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Sarkany RPE, Canfield M, Morgan M, Foster L, Johnstone K, Sainsbury K, Araujo-Soares V, Wulf HC, Weinman J, Walburn J, Norton S. Ultraviolet exposure to the face in patients with xeroderma pigmentosum and healthy controls: applying a novel methodology to define photoprotection behaviour. Br J Dermatol 2021; 186:713-720. [PMID: 34783007 PMCID: PMC9306996 DOI: 10.1111/bjd.20899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND In Xeroderma Pigmentosum (XP), the main means of preventing skin and eye cancers is extreme protection against ultraviolet radiation (UVR). Protection is most important for the face. OBJECTIVES We aimed to assess how well patients with XP adhere to medical advice to protect against UVR by objectively estimating the mean daily dose of UVR to the face. METHODS We objectively estimated the UVR dose to the face in 36 XP patients and 25 healthy individuals over 3 weeks in the summer. We used a new methodology which combined UVR dose measurements from a wrist-worn dosimeter with an activity diary record of face photoprotection behaviour for each 15 minute period spent outside. A protection factor was associated with each behaviour, and the data analysed using a negative binomial mixed-effects model. RESULTS The mean daily UVR dose (weighted for DNA damage capacity) to the face in the XP patients was 0.13 Standard Erythemal Doses (SED) (mean in healthy individuals = 0.51 SED). There was wide variation between patients (range <0.01 - 0.48 SED/day). Self-caring adult patients had a very similar UV dose to the face to cared-for patients (0.13 vs 0.12 SED/day) despite photoprotecting much more poorly when outside, because the self-caring adults were outside in daylight much less. CONCLUSIONS Photoprotection behaviour varies widely within the XP group indicating that non-adherence to photoprotection advice is a significant issue. Timing and duration of going outside are as important as photoprotective measures taken when outside, to determine the UVR exposure to the face. This new methodology will be of value in identifying the sources of UVR exposure in other conditions where facial UV exposure is a key outcome, particularly in patients with multiple non-melanoma skin cancers.
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Affiliation(s)
- R P E Sarkany
- Xeroderma Pigmentosum Unit, Guys and St Thomas' NHS Foundation Trust, UK
| | - M Canfield
- Health Psychology Section, Institute of Psychiatry, King's College London, Psychology & Neuroscience, UK
| | - M Morgan
- School of Cancer and Pharmaceutical Sciences, King's College London, UK
| | - L Foster
- Xeroderma Pigmentosum Unit, Guys and St Thomas' NHS Foundation Trust, UK
| | - K Johnstone
- School of Cancer and Pharmaceutical Sciences, King's College London, UK
| | - K Sainsbury
- Population Health Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - V Araujo-Soares
- Population Health Institute, Faculty of Medical Sciences, Newcastle University, UK.,Health Technology and Services Research, Technical Medical Centre, University of Twente, The Netherlands
| | - H C Wulf
- Department of Dermatology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - J Weinman
- School of Cancer and Pharmaceutical Sciences, King's College London, UK
| | - J Walburn
- School of Cancer and Pharmaceutical Sciences, King's College London, UK
| | - S Norton
- Health Psychology Section, Institute of Psychiatry, King's College London, Psychology & Neuroscience, UK
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Lamarca A, Foster L, Satyadas T, Siriwardena A, Valle JW. Erratum to 'FOLFIRINOX or FOLFOXIRI in locally advanced duodenal adenocarcinoma: are we missing out?': [ESMO Open Volume 5, Issue 5, 2020, e000633]. ESMO Open 2021; 6:100138. [PMID: 34144782 DOI: 10.1016/j.esmoop.2021.100138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- A Lamarca
- Department of Medical Oncology, The Christie NHS Foundation Trust/Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - L Foster
- Department of Pathology, Manchester Royal Infirmary, Manchester, UK
| | - T Satyadas
- Department of HPB Surgery, Manchester Royal Infirmary, Manchester, UK
| | - A Siriwardena
- Department of HPB Surgery, Manchester Royal Infirmary, Manchester, UK
| | - J W Valle
- Division of Cancer Sciences, University of Manchester/Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK.
