds.2021-20343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 08/26/2021] [Indexed: 11/19/2022]
Abstract
The role of colostrum management in providing adequate immunological protection to neonatal calves has been widely investigated, and thresholds for colostrum quality, as well as optimum volume and timing for colostrum feeding have been established. However, limited information is available on the effect of colostrum source (single dam or pooled) on passive immunity, as well as subsequent antibody survival in the calf. This study aimed to assess the effect of feeding single-dam colostrum (own and other dam) or pooled colostrum on transfer of passive immunity, and also investigate the rate of depletion of disease-specific antibodies among dairy calves. In total, 320 cows and 119 dairy heifer calves were enrolled in the study. Calves were blood-sampled immediately after birth and received either own-dam, other-dam, or pooled colostrum. Calves were blood-sampled at 24 h to assess serum IgG concentrations and at monthly intervals thereafter to document disease-specific antibody survival. Mean colostrum IgG concentration was higher for other-dam treatment group, whereas own-dam and pooled treatments were similar. For all treatment groups, the mean IgG concentration was >80 mg/mL, exceeding the quality threshold of 50 mg/mL. Mean calf serum IgG concentration was lower for calves fed pooled colostrum compared with those that received colostrum from a single cow. There was a negative association with 24-h serum IgG and calf birth bodyweight; calves <30 kg at birth had the highest 24-h serum IgG concentration. Survival of antibodies to bovine viral diarrhea, Salmonella infection, leptospirosis, bovine parainfluenza 3 virus, bovine respiratory syncytical virus, rotavirus, and coronavirus was not associated with colostrum source; however, antibodies to infectious bovine rhinotracheitis had a greater period of survival among calves fed own-dam colostrum. We found that feeding single-dam colostrum can thus improve calf immunity through increased serum IgG levels and antibody survival rates. Furthermore, we hypothesize that immune exclusion may occur with pooled colostrum; therefore, providing pooled colostrum may still be a good practice as long as it can be ensured that enough antibodies are absorbed into the blood stream to deal with pathogens calves may encounter because different dams may have antibodies against different strains of viruses and bacteria, yielding cross protection.
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Longitudinal outcomes of gender identity in children (LOGIC): a study protocol for a prospective longitudinal qualitative study of the experiences and well-being of families referred to the UK Gender Identity Development Service. BMJ Open 2021; 11:e047875. [PMID: 34732477 PMCID: PMC8572378 DOI: 10.1136/bmjopen-2020-047875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Gender Identity Development Services (GIDS) worldwide have experienced a significant increase in referrals in recent years. However, little is currently known about the experiences of the children and young people (CYP) and their families attending these services and the influences on their well-being. Most published qualitative studies have explored gender identity and gender questioning CYP from either a parental perspective or in an adolescent sample. Consequently, there is a need for research to explore the voices of younger children and adolescents who are referred to GIDS. This study aims to address current gaps in understanding of the experiences of CYP referred to the UK GIDS, specifically regarding the personal, familial, educational, and social contexts in which CYP and their parents/caregivers are navigating gender identity, social and physical transition, and the healthcare system. METHODS AND ANALYSIS A prospective longitudinal qualitative study examining the experiences and well-being of CYP referred to the UK GIDS. A purposive sample of up to 40 families will be recruited. Families will be eligible for the study if the child or young person was aged 3-14 years at the time of referral to the GIDS. Semistructured interviews will be conducted with both the child/young person and their parents/caregivers. Analysis of anonymised interview transcripts will be interpretive and pluralistic, informed by both narrative and thematic approaches. This study forms part of a wider programme of research investigating longitudinal outcomes of gender identity in children (the LOGIC Study). ETHICS AND DISSEMINATION The proposed study has been approved by the UK Health Research Authority and London-Hampstead Research Ethics Committee as application 19/LO/0857. The study findings will be published in peer-reviewed journals and presented at both conferences and stakeholder events.
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Fears, Reassurance, and Milestones: A Twitter Analysis around World Prematurity Day during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010807. [PMID: 34682550 PMCID: PMC8535517 DOI: 10.3390/ijerph182010807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 12/02/2022]
Abstract
Preterm birth (birth <37 completed weeks’ gestation) is common, affecting 10.6% of live births globally (nearly 15 million babies per year). Having a new baby admitted to a neonatal unit often triggers stress and anxiety for parents. This paper seeks to explore experiences of preterm birth via Twitter. The intermingling of COVID-19 restrictions and World Prematurity Day allows for an understanding of both the additional stresses incurred as a consequence of the pandemic and the more “everyday” experiences in the NICU and beyond. The content analysis of the data included 3161 tweets. Three themes were identified: 1. COVID-19 was not the only trauma; 2. Raising awareness, especially World Prematurity Day; and, 3. Baby milestones. These themes highlight the multi-level challenges faced by parents of premature babies and the healthcare professionals involved in their care. The COVID-19 pandemic and the consequent restrictions imposed on parents’ contact with their babies have resulted in immense emotional strain for families. The reported COVID-19 pandemic “baby blind spot” appears to particularly impact this group of babies. Improved understanding of the lived experiences of preterm babies and their families should inform greater awareness and improved support.
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Longitudinal Outcomes of Gender Identity in Children (LOGIC): protocol for a prospective longitudinal cohort study of children referred to the UK gender identity development service. BMJ Open 2021; 11:e045628. [PMID: 34493504 PMCID: PMC8424855 DOI: 10.1136/bmjopen-2020-045628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Gender identity development services (GIDS) worldwide have seen a significant increase in referrals in recent years. Many of these referrals consist of children and young people (CYP) who experience gender-related distress. This study aims to improve understanding of outcomes of CYP referred to the UK GIDS, specifically regarding gender identity, mental health, physical health and quality of life. The impact of factors such as co-occurring autism and early social transition on outcomes over time will be explored. METHODS AND ANALYSIS This is a prospective cohort study of CYP aged 3-14 years when referred to the UK GIDS. Eligible participants will be ≤14 years at the time their referral was accepted and will be on the waitlist for the service when baseline measures are completed. Children aged under 12 years will complete the measures in an interview format with a researcher, while young people aged 12 years and over and their parents/caregivers will complete online or paper-based questionnaires. Participants will complete follow-up measures 12 months and 24 months later. The final sample size is expected to be approximately 500. Logistic regression models will be used to explore associations between prespecified explanatory variables and gender dysphoria. Appropriate regression models will also be used to investigate explanatory variables for other outcomes. Subgroup analyses based on birth-assigned gender, age at referral and co-occurring autistic traits will be explored. ETHICS AND DISSEMINATION The study has been approved by the Health Research Authority and London - Hampstead Research Ethics Committee (reference: 19/LO/0857). The study findings will be published in peer-reviewed journals and presented at both conferences and stakeholder events. Findings will be used to inform clinical practice.