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Abstract
The aim of this study was to assess what drives gender-based differences in the experience of cybersickness within virtual environments. In general, those who have studied cybersickness (i.e., motion sickness associated with virtual reality [VR] exposure), oftentimes report that females are more susceptible than males. As there are many individual factors that could contribute to gender differences, understanding the biggest drivers could help point to solutions. Two experiments were conducted in which males and females were exposed for 20 min to a virtual rollercoaster. In the first experiment, individual factors that may contribute to cybersickness were assessed via self-report, body measurements, and surveys. Cybersickness was measured via the simulator sickness questionnaire and physiological sensor data. Interpupillary distance (IPD) non-fit was found to be the primary driver of gender differences in cybersickness, with motion sickness susceptibility identified as a secondary driver. Females whose IPD could not be properly fit to the VR headset and had a high motion sickness history suffered the most cybersickness and did not fully recover within 1 h post exposure. A follow-on experiment demonstrated that when females could properly fit their IPD to the VR headset, they experienced cybersickness in a manner similar to males, with high cybersickness immediately upon cessation of VR exposure but recovery within 1 h post exposure. Taken together, the results suggest that gender differences in cybersickness may be largely contingent on whether or not the VR display can be fit to the IPD of the user; with a substantially greater proportion of females unable to achieve a good fit. VR displays may need to be redesigned to have a wider IPD adjustable range in order to reduce cybersickness rates, especially among females.
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Affiliation(s)
- Kay Stanney
- Design Interactive, Inc., Orlando, FL, United States
| | | | - Linda Foster
- Lockheed Martin Corporate, Washington, DC, United States
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Towell-Barnard A, Coventry L, Foster L, Davis S, Twigg DE, Bharat C, Boston J. The psychometric validation of the quality practical experience (QPE) instruments (nurses and student nurse) to evaluate clinical supervision of undergraduate student nurses. Nurse Educ Pract 2020; 43:102697. [PMID: 31981971 DOI: 10.1016/j.nepr.2020.102697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/09/2019] [Accepted: 01/13/2020] [Indexed: 11/22/2022]
Abstract
It is important to evaluate stakeholder feedback regarding any change to a clinical supervision model to maintain quality. The Quality Practical Experience (QPE) instruments offer both the nurse on the ward involved with supervising student learning and the student nurse the opportunity to evaluate their satisfaction with the supervision model. This paper reports on the evaluation of the construct validity and the reliability of the QPE instruments measuring nurse and nursing student satisfaction with the clinical supervision model. Methodological design for the reliability and validation of a measuring instrument. The nurse and the student QPE instruments were tested with convenience samples of 488 nurses and 1116 student nurses, respectively. Psychometric tests included internal reliability, test-retest reliability and factor analyses. Exploratory factor analysis for both QPEs supported a three-factor solution; the nurse QPE explained 48% and student nurse QPE 45% of variance. Internal reliability and test-retest reliability were stable over time (nurse QPE ICC = 0.82; student nurse QPE ICC = 0.71). Both QPE instruments were found to be valid and reliable. Feedback from all stakeholders involved with supporting student nurses during clinical placement is important.
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Affiliation(s)
- Amanda Towell-Barnard
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia; Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
| | - Linda Coventry
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia; Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
| | - L Foster
- Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
| | - Susan Davis
- Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
| | - Dianne E Twigg
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia; Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
| | - Chrianna Bharat
- Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia; National Drug and Alcohol Research Centre (UNSW), Australia.
| | - J Boston
- School of Nursing & Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, Western Australia, 6027, Australia; Sir Charles Gairdner Hospital Centre for Nursing Research, Hospital Avenue, Nedlands, Western Australia, 6009, Australia.
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Dong K, Foster L, Tebbutt S, Ng R, Sin D, Quon B. P216 Untargeted plasma proteomics to identify novel blood biomarkers of treatment response in cystic fibrosis pulmonary exacerbations. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30509-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Deutsch A, Heinemann AW, Cook KF, Foster L, Miskovic A, Goldsmith A, Cella D. Inpatient Rehabilitation Quality of Care From the Patient's Perspective: Effect of Data Collection Timing and Patient Characteristics. Arch Phys Med Rehabil 2018; 100:1032-1041. [PMID: 30476488 DOI: 10.1016/j.apmr.2018.10.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/11/2018] [Accepted: 10/19/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare, by collection time and patient characteristics, inpatient rehabilitation quality measure scores calculated using patient-reported data. DESIGN Cohort study of rehabilitation inpatients with neurologic conditions who reported their experience of care and pain status at discharge and 1month after discharge. SETTING Two inpatient rehabilitation facilities (IRFs). PARTICIPANTS Patients with neurologic conditions (N=391). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES We calculated 18 quality measure scores using participants' responses to 55 experience of care and health status questions addressing communication, support and encouragement, care coordination, discharge information, goals, new medications, responsiveness of staff, cleanliness, quietness, pain management, care transitions, overall hospital rating, willingness to recommend, and pain. RESULTS Of the 391 participants reporting at discharge, 277 (71%) also reported postdischarge after multiple attempts by e-mail, mail, and telephone. Discharge experience of care quality scores ranged from 25% (responsiveness of hospital staff) to 75% (willingness to recommend hospital); corresponding postdischarge scores were 32% to 87%, respectively. Five of the 16 experience of care quality scores increased significantly between discharge and postdischarge. The percentage of participants reporting high pain levels at discharge did not change across time periods. Patients with less education, older age, higher motor and cognitive function, and those who were not Hispanic or black had more favorable quality measure scores. CONCLUSION Patients' experience of care responses tended to be more favorable after discharge compared to discharge, suggesting that survey timing is important. Responses were more favorable for patients with selected characteristics, suggesting the possible need for risk adjustment if patient-reported quality measure scores are compared across IRFs.
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Affiliation(s)
- Anne Deutsch
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL; Quality Measurement and Health Policy Program, RTI International, Chicago, IL.
| | - Allen W Heinemann
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Karon F Cook
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Linda Foster
- Alexian Brothers Rehabilitation Hospital, Elk Grove Village, IL
| | - Ana Miskovic
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL
| | - Arielle Goldsmith
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL
| | - David Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Foster L, Allchorne P, Fleure L, Clovis S, Gibbs E, Bennett J, Kinsella J, Carhill J, Green J. Are shared medical appointments an effective method of delivering discharge information to prepare prostate cancer patients for discharge from secondary care? Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Schalet BD, Kallen MA, Heinemann AW, Deutsch A, Cook KF, Foster L, Cella D. Using PROMIS Pain Interference Items to Improve Quality Measurement in Inpatient Rehabilitation Facilities. J Am Med Dir Assoc 2018; 19:846-851.e2. [PMID: 29804893 DOI: 10.1016/j.jamda.2018.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 02/16/2018] [Accepted: 03/10/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference items for use in a quality measure and to compare the resulting quality score, along with internal reliability and validity, to a similar item set in the Minimum Data Set Version 3.0 (MDS). DESIGN Cross-sectional, observational study. SETTING One freestanding inpatient rehabilitation facility (IRF) and one large hospital-based IRF. PARTICIPANTS Patients with neurologic disorders. Of 1055 consecutive admissions, 26% were excluded based on clinician-determined cognitive impairment or emotional distress. Of the remainder, 50% consented and completed the survey near the end of their IRF stay (N = 391). Of these, more than half (57%) reported pain over the last day (n = 224). MEASUREMENTS Psychometric statistics and quality scores were computed from a 55-question survey, including the MDS and PROMIS pain interference items. RESULTS Estimates for internal reliability were higher for the PROMIS 2-item scale compared to the MDS: Cronbach α (0.86 vs 0.48) and interitem correlations (0.75 vs 0.31). The PROMIS-2 items were better able to detect differences in patients with mild and severe pain intensity (Cohen d = 1.57) relative to the corresponding MDS items (Cohen d = 0.81). Two quality scores based on the PROMIS-2 items, reflecting low and high levels of pain interference, showed 46% or 12% of patients meeting these thresholds. This compared to a 30% rate when patients were classified by the MDS as experiencing pain interference. CONCLUSIONS PROMIS pain interference items appear to be more internally consistent than similar MDS items. The graded PROMIS items permit the creation of multiple quality scores, showing predictable overlap with corresponding MDS quality scores. Because PROMIS items provide finer distinctions, they allow greater latitude in reporting quality scores. We recommend further study of pain interference scores across IRFs to improve their reliability and validity.