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Validating the n-alkane technique for determining herbage dry matter intake in sheep offered perennial ryegrass harvested at varying growth stages and seasons. Anim Feed Sci Technol 2021. [DOI: 10.1016/j.anifeedsci.2021.115025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Editorial: Is Preterm Birth Overlooked in Child and Adolescent Psychiatry? J Am Acad Child Adolesc Psychiatry 2021; 60:1066-1068. [PMID: 33340645 DOI: 10.1016/j.jaac.2020.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/10/2020] [Indexed: 11/15/2022]
Abstract
Obstetric factors have long been recognized as risk factors for the later development of poor mental health. One of the most consistently reported of these associations is for preterm birth (birth before 37 weeks' gestation), a form of early adversity that impacts health and development across the life course. Preterm birth is not uncommon: in 2014, 10.6% of live births globally (nearly 15 million babies) were preterm.1 Advances in neonatal care since the early 1990s have dramatically increased the numbers of babies who survive extreme preterm birth (birth at <28 weeks' gestation) in high-income countries. This has led to growing interest in how extreme preterm birth impacts longer term outcomes including psychosocial development across the life span.
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Gender identity development in children and young people: A systematic review of longitudinal studies. Clin Child Psychol Psychiatry 2021; 26:706-719. [PMID: 33827265 DOI: 10.1177/13591045211002620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Children are presenting in greater numbers to gender clinics around the world. Prospective longitudinal research is important to better understand outcomes and trajectories for these children. This systematic review aims to identify, describe and critically evaluate longitudinal studies in the field. METHOD Five electronic databases were systematically searched from January 2000 to February 2020. Peer-reviewed articles assessing gender identity and psychosocial outcomes for children and young people (<18 years) with gender diverse identification were included. RESULTS Nine articles from seven longitudinal studies were identified. The majority were assessed as being of moderate quality. Four studies were undertaken in the Netherlands, two in North America and one in the UK. The majority of studies had small samples, with only two studies including more than 100 participants and attrition was moderate to high, due to participants lost to follow-up. Outcomes of interest focused predominantly on gender identity over time and emotional and behavioural functioning. CONCLUSIONS Larger scale and higher quality longitudinal research on gender identity development in children is needed. Some externally funded longitudinal studies are currently in progress internationally. Findings from these studies will enhance understanding of outcomes over time in relation to gender identity development in children and young people.
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Children are safe in schools: a review of the Irish experience of reopening schools during the COVID-19 pandemic. Public Health 2021; 195:158-160. [PMID: 34130002 PMCID: PMC8547945 DOI: 10.1016/j.puhe.2021.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/08/2021] [Indexed: 11/27/2022]
Abstract
Objectives Schools in the Republic of Ireland reopened to students and staff in late August 2020. We sought to determine the test positivity rate of close contacts of cases of coronavirus disease 2019 (COVID-19) in schools during the first half-term of the 2020/2021 academic year. Methods National-level data from the schools' testing pathway were interrogated to determine the positivity rate of close contacts of cases of COVID-19 in Irish primary, postprimary and special schools during the first half-term of 2020/2021 academic year. The positivity rates among adult and child close contacts were compared and the proportion of national cases of COVID-19 who were aged 4–18 years during the observation period was calculated to assess whether this proportion increased after schools reopened. Results Of all, 15,533 adult and child close contacts were tested for COVID-19 through the schools' testing pathway during the first half-term of the 2020/2021 academic year. Three hundred and ninety-nine close contacts tested positive, indicating a positivity rate of 2.6% (95% confidence interval: 2.3–2.8%). The positivity rates of child and adult close contacts were similarly low (2.6% vs 2.7%, P = 0.7). The proportion of all national cases of COVID-19 who were aged 4–18 years did not increase during the first half-term of the 2020/2021 school year. Conclusions The low positivity rate of close contacts of cases of COVID-19 in schools indicate that transmission of COVID-19 in Irish schools during the first half-term of the 2020/2021 academic year was low. These findings support policies to keep schools open during the pandemic.
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Imaging flow cytometry elucidates the cellular uptake of extracellular vesicles loaded with a novel therapeutic peptide. Cytotherapy 2021. [DOI: 10.1016/s146532492100459x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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The Evidence-Base for Psychodynamic Psychotherapy With Children and Adolescents: A Narrative Synthesis. Front Psychol 2021; 12:662671. [PMID: 33986713 PMCID: PMC8110733 DOI: 10.3389/fpsyg.2021.662671] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/17/2021] [Indexed: 12/26/2022] Open
Abstract
Despite a rich theoretical and clinical history, psychodynamic child and adolescent psychotherapy has been slow to engage in the empirical assessment of its effectiveness. This systematic review aims to provide a narrative synthesis of the evidence base for psychodynamic therapy with children and adolescents. Building on two earlier systematic reviews, which covered the period up to 2017, the current study involved two stages: an updated literature search, covering the period between January 2017 and May 2020, and a narrative synthesis of these new studies with those identified in the earlier reviews. The updated search identified 37 papers (28 distinct studies). When combined with papers identified in the earlier systematic reviews, this resulted in a combined total of 123 papers (82 distinct studies). The narrative synthesis of findings indicates that there is evidence of effectiveness for psychodynamic therapy in treating a wide range of mental health difficulties in children and adolescents. The evidence suggests this approach may be especially effective for internalizing disorders such as depression and anxiety, as well as in the treatment of emerging personality disorders and in the treatment of children who have experience of adversity. Both the quality and quantity of empirical papers in this field has increased over time. However, much of the research demonstrates a range of methodological limitations (small sample sizes, lack of control groups etc.), and only 22 studies were Randomized Controlled Trials. Further high-quality research is needed in order to better understand the effectiveness of psychodynamic psychotherapy for children and young people.
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"At Least until the Second Wave Comes…": A Twitter Analysis of the NHS and COVID-19 between March and June 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083943. [PMID: 33918586 PMCID: PMC8069751 DOI: 10.3390/ijerph18083943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/31/2021] [Accepted: 04/07/2021] [Indexed: 12/22/2022]
Abstract
In the UK, tweets around COVID-19 and health care have primarily focused on the NHS. Recent research has identified that the psychological well-being of NHS staff has been adversely impacted as a result of the COVID-19 pandemic. The aim of this study was to investigate narratives relating to the NHS and COVID-19 during the first lockdown (26 March–4 July 2020). A total of 123,880 tweets were collated and downloaded bound to the time period of the first lockdown in order to analyse the real-time discourse around COVID-19 and the NHS. Content analysis was undertaken and tweets were coded to positive and negative sentiments. Five main themes were identified: (1) the dichotomies of ‘clap for carers’; (2) problems with PPE and testing; (3) peaks of anger; (4) issues around hero worship; and (5) hints of a normality. Further research exploring and documenting social media narratives around COVID-19 and the NHS, in this and subsequent lockdowns, should help in tailoring suitable support for staff in the future and acknowledging the profound impact that the pandemic has had.