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Affiliation(s)
- Benjamin D Schalet
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL.
| | - Michael A Kallen
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Allen W Heinemann
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Anne Deutsch
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL; Quality Measurement and Health Policy Program, eHealth, Quality & Analytics Division, RTI International, Chicago, IL
| | - Karon F Cook
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Linda Foster
- Alexian Brothers Rehabilitation Hospital, Elk Grove Village, IL
| | - David Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Palesch Y, Ramakrishnan V, Foster L, Martin R, Cassarly C, Barsan W, Moy C, Qureshi A. Antihypertensive treatment of acute cerebral hemorrhage phase iii (ATACH-II) trial: Secondary analysis of Asian and non-Asian subgroups using 24-hour blood pressure profile data. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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10
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Affiliation(s)
- L. Foster
- University of Sheffield, Sheffield, United Kingdom
| | - M. Heneghan
- University of Sheffield, Sheffield, United Kingdom
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Heinemann AW, Deutsch A, Cella D, Cook KF, Foster L, Miskovic A, Davis K, Goldsmith A. Feasibility of Collecting Patient-Reported Outcomes for Inpatient Rehabilitation Quality Reporting. Health Serv Res 2017. [PMID: 28620996 DOI: 10.1111/1475-6773.12729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To evaluate rehabilitation inpatients' willingness and ability to complete patient-reported outcomes (PROs) and the burden of completion on patients and staff. DATA SOURCES/STUDY SETTING Two inpatient rehabilitation facilities. STUDY DESIGN Patients with neurological disorders were assigned randomly to receive a nominal monetary incentive during or 1 month after the stay. DATA COLLECTION Patients responded using a tablet computer or paper. PRINCIPAL FINDINGS Of the 1,055 admissions, 74 percent were eligible, and 51 percent of eligible patients completed the survey. Most answered without assistance. A majority completed the survey 1 month after discharge; incentive timing was unrelated to postdischarge completion. Half of the 285 follow-up respondents required at least two reminder calls. CONCLUSIONS Collection of PROs from rehabilitation patients is feasible. Results inform policy makers regarding feasibility of PRO data in evaluating rehabilitation quality.
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Affiliation(s)
- Allen Walter Heinemann
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL.,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Anne Deutsch
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL.,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - David Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Karon Frances Cook
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Linda Foster
- Alexian Brothers Rehabilitation Hospital, Elk Grove Village, IL
| | - Ana Miskovic
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL
| | - Katharine Davis
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL
| | - Arielle Goldsmith
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL
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12
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Tomsick TA, Carrozzella J, Foster L, Hill MD, von Kummer R, Goyal M, Demchuk AM, Khatri P, Palesch Y, Broderick JP, Yeatts SD, Liebeskind DS. Endovascular Therapy of M2 Occlusion in IMS III: Role of M2 Segment Definition and Location on Clinical and Revascularization Outcomes. AJNR Am J Neuroradiol 2016; 38:84-89. [PMID: 27765740 DOI: 10.3174/ajnr.a4979] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 08/01/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Uncertainty persists regarding the safety and efficacy of endovascular therapy of M2 occlusions following IV tPA. We reviewed the impact of revascularization on clinical outcomes in 83 patients with M2 occlusions in the Interventional Management of Stroke III trial according to specific M1-M2 segment anatomic features. MATERIALS AND METHODS Perfusion of any M2 branch distinguished M2-versus-M1 occlusion. Prespecified modified TICI and arterial occlusive lesion revascularization and clinical mRS 0-2 end points at 90 days for endovascular therapy-treated M2 occlusions were analyzed. Post hoc analyses of the relationship of outcomes to multiple baseline angiographic M2 and M1 subgroup characteristics were performed. RESULTS Of 83 participants with M2 occlusion who underwent endovascular therapy, 41.0% achieved mRS 0-2 at 90 days, including 46.6% with modified TICI 2-3 reperfusion compared with 26.1% with modified TICI 0-1 reperfusion (risk difference, 20.6%; 95% CI, -1.4%-42.5%). mRS 0-2 outcome was associated with reperfusion for M2 trunk (n = 9) or M2 division (n = 42) occlusions, but not for M2 branch occlusions (n = 28). Of participants with trunk and division occlusions, 63.2% with modified TICI 2a and 42.9% with modified TICI 2b reperfusion achieved mRS 0-2 outcomes; mRS 0-2 outcomes for M2 trunk occlusions (33%) did not differ from distal (38.2%) and proximal (26.9%) M1 occlusions. CONCLUSIONS mRS 0-2 at 90 days was dependent on reperfusion for M2 trunk but not for M2 branch occlusions. For M2 division occlusions, good outcome with modified TICI 2b reperfusion did not differ from that in modified TICI 2a. M2 segment definition and occlusion location may contribute to differences in revascularization and good outcome between Interventional Management of Stroke III and other endovascular therapy studies.
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Affiliation(s)
- T A Tomsick
- From the Department of Radiology (T.A.T., J.C.), University of Cincinnati Academic Health Center, University Hospital, Cincinnati, Ohio
| | - J Carrozzella
- From the Department of Radiology (T.A.T., J.C.), University of Cincinnati Academic Health Center, University Hospital, Cincinnati, Ohio
| | - L Foster
- Department of Biostatistics, Bioinformatics, and Epidemiology (L.F., Y.P., S.D.Y.), Medical University of South Carolina, Charleston, South Carolina
| | - M D Hill
- Calgary Stroke Program (M.D.H., A.M.D.), Department of Clinical Neurosciences, Medicine, Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Foothills Hospital, Calgary, Alberta, Canada
| | - R von Kummer
- Department of Neuroradiology (R.v.K.), Dresden University Stroke Center, Universitätsklinikum Carl Gustav Carusan deTechnischen Universität Dresden, Dresden, Germany
| | - M Goyal
- Department of Radiology and Clinical Neurosciences (M.G.), University of Calgary, Calgary, Alberta, Canada
| | - A M Demchuk
- Calgary Stroke Program (M.D.H., A.M.D.), Department of Clinical Neurosciences, Medicine, Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Foothills Hospital, Calgary, Alberta, Canada
| | - P Khatri
- Department of Neurology (P.K., J.P.B.), University of Cincinnati Academic Health Center, Cincinnati, Ohio
| | - Y Palesch
- Department of Biostatistics, Bioinformatics, and Epidemiology (L.F., Y.P., S.D.Y.), Medical University of South Carolina, Charleston, South Carolina
| | - J P Broderick
- Department of Neurology (P.K., J.P.B.), University of Cincinnati Academic Health Center, Cincinnati, Ohio
| | - S D Yeatts
- Department of Biostatistics, Bioinformatics, and Epidemiology (L.F., Y.P., S.D.Y.), Medical University of South Carolina, Charleston, South Carolina
| | - D S Liebeskind
- University of California Los Angeles Stroke Center (D.S.L.), Los Angeles, California
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Foster L. I don't need a degree to know how to be a good nurse. Nurs Stand 2016; 30:28-29. [PMID: 27154110 DOI: 10.7748/ns.30.36.28.s37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
I recently returned home after caring for a patient who had been neither shaved nor adequately fed for 12 days. I returned home to a daughter who had been refused entry to do a nursing degree at university because her grades were not ABB. I didn't need a degree to ask my patient if he normally had a beard, to encourage him to order breakfast or to find out that he didn't want to be any trouble and, due to a fractured arm, could not feed or shave himself.