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A105 RAPID INTERDISCIPLINARY IBD CLINIC RESULTS IN TIMELY IBD WAIT TIMES, IMPROVED PATIENT SATISFACTION & PATIENT REPORTED OUTCOMES. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Inflammatory Bowel Disease (IBD) patients often have disease flares and extraintestinal manifestations such as rashes, arthralgias & perianal fistulas that require timely assessments. We implemented a Rapid Interdisciplinary IBD program at Mount Sinai Hospital with expedited consultation by an IBD specialist and referral with clinical need to collaborative colorectal surgeon, dermatologist, rheumatologist, and/or high-risk obstetrician. The RAPID program includes an online IBD Dashboard for patients to respond to questionnaires which is closely monitored 90 days post-enrolment by the IBD nurse.
Aims
To assess the implementation of an Interdisciplinary IBD Clinic & online IBD Dashboard monitoring system on the ability to increase patient satisfaction regarding their IBD care.
Methods
Upon consent into the RAPID IBD program, patients are enrolled to the IBD Dashboard and complete a Patient Satisfaction (CACHE) questionnaire at baseline, 3, 6, 12 months follow up and clinical disease activity scores at baseline, 1, 2, 3 months post enrollment; the Modified Harvey Bradshaw Index (mHBI) for Crohn’s disease (CD); partial Mayo score and Simple Clinical Colitis Activity Index (SCCAI) for ulcerative colitis (UC) and IBD unclassified (IBDU) patients. Results were compared pre/post enrollment with changes in median and interquartile ranges (IQR).
Results
109 patients were referred to RAPID, 88 (49 CD, 33 UC, 6 IBDU) enrolled & 62 consented to IBD Dashboard monitoring. Of those enrolled, 40 patients were referred based on flaring of clinical scores, 23 with potential flare or complication, 17 with acute extraintestinal manifestations, 4 pregnant and 4 with perianal disease. Median 4 (2–7) days to first GI IBD clinic. 15 patients were referred to dermatology, 12 to colorectal surgery, 8 to rheumatology and 3 to obstetrics. 6 patients visited the ER within the first 90 days after enrollment, with 1 (1–2) ER visits. Patient satisfaction improved from baseline 73.5% (68.4%-77.4%) (n=53) to 82.3% (75.5% - 84.0%) at 3 months (n=28). Clinical responses were seen post enrollment with a decrease in mHBI of 3.0 at 2 months, 1.5 on the 6-point Mayo (SF + RB) at 1 & 3 months and patient defined significant improvement in SCCAI greater than 1.5 after 1 month.
Conclusions
Preliminary results with RAPID IBD program demonstrate a short time to be seen by an IBD specialist, improvement in patient satisfaction and clinical responses in mHBI, pMayo and SCCAI scores 1–3 months post enrollment.
Funding Agencies
AMO
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Measurement of single-diffractive dijet production in proton-proton collisions at s = 8 Te with the CMS and TOTEM experiments. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2020; 80:1164. [PMID: 33362286 PMCID: PMC7746569 DOI: 10.1140/epjc/s10052-020-08562-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 10/18/2020] [Indexed: 06/12/2023]
Abstract
Measurements are presented of the single-diffractive dijet cross section and the diffractive cross section as a function of the proton fractional momentum loss ξ and the four-momentum transfer squared t. Both processesp p → p X andp p → X p , i.e. with the proton scattering to either side of the interaction point, are measured, whereX includes at least two jets; the results of the two processes are averaged. The analyses are based on data collected simultaneously with the CMS and TOTEM detectors at the LHC in proton-proton collisions ats = 8 Te during a dedicated run withβ ∗ = 90 m at low instantaneous luminosity and correspond to an integrated luminosity of 37.5 nb - 1 . The single-diffractive dijet cross section σ jj p X , in the kinematic region ξ < 0.1 ,0.03 < | t | < 1 Ge 2 , with at least two jets with transverse momentump T > 40 Ge , and pseudorapidity | η | < 4.4 , is 21.7 ± 0.9 (stat) - 3.3 + 3.0 (syst) ± 0.9 (lumi) nb . The ratio of the single-diffractive to inclusive dijet yields, normalised per unit of ξ , is presented as a function of x, the longitudinal momentum fraction of the proton carried by the struck parton. The ratio in the kinematic region defined above, for x values in the range - 2.9 ≤ log 10 x ≤ - 1.6 , is R = ( σ jj p X / Δ ξ ) / σ jj = 0.025 ± 0.001 (stat) ± 0.003 (syst) , where σ jj p X and σ jj are the single-diffractive and inclusive dijet cross sections, respectively. The results are compared with predictions from models of diffractive and nondiffractive interactions. Monte Carlo predictions based on the HERA diffractive parton distribution functions agree well with the data when corrected for the effect of soft rescattering between the spectator partons.