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Beevers C, Pearce G, Foster L, Mortimer R. Positive control dose response curves in the in vivo comet assay. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mirza A, Foster L, Valentine H, Welch I, West CM, Pritchard S. Investigation of the epithelial to mesenchymal transition markers S100A4, vimentin and Snail1 in gastroesophageal junction tumors. Dis Esophagus 2014; 27:485-92. [PMID: 23082947 DOI: 10.1111/j.1442-2050.2012.01435.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Epithelial to mesenchymal transition (EMT) promotes tumor progression and invasion. As no study has focused on gastroesophageal junction (GEJ) tumors, the expression of three EMT-related proteins (S100A4, vimentin, and Snail1) was investigated with the aim of assessing their pathologic and prognostic significance. Resection specimens were obtained from 104 patients who underwent surgery for GEJ adenocarcinoma, without preoperative chemotherapy. Three tissue cores were obtained from each of the tumor body (TB), luminal surface (LS), and invasive edge (IE) to produce tissue microarrays, and immunohistochemical staining was performed. The microarrays were scored independently by two observers. The demographic and histopathologic details of the patients were collected. Overall positive expression was observed in 88 (S100A4, 85%), 16 (vimentin, 14%), and 92 (Snail1, 89%) tumors. Staining for S100 A4 was positive in 79 (76%) of TB, 69 (66%) of IE, and 69 (66%) of LS specimens. Staining for vimentin was positive in 7 (6%) of TB, 11 (11%) of IE, and 5 (5%) of LS specimens. Staining for Snail1 was positive in 83 (80%) of TB, 51 (49%) of IE, and 78 (75%) of LS specimens. Positive staining of TB for S100A4 (P = 0.04) and Snail1 at IE (P = 0.01) was associated with involvement of circumferential resection margins. Positive staining for S100A4 in the TB (P = 0.02) and LS (P = 0.01) was associated with poor 5-year overall survival. Vimentin had no statistically significant relationships with pathologic factors or outcome. The acquisition of mesenchymal protein S100A4 is associated with a poor prognosis in patients with GEJ tumors who undergo potentially curative surgery, and LS samples can be used to obtain prognostic information. Increased EMT-related protein expression (S100A4, Snail1) is associated with the involvement of circumferential resection margin.
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Affiliation(s)
- A Mirza
- Department of Gastrointestinal Surgery, University Hospital of South Manchester, Manchester, UK; Department of Histopathology, University Hospital of South Manchester, Manchester, UK
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Daley AJ, Foster L, Long G, Palmer C, Robinson O, Walmsley H, Ward R. The effectiveness of exercise for the prevention and treatment of antenatal depression: systematic review with meta-analysis. BJOG 2014; 122:57-62. [DOI: 10.1111/1471-0528.12909] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2014] [Indexed: 11/28/2022]
Affiliation(s)
- AJ Daley
- Primary Care Clinical Sciences; University of Birmingham; Birmingham UK
| | - L Foster
- College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
| | - G Long
- College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
| | - C Palmer
- College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
| | - O Robinson
- College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
| | - H Walmsley
- College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
| | - R Ward
- College of Medical and Dental Sciences; University of Birmingham; Birmingham UK
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17
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Foster L, Tate D, Poulton K. A group-specific sequencing approach to investigate the presence of atypical human leucocyte antigen alleles. Int J Immunogenet 2013; 40:453-9. [PMID: 23724946 DOI: 10.1111/iji.12070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 05/26/2013] [Accepted: 05/15/2013] [Indexed: 11/29/2022]
Abstract
Accurate human leucocyte antigen (HLA) typing results are essential in determining the degree of compatibility between donor and recipient in both solid organ (SO) and hematopoietic stem cell (HSC) transplantation. Current HLA typing methodologies can generate ambiguous results which may need resolving. This group-specific sequencing approach allowed investigation into the presence of the low expressor HLA-A*24:02:01:02L allele and the rare HLA-A*02:64 allele in a SO transplant recipient and a HSC transplant recipient, respectively. Locus-specific amplification of HLA-A was performed. Exons 2 and 3 were sequenced in both directions followed by group-specific sequencing to resolve ambiguities. Hemizygous sequence data of intron 2 generated from the HLA-A*24 allele indicated the presence of the HLA-A*24:02:01:01 allele. HLA-A*02:64 was identified by sequencing the allele in isolation over exons 2 and 3 and allowed confirmation of this allele sequence with the IMGT/HLA database (Accession number AY297166). This approach is cost efficient and can be modified to sequence alleles at other HLA loci. It has also been adapted to characterize the novel HLA-DQB1*06:48 allele (Accession number HE647646) as well as the non-HLA gene, UGT2B17, making it a useful tool to augment existing typing methodologies.