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Grants
- Austrian Federal Ministry of Education, Science and Research
- Austrian Science Fund
- Belgian Fonds de la Recherche Scientifique
- Belgian Fonds voor Wetenschappelijk Onderzoek
- CNPq
- CAPES
- FAPERJ
- FAPERGS
- FAPESP
- Bulgarian Ministry of Education and Science
- CERN
- Chinese Academy of Sciences
- Ministry of Science and Technology
- Chinese National Natural Science Foundation of China
- Colombian Funding Agency (COLCIENCIAS)
- Croatian Ministry of Science, Education and Sport
- Croatian Science Foundation
- Research Promotion Foundation
- SENESCYT
- Ministry of Education and Research
- Estonian Research Council via IUT23-4 and IUT23-6
- European Regional Development Fund
- Academy of Finland
- Finnish Ministry of Education and Culture
- Helsinki Institute of Physics
- Institut National de Physique Nucléaire et de Physique des Particules
- Centre National de la Recherche Scientifique
- Commissariat à l’Énergie Atomique et aux Énergies Alternatives
- Bundesministerium für Bildung und Forschung
- Deutsche Forschungsgemeinschaft
- Helmholtz-Gemeinschaft Deutscher Forschungszentren
- General Secretariat for Research and Technology
- National Research, Development and Innovation Fund
- Department of Atomic Energy
- Department of Science and Technology
- Institute for Research in Fundamental Studies
- Science Foundation
- Istituto Nazionale di Fisica Nucleare
- Korean Ministry of Education, Science and Technology
- National Research Foundation of Korea (NRF)
- MES
- Lithuanian Academy of Sciences
- Ministry of Education
- University of Malaya
- BUAP
- CINVESTAV
- CONACYT
- LNS
- SEP
- UASLP
- MOS
- Ministry of Business, Innovation and Employment
- Pakistan Atomic Energy Commission
- Ministry of Science and Higher Education
- National Science Centre
- Fundação para a Ciência e a Tecnologia
- JINR, Dubna
- Ministry of Education and Science of the Russian Federation
- Federal Agency of Atomic Energy of the Russian Federation
- Russian Academy of Sciences
- Russian Foundation for Basic Research
- National Research Center “Kurchatov Institute”
- Ministry of Education, Science and Technological Development of Serbia
- Secretaría de Estado de Investigación, Desarrollo e Innovación
- Programa Consolider-Ingenio 2010
- Plan de Ciencia, Tecnología e Innovación 2013-2017 del Principado de Asturias
- Fondo Europeo de Desarrollo Regional, Spain
- MOSTR
- ETH Board
- ETH Zurich
- PSI
- SNF
- UniZH
- Canton Zurich
- SER
- Ministry of Science and Technology
- Thailand Center of Excellence in Physics
- Institute for the Promotion of Teaching Science and Technology of Thailand
- Special Task Force for Activating Research
- National Science and Technology Development Agency of Thailand
- Scientific and Technical Research Council of Turkey
- Turkish Atomic Energy Authority
- National Academy of Sciences of Ukraine
- Science and Technology Facilities Council
- US Department of Energy
- US National Science Foundation
- Marie-Curie programme
- European Research Council and EPLANET (European Union)
- Horizon 2020 Grant, contract Nos. 675440, 752730, and 765710 (European Union)
- Leventis Foundation
- Alfred P. Sloan Foundation
- Alexander von Humboldt Foundation
- Belgian Federal Science Policy Office
- Fonds pour la Formation à la Recherche dans l’Industrie et dans l’Agriculture (FRIA-Belgium)
- Agentschap voor Innovatie door Wetenschap en Technologie (IWT-Belgium)
- Belgian Fonds de la Recherche Scientifique, “Excellence of Science-EOS”-be.h project n. 30820817
- Belgian Fonds voor Wetenschappelijk Onderzoek, “Excellence of Science-EOS”-be.h project n. 30820817
- Beijing Municipal Science and Technology Commission, No. Z191100007219010
- Ministry of Education, Youth and Sports (MEYS) of the Czech Republic
- Deutsche Forschungsgemeinschaft (DFG) under Germany’s Excellence Strategy-EXC 2121 “Quantum Universe”-390833306
- Lendúlet (“Momentum”) Programme and the János Bolyai Research Scholarship of the Hungarian Academy of Sciences
- New National Excellence Program ÚNKP, the NKFIA research grants 123842, 123959, 124845, 124850, 125105, 128713, 128786, and 129058
- Council of Scientific and Industrial Research, India
- HOMING PLUS programme of Foundation for Polish Science, cofinanced from European Union, Regional Development Fund
- National Science Center, contracts Harmonia 2014/14/M/ST2/00428, Opus 2014/13/B/ST2/02543, 2014/15/B/ST2/03998, and 2015/19/B/ST2/02861, Sonata-bis 2012/07/E/ST2/01406
- National Priorities Research Program by Qatar National Research Fund
- Ministry of Science and Education, grant no. 14.W03.31.0026
- Programa Estatal de Fomento de la Investigación Científica y Técnica de Excelencia María de Maeztu, grant MDM-2015-0509
- Programa Severo Ochoa del Principado de Asturias
- Thalis and Aristeia programmes cofinanced by EU-ESF and the Greek NSRF
- Rachadapisek Sompot Fund for Postdoctoral Fellowship, Chulalongkorn University (Thailand)
- CUAASC
- Kavli Foundation
- Nvidia Corporation
- Welch Foundation, contract C-1845
- Weston Havens Foundation
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Measurement of single-diffractive dijet production in proton-proton collisions at s = 8 Te with the CMS and TOTEM experiments. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2020; 80:1164. [PMID: 33362286 PMCID: PMC7746569 DOI: 10.1140/epjc/s10052-020-08562-y 10.1140/epjc/s10052-021-08863-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 10/18/2020] [Indexed: 07/14/2023]
Abstract
Measurements are presented of the single-diffractive dijet cross section and the diffractive cross section as a function of the proton fractional momentum loss ξ and the four-momentum transfer squared t. Both processes p p → p X and p p → X p , i.e. with the proton scattering to either side of the interaction point, are measured, where X includes at least two jets; the results of the two processes are averaged. The analyses are based on data collected simultaneously with the CMS and TOTEM detectors at the LHC in proton-proton collisions at s = 8 Te during a dedicated run with β ∗ = 90 m at low instantaneous luminosity and correspond to an integrated luminosity of 37.5 nb - 1 . The single-diffractive dijet cross section σ jj p X , in the kinematic region ξ < 0.1 , 0.03 < | t | < 1 Ge 2 , with at least two jets with transverse momentum p T > 40 Ge , and pseudorapidity | η | < 4.4 , is 21.7 ± 0.9 (stat) - 3.3 + 3.0 (syst) ± 0.9 (lumi) nb . The ratio of the single-diffractive to inclusive dijet yields, normalised per unit of ξ , is presented as a function of x, the longitudinal momentum fraction of the proton carried by the struck parton. The ratio in the kinematic region defined above, for x values in the range - 2.9 ≤ log 10 x ≤ - 1.6 , is R = ( σ jj p X / Δ ξ ) / σ jj = 0.025 ± 0.001 (stat) ± 0.003 (syst) , where σ jj p X and σ jj are the single-diffractive and inclusive dijet cross sections, respectively. The results are compared with predictions from models of diffractive and nondiffractive interactions. Monte Carlo predictions based on the HERA diffractive parton distribution functions agree well with the data when corrected for the effect of soft rescattering between the spectator partons.
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Grants
- Austrian Federal Ministry of Education, Science and Research
- Austrian Science Fund
- Belgian Fonds de la Recherche Scientifique
- Belgian Fonds voor Wetenschappelijk Onderzoek
- CNPq
- CAPES
- FAPERJ
- FAPERGS
- FAPESP
- Bulgarian Ministry of Education and Science
- CERN
- Chinese Academy of Sciences
- Ministry of Science and Technology
- Chinese National Natural Science Foundation of China
- Colombian Funding Agency (COLCIENCIAS)
- Croatian Ministry of Science, Education and Sport
- Croatian Science Foundation
- Research Promotion Foundation
- SENESCYT
- Ministry of Education and Research
- Estonian Research Council via IUT23-4 and IUT23-6
- European Regional Development Fund
- Academy of Finland
- Finnish Ministry of Education and Culture
- Helsinki Institute of Physics
- Institut National de Physique Nucléaire et de Physique des Particules
- Centre National de la Recherche Scientifique
- Commissariat à l’Énergie Atomique et aux Énergies Alternatives
- Bundesministerium für Bildung und Forschung
- Deutsche Forschungsgemeinschaft
- Helmholtz-Gemeinschaft Deutscher Forschungszentren
- General Secretariat for Research and Technology
- National Research, Development and Innovation Fund
- Department of Atomic Energy
- Department of Science and Technology
- Institute for Research in Fundamental Studies
- Science Foundation
- Istituto Nazionale di Fisica Nucleare
- Korean Ministry of Education, Science and Technology
- National Research Foundation of Korea (NRF)
- MES
- Lithuanian Academy of Sciences
- Ministry of Education
- University of Malaya
- BUAP
- CINVESTAV
- CONACYT
- LNS
- SEP
- UASLP
- MOS
- Ministry of Business, Innovation and Employment
- Pakistan Atomic Energy Commission
- Ministry of Science and Higher Education
- National Science Centre
- Fundação para a Ciência e a Tecnologia
- JINR, Dubna
- Ministry of Education and Science of the Russian Federation
- Federal Agency of Atomic Energy of the Russian Federation
- Russian Academy of Sciences
- Russian Foundation for Basic Research
- National Research Center “Kurchatov Institute”
- Ministry of Education, Science and Technological Development of Serbia
- Secretaría de Estado de Investigación, Desarrollo e Innovación
- Programa Consolider-Ingenio 2010
- Plan de Ciencia, Tecnología e Innovación 2013-2017 del Principado de Asturias
- Fondo Europeo de Desarrollo Regional, Spain
- MOSTR
- ETH Board
- ETH Zurich
- PSI
- SNF
- UniZH
- Canton Zurich
- SER
- Ministry of Science and Technology
- Thailand Center of Excellence in Physics
- Institute for the Promotion of Teaching Science and Technology of Thailand
- Special Task Force for Activating Research
- National Science and Technology Development Agency of Thailand
- Scientific and Technical Research Council of Turkey
- Turkish Atomic Energy Authority
- National Academy of Sciences of Ukraine
- Science and Technology Facilities Council
- US Department of Energy
- US National Science Foundation
- Marie-Curie programme
- European Research Council and EPLANET (European Union)
- Horizon 2020 Grant, contract Nos. 675440, 752730, and 765710 (European Union)
- Leventis Foundation
- Alfred P. Sloan Foundation
- Alexander von Humboldt Foundation
- Belgian Federal Science Policy Office
- Fonds pour la Formation à la Recherche dans l’Industrie et dans l’Agriculture (FRIA-Belgium)
- Agentschap voor Innovatie door Wetenschap en Technologie (IWT-Belgium)
- Belgian Fonds de la Recherche Scientifique, “Excellence of Science-EOS”-be.h project n. 30820817
- Belgian Fonds voor Wetenschappelijk Onderzoek, “Excellence of Science-EOS”-be.h project n. 30820817
- Beijing Municipal Science and Technology Commission, No. Z191100007219010
- Ministry of Education, Youth and Sports (MEYS) of the Czech Republic
- Deutsche Forschungsgemeinschaft (DFG) under Germany’s Excellence Strategy-EXC 2121 “Quantum Universe”-390833306
- Lendúlet (“Momentum”) Programme and the János Bolyai Research Scholarship of the Hungarian Academy of Sciences
- New National Excellence Program ÚNKP, the NKFIA research grants 123842, 123959, 124845, 124850, 125105, 128713, 128786, and 129058
- Council of Scientific and Industrial Research, India
- HOMING PLUS programme of Foundation for Polish Science, cofinanced from European Union, Regional Development Fund
- National Science Center, contracts Harmonia 2014/14/M/ST2/00428, Opus 2014/13/B/ST2/02543, 2014/15/B/ST2/03998, and 2015/19/B/ST2/02861, Sonata-bis 2012/07/E/ST2/01406
- National Priorities Research Program by Qatar National Research Fund
- Ministry of Science and Education, grant no. 14.W03.31.0026
- Programa Estatal de Fomento de la Investigación Científica y Técnica de Excelencia María de Maeztu, grant MDM-2015-0509
- Programa Severo Ochoa del Principado de Asturias
- Thalis and Aristeia programmes cofinanced by EU-ESF and the Greek NSRF
- Rachadapisek Sompot Fund for Postdoctoral Fellowship, Chulalongkorn University (Thailand)
- CUAASC
- Kavli Foundation
- Nvidia Corporation
- Welch Foundation, contract C-1845
- Weston Havens Foundation
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Informing the personalisation of interventions for parents of children with conduct problems: a qualitative study. BMC Psychiatry 2020; 20:513. [PMID: 33081742 PMCID: PMC7576822 DOI: 10.1186/s12888-020-02917-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/13/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Parenting programmes aim to alleviate behavioural problems in children, including conduct disorder. This study was part of a multi-phase mixed-methods project seeking to extend the reach of parenting programmes for the treatment of conduct problems through developing an evidence base to inform a personalised approach. It explored the narratives of parents of children with behavioural and conduct problems about parenting programmes to identify how such programmes could be personalised in order to extend their reach to parents and children who do not currently benefit. METHODS Face-to-face semi-structured interviews with a purposive sample of 42 parents, who had different experiences of parenting programmes. Interviews were conversational and informed by a topic guide. Analysis of transcripts of audio-recorded interviews drew on inductive thematic approaches and was framed largely within a phenomenological perspective. RESULTS Parents' accounts demonstrated three themes: 1) a personalised approach needs to include the child; 2) a supportive school matters; and, 3) the programme needs to feel personal. Parents were more likely to have a positive experience at a parenting programme, and for their child to demonstrate positive behavioural changes, when they felt their concerns were validated within the group and they also felt supported by the child's teachers. Parents whose children had been assessed prior to undertaking the programme were also more likely to perceive the programme to be beneficial, compared to parents who felt their child's individual issues were never considered. CONCLUSIONS Our findings point to the potential for personalised approaches to extend the reach of parenting programmes to parents and children who do not currently benefit from such programmes. Important in personalising parenting programmes is assessing children before parents are referred, to directly work with children as well as parents, and to work collaboratively with parents and children to identify which families are most suited to group support or one-to-one support and how this may change depending on circumstances.