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Affiliation(s)
- L Foster
- Transplantation Laboratory, Manchester Royal Infirmary, Manchester, UK
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Darkins A, Foster L, Anderson C, Goldschmidt L, Selvin G. The design, implementation, and operational management of a comprehensive quality management program to support national telehealth networks. Telemed J E Health 2013; 19:557-64. [PMID: 23705961 DOI: 10.1089/tmj.2012.0263] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Veterans Health Administration (VHA) is a large integrated healthcare system with a mission to care for over 5.6 million Veteran patients annually. VHA, like other healthcare organizations, is challenged with providing access to care to those it serves when they live at a distance from a physical site of care. VHA has embraced telehealth as a way of delivering care at a distance and increase access to specialty care services. Since 2003 VHA has developed large national telehealth networks that provided care to 497,342 patients in fiscal year 2012, who received 1,429,424 episodes of care, and is recognized as a national leader in this field. To ensure the safety and effectiveness of its telehealth networks in their delivery of care VHA has implemented a dedicated quality management (QM) program for telehealth. QM data for telehealth are reviewed at 3-month intervals, and the procedures and processes in place to support telehealth in VHA are assessed biannually in an internal accreditation process called "Telehealth Conditions of Participation." This collegial, nonadversarial process has ensured that all designated telehealth programs meet minimal standards and disseminate best practice. As a result of VHA's QM program, telehealth services in VHA meet consistently high clinical outcomes and have received no adverse Joint Commission citations. The Joint Commission regularly assesses patients managed via telehealth under its tracer methodology reviews.
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Affiliation(s)
- Adam Darkins
- Telehealth Services, Department of Veterans Affairs, Washington, DC 20420, USA.
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Foster L, Tate D, Poulton K. Characterization of the novel HLA-DQB1*06:48 allele by group-specific sequencing. Int J Immunogenet 2012; 40:322-3. [DOI: 10.1111/iji.12004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 09/20/2012] [Indexed: 11/28/2022]
Affiliation(s)
- L. Foster
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - D. Tate
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - K. Poulton
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
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Bohm M, Cotton D, Foster L, Custodis F, Laufs U, Sacco R, Bath PMW, Yusuf S, Diener HC. Impact of resting heart rate on mortality, disability and cognitive decline in patients after ischaemic stroke. Eur Heart J 2012; 33:2804-12. [DOI: 10.1093/eurheartj/ehs250] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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22
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Jervis S, Collins P, Tate D, Foster L, Bowman V, Adhern C, Bloor A, Yin J, Wynn R, Poulton K. Increased severity of acute graft versus host disease as a result of differential expression following a homozygous gene deletion. Int J Immunogenet 2012; 40:116-9. [DOI: 10.1111/j.1744-313x.2012.01138.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 04/23/2012] [Accepted: 05/24/2012] [Indexed: 11/28/2022]
Affiliation(s)
- S. Jervis
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - P. Collins
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - D. Tate
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - L. Foster
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - V. Bowman
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
| | - C. Adhern
- Clinical Trials Department; Manchester Royal Infirmary; Manchester; UK
| | - A. Bloor
- Department of Haematology; The Christie Hospital NHS Foundation Trust; Manchester; UK
| | - J. Yin
- Department of Haematology; Manchester