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Regional Therapies for Colorectal Liver Metastases: Systematic Review and Clinical Practice Guideline. Clin Colorectal Cancer 2020; 20:20-28. [PMID: 33257278 DOI: 10.1016/j.clcc.2020.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/23/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Resection is the foundation for cure for colorectal cancer (CRC) liver metastases; however, only 20% of patients are suitable for surgery. Those suitable would be considered for resection or local therapies before being considered for regional therapies. Noncurative treatment is usually systemic chemotherapy. For patients with liver-only or liver-predominant metastases that are unresectable, regional therapies [conventional transarterial chemoembolization (cTACE), drug-eluting bead transarterial chemoembolization (DEB-TACE), and transarterial radioembolization (TARE)] may be considered. We review the current evidence for regional therapies for CRC liver metastases. PATIENTS AND METHODS Literature searches (January 2000 to March 2019 or January 2010 to March 2019 depending on the specific systematic review question) were conducted, including Medline, Embase, Cochrane Library, and 2018 American Society of Clinical Oncology (ASCO) abstracts. RESULTS A total of 4100 articles were identified; 15 studies were included in the review. There were no comparative data regarding the resectable population. There was either insufficient evidence (cTACE or DEB-TACE) or evidence against (TARE) the addition of regional therapies to systemic therapy in the first line in the unresectable population. There was either no evidence (cTACE) or weak evidence (DEB-TACE or TARE) for the addition of regional therapies with or without systemic therapy in the second line or later in the unresectable population. CONCLUSION Limited evidence supports the delivery of percutaneous regional therapies in patients with unresectable CRC liver metastases. There are strong data demonstrating positive effects of TARE within the liver, but they do not translate to a benefit in patient-important outcomes. DEB-TACE appears to offer a survival benefit in the second-line setting, although the evidence is limited by small sample size and larger trials are needed.
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Studies of Charm Quark Diffusion inside Jets Using Pb-Pb and pp Collisions at sqrt[s_{NN}]=5.02 TeV. PHYSICAL REVIEW LETTERS 2020; 125:102001. [PMID: 32955327 DOI: 10.1103/physrevlett.125.102001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 05/28/2020] [Accepted: 08/05/2020] [Indexed: 06/11/2023]
Abstract
The first study of charm quark diffusion with respect to the jet axis in heavy ion collisions is presented. The measurement is performed using jets with p_{T}^{jet}>60 GeV/c and D^{0} mesons with p_{T}^{D}>4 GeV/c in lead-lead (Pb-Pb) and proton-proton (pp) collisions at a nucleon-nucleon center-of-mass energy of sqrt[s_{NN}]=5.02 TeV, recorded by the CMS detector at the LHC. The radial distribution of D^{0} mesons with respect to the jet axis is sensitive to the production mechanisms of the meson, as well as to the energy loss and diffusion processes undergone by its parent parton inside the strongly interacting medium produced in Pb-Pb collisions. When compared to Monte Carlo event generators, the radial distribution in pp collisions is found to be well described by pythia, while the slope of the distribution predicted by sherpa is steeper than that of the data. In Pb-Pb collisions, compared to the pp results, the D^{0} meson distribution for 4<p_{T}^{D}<20 GeV/c hints at a larger distance on average with respect to the jet axis, reflecting a diffusion of charm quarks in the medium created in heavy ion collisions. At higher p_{T}^{D}, the Pb-Pb and pp radial distributions are found to be similar.
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Study of central exclusive production in proton-proton collisions at s = 5.02 and 13TeV. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2020; 80:718. [PMID: 32834020 PMCID: PMC7418521 DOI: 10.1140/epjc/s10052-020-8166-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Abstract
Central exclusive and semiexclusive production of pairs is measured with the CMS detector in proton-proton collisions at the LHC at center-of-mass energies of 5.02 and 13TeV. The theoretical description of these nonperturbative processes, which have not yet been measured in detail at the LHC, poses a significant challenge to models. The two pions are measured and identified in the CMS silicon tracker based on specific energy loss, whereas the absence of other particles is ensured by calorimeter information. The total and differential cross sections of exclusive and semiexclusive central production are measured as functions of invariant mass, transverse momentum, and rapidity of the system in the fiducial region defined as transverse momentum and pseudorapidity . The production cross sections for the four resonant channels , , , and are extracted using a simple model. These results represent the first measurement of this process at the LHC collision energies of 5.02 and 13TeV.
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Grants
- Austrian Federal Ministry of Education, Science, and Research
- Austrian Science Fund
- Belgian Fonds de la Recherche Scientifique
- Belgian Fonds voor Wetenschappelijk Onderzoek
- CNPq
- CAPES
- FAPERJ
- FAPERGS
- FAPESP
- Bulgarian Ministry of Education and Science
- CERN
- Chinese Academy of Sciences
- Ministry of Science and Technology
- Chinese National Natural Science Foundation of China
- Colombian Funding Agency (COLCIENCIAS)
- Croatian Ministry of Science, Education and Sport
- Croatian Science Foundation
- Research Promotion Foundation
- SENESCYT
- Ministry of Education and Research
- Estonian Research Council via PRG780, PRG803, and PRG445
- European Regional Development Fund
- Academy of Finland
- Finnish Ministry of Education and Culture
- Helsinki Institute of Physics
- Institut National de Physique Nucléaire et de Physique des Particules
- Centre National de la Recherche Scientifique
- Commissariat à l’Énergie Atomique et aux Énergies Alternatives
- Bundesministerium für Bildung und Forschung
- Deutsche Forschungsgemeinschaft
- Helmholtz-Gemeinschaft Deutscher Forschungszentren
- General Secretariat for Research and Technology
- National Research, Development and Innovation Fund
- Department of Atomic Energy
- Department of Science and Technology
- Institute for Research in Fundamental Studies
- Science Foundation
- Istituto Nazionale di Fisica Nucleare
- Korean Ministry of Education, Science and Technology
- National Research Foundation of Korea (NRF)
- MES
- Lithuanian Academy of Sciences
- Ministry of Education
- University of Malaya
- BUAP
- CINVESTAV
- CONACYT
- LNS
- SEP
- UASLP
- MOS
- Ministry of Business, Innovation and Employment
- Pakistan Atomic Energy Commission
- Ministry of Science and Higher Education
- National Science Centre
- Fundação para a Ciência e a Tecnologia
- JINR, Dubna
- Ministry of Education and Science of the Russian Federation
- Federal Agency of Atomic Energy of the Russian Federation
- Russian Academy of Sciences
- Russian Foundation for Basic Research
- National Research Center “Kurchatov Institute"
- Ministry of Education, Science and Technological Development of Serbia
- Secretaría de Estado de Investigación, Desarrollo e Innovación
- Programa Consolider-Ingenio 2010
- Plan de Ciencia, Tecnología e Innovación 2017-2020 del Principado de Asturias research project IDI-2018-000174
- Fondo Europeo de Desarrollo Regional, Spain
- MOSTR
- ETH Board
- ETH Zurich
- PSI
- SNF
- UniZH
- Canton Zurich
- SER
- Ministry of Science and Technology
- Thailand Center of Excellence in Physics
- Institute for the Promotion of Teaching Science and Technology of Thailand
- Special Task Force for Activating Research
- National Science and Technology Development Agency of Thailand
- Scientific and Technical Research Council of Turkey
- Turkish Atomic Energy Authority
- National Academy of Sciences of Ukraine
- Science and Technology Facilities Council
- US Department of Energy
- US National Science Foundation
- Marie-Curie programme
- European Research Council and EPLANET (European Union)
- Horizon 2020 Grant, contract Nos. 675440, 752730, and 765710 (European Union)
- Leventis Foundation
- Alfred P. Sloan Foundation
- Alexander von Humboldt Foundation
- Belgian Federal Science Policy Office
- Fonds pour la Formation à la Recherche dans l’Industrie et dans l’Agriculture (FRIA-Belgium)
- Agentschap voor Innovatie door Wetenschap en Technologie (IWT-Belgium)
- Belgian Fonds de la Recherche Scientifique, "Excellence of Science - EOS" - be.h project n. 30820817
- Belgian Fonds voor Wetenschappelijk Onderzoek, "Excellence of Science - EOS" - be.h project n. 30820817
- Beijing Municipal Science & Technology Commission No. Z181100004218003
- Ministry of Education, Youth and Sports (MEYS) of the Czech Republic
- Deutsche Forschungsgemeinschaft (DFG) under Germany’s Excellence Strategy - EXC 2121 “Quantum Universe” – 390833306
- Lendúlet ("Momentum") Programme and the János Bolyai Research Scholarship of the Hungarian Academy of Sciences
- New National Excellence Program ÚNKP, the NKFIA research grants 123842, 123959, 124845, 124850and, 125105, 128713, 128786, and 129058
- Council of Scientific and Industrial Research, India
- HOMING PLUS programme of Foundation for Polish Science, cofinanced from European Union, Regional Development Fund
- National Science Center, contracts Harmonia 2014/14/M/ST2/00428, Opus 2014/13/B/ST2/02543, 2014/15/B/ST2/03998, and 2015/19/B/ST2/02861, Sonata-bis 2012/07/E/ST2/01406
- National Priorities Research Program by Qatar National Research Fund
- Ministry of Science and Education, grant no. 14.W03.31.0026
- Tomsk Polytechnic University Competitiveness Enhancement Program and “Nauka" Project FSWW-2020-0008
- Programa Estatal de Fomento de la Investigación Científica y Técnica de Excelencia María de Maeztu, grant MDM-2015-0509
- Programa Severo Ochoa del Principado de Asturias
- Thalis and Aristeia programmes cofinanced by EU-ESF and the Greek NSRF
- Rachadapisek Sompot Fund for Postdoctoral Fellowship, Chulalongkorn University (Thailand)
- CUAASC
- Kavli Foundation
- Nvidia Corporation
- Welch Foundation, contract C-1845
- Weston Havens Foundation
- See spreadsheet included with submission
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The Primary Sclerosing Cholangitis (PSC) Wellbeing Study: Understanding psychological distress in those living with PSC and those who support them. PLoS One 2020; 15:e0234624. [PMID: 32628685 PMCID: PMC7337345 DOI: 10.1371/journal.pone.0234624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 05/31/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The impact of living with Primary Sclerosing Cholangitis (PSC) on psychological wellbeing is not well-known. A recent scoping review by the authors found that both depression and anxiety frequently featured in the accounts of those living with the illness. However, less clear were the factors that led to such psychological distress, the impact that the illness had on families and how to best support those living or supporting someone living with the illness. In light of this, the aim of this study was to explore how the illness impacted the lives of both those diagnosed with the illness and those supporting them. METHOD AND RESULTS This study adopted a phenomenological approach to understand the subjective experiences of individual participants. A total of 30 individuals took part in Asynchronous Virtual Focus Groups hosted on a Virtual Learning Environment for a four-week period. Chronological narratives of individuals' lived experiences from diagnosis to post-transplant are presented below. These narratives centred upon individuals' and families' experiences of receiving a diagnosis, and adjusting to life post-diagnosis, particularly in regard to their relationships with health professionals and other family members, and in preparing for the possibility of transplant. DISCUSSION The present article provides an in-depth look at how PSC can impact psychological wellbeing, how psychological distress arises and includes advice tailored to individuals, families and health professionals on how to best support each other.
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P-133 Extramural venous invasion detected with an elastin stain is a powerful predictor of cancer-specific mortality in STAGE I-IIIB resected colorectal cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Mixed higher-order anisotropic flow and nonlinear response coefficients of charged particles in PbPb collisions at s NN = 2.76 and 5.02 TeV. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2020; 80:534. [PMID: 32589167 PMCID: PMC7307424 DOI: 10.1140/epjc/s10052-020-7834-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 03/14/2020] [Indexed: 06/11/2023]
Abstract
Anisotropies in the initial energy density distribution of the quark-gluon plasma created in high energy heavy ion collisions lead to anisotropies in the azimuthal distributions of the final-state particles known as collective anisotropic flow. Fourier harmonic decomposition is used to quantify these anisotropies. The higher-order harmonics can be induced by the same order anisotropies (linear response) or by the combined influence of several lower order anisotropies (nonlinear response) in the initial state. The mixed higher-order anisotropic flow and nonlinear response coefficients of charged particles are measured as functions of transverse momentum and centrality in PbPb collisions at nucleon-nucleon center-of-mass energies s NN = 2.76 and 5.02 TeV with the CMS detector. The results are compared with viscous hydrodynamic calculations using several different initial conditions, as well as microscopic transport model calculations. None of the models provides a simultaneous description of the mixed higher-order flow harmonics and nonlinear response coefficients.
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Grants
- Austrian Federal Ministry of Education, Science, and Research
- Austrian Science Fund
- Belgian Fonds de la Recherche Scientifique
- Belgian Fonds voor Wetenschappelijk Onderzoek
- CNPq
- CAPES
- FAPERJ
- FAPERGS
- FAPESP
- Bulgarian Ministry of Education and Science
- CERN
- Chinese Academy of Sciences
- Ministry of Science and Technology
- Chinese National Natural Science Foundation of China
- Colombian Funding Agency (COLCIENCIAS)
- Croatian Ministry of Science, Education and Sport
- Croatian Science Foundation
- Research Promotion Foundation
- SENESCYT
- Ministry of Education and Research
- Estonian Research Council via IUT23-4, IUT23-6, and PRG445
- European Regional Development Fund
- Academy of Finland
- Finnish Ministry of Education and Culture
- Helsinki Institute of Physics
- Institut National de Physique Nucléaire et de Physique des Particules
- Centre National de la Recherche Scientifique
- Commissariat à l’Énergie Atomique et aux Énergies Alternatives
- Bundesministerium für Bildung und Forschung
- Deutsche Forschungsgemeinschaft
- Helmholtz-Gemeinschaft Deutscher Forschungszentren
- General Secretariat for Research and Technology
- National Research, Development and Innovation Fund
- Department of Atomic Energy
- Department of Science and Technology
- Institute for Research in Fundamental Studies
- Science Foundation
- Istituto Nazionale di Fisica Nucleare
- Korean Ministry of Education, Science and Technology
- National Research Foundation of Korea (NRF)
- MES
- Lithuanian Academy of Sciences
- Ministry of Education
- University of Malaya
- BUAP
- CINVESTAV
- CONACYT
- LNS
- SEP
- UASLP
- MOS
- Ministry of Business, Innovation and Employment
- Pakistan Atomic Energy Commission
- Ministry of Science and Higher Education
- National Science Centre
- Fundação para a Ciência e a Tecnologia
- JINR, Dubna
- Ministry of Education and Science of the Russian Federation
- Federal Agency of Atomic Energy of the Russian Federation
- Russian Academy of Sciences
- Russian Foundation for Basic Research
- National Research Center “Kurchatov Institute"
- Ministry of Education, Science and Technological Development of Serbia
- Secretaría de Estado de Investigación, Desarrollo e Innovación
- Programa Consolider-Ingenio 2010
- Plan de Ciencia, Tecnología e Innovación 2017-2020 del Principado de Asturias research project IDI-2018-000174
- Fondo Europeo de Desarrollo Regional, Spain
- MOSTR
- ETH Board
- ETH Zurich
- PSI
- SNF
- UniZH
- Canton Zurich
- SER
- Ministry of Science and Technology
- Thailand Center of Excellence in Physics
- Institute for the Promotion of Teaching Science and Technology of Thailand
- Special Task Force for Activating Research
- National Science and Technology Development Agency of Thailand
- Scientific and Technical Research Council of Turkey
- Turkish Atomic Energy Authority
- National Academy of Sciences of Ukraine
- Science and Technology Facilities Council
- US Department of Energy
- US National Science Foundation
- Marie-Curie programme
- European Research Council and EPLANET (European Union)
- Horizon 2020 Grant, contract Nos. 675440, 752730, and 765710 (European Union)
- Leventis Foundation
- Alfred P. Sloan Foundation
- Alexander von Humboldt Foundation
- Belgian Federal Science Policy Office
- Fonds pour la Formation à la Recherche dans l’Industrie et dans l’Agriculture (FRIA-Belgium)
- Agentschap voor Innovatie door Wetenschap en Technologie (IWT-Belgium)
- Belgian Fonds de la Recherche Scientifique, "Excellence of Science - EOS" - be.h project n. 30820817
- Belgian Fonds voor Wetenschappelijk Onderzoek, "Excellence of Science - EOS" - be.h project n. 30820817
- Beijing Municipal Science & Technology Commission No. Z181100004218003
- Ministry of Education, Youth and Sports (MEYS) of the Czech Republic
- Lendúlet ("Momentum") Programme and the János Bolyai Research Scholarship of the Hungarian Academy of Sciences
- New National Excellence Program ÚNKP, the NKFIA research grants 123842, 123959, 124845, 124850, 125105, 128713, 128786, and 129058
- Council of Scientific and Industrial Research, India
- HOMING PLUS programme of Foundation for Polish Science, cofinanced from European Union, Regional Development Fund
- National Science Center, contracts Harmonia 2014/14/M/ST2/00428, Opus 2014/13/B/ST2/02543, 2014/15/B/ST2/03998, and 2015/19/B/ST2/02861, Sonata-bis 2012/07/E/ST2/01406
- National Priorities Research Program by Qatar National Research Fund
- Ministry of Science and Education, grant no. 3.2989.2017
- Programa Estatal de Fomento de la Investigación Científica y Técnica de Excelencia María de Maeztu, grant MDM-2015-0509
- Programa Severo Ochoa del Principado de Asturias
- Thalis and Aristeia programmes cofinanced by EU-ESF and the Greek NSRF
- Rachadapisek Sompot Fund for Postdoctoral Fellowship, Chulalongkorn University (Thailand)
- CUAASC
- Nvidia Corporation
- Welch Foundation, contract C-1845
- Weston Havens Foundation
- Corresponds to version r145 of the written acknowledgments
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Indications for hyperthermic intraperitoneal chemotherapy with cytoreductive surgery: a clinical practice guideline. ACTA ACUST UNITED AC 2020; 27:146-154. [PMID: 32669924 DOI: 10.3747/co.27.6033] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objective The purpose of the present review was to provide evidence-based guidance about the provision of cytoreductive surgery (crs) with hyperthermic intraperitoneal chemotherapy (hipec) in the treatment of peritoneal cancers. Methods The guideline was developed by the Program in Evidence-Based Care together with the Surgical Oncology Program at Ontario Health (Cancer Care Ontario) through a systematic review of relevant literature, patient- and caregiver-specific consultation, and internal and external reviews. Results Recommendation 1a: For patients with newly diagnosed stage iii primary epithelial ovarian or fallopian tube carcinoma, or primary peritoneal carcinoma, hipec should be considered for those with at least stable disease after neoadjuvant chemotherapy at the time that interval crs (if complete) or optimal cytoreduction is achieved. Recommendation 1b: There is insufficient evidence to recommend the addition of hipec when primary crs is performed for patients with newly diagnosed advanced primary epithelial ovarian or fallopian tube carcinoma, or primary peritoneal carcinoma, outside of a clinical trial. Recommendation 2: There is insufficient evidence to recommend hipec with crs in patients with recurrent ovarian cancer outside the context of a clinical trial. Recommendation 3: There is insufficient evidence to recommend hipec with crs in patients with peritoneal colorectal carcinomatosis outside the context of a clinical trial. Recommendation 4: There is insufficient evidence to recommend hipec with crs for the prevention of peritoneal carcinomatosis in colorectal cancer outside the context of a clinical trial; however, hipec using oxaliplatin is not recommended. Recommendation 5: There is insufficient evidence to recommend hipec with crs for the treatment of gastric peritoneal carcinomatosis outside the context of a clinical trial. Recommendation 6: There is insufficient evidence to recommend hipec with crs for the prevention of gastric peritoneal carcinomatosis outside the context of a clinical trial. Recommendation 7: There is insufficient evidence to recommend hipec with crs as a standard of care in patients with malignant peritoneal mesothelioma; however, patients should be referred to hipec specialty centres for assessment for treatment as part of an ongoing research protocol. Recommendation 8: There is insufficient evidence to recommend hipec with crs as a standard of care in patients with disseminated mucinous neoplasm in the appendix; however, patients should be referred to hipec specialty centres for assessment for treatment as part of an ongoing research protocol.
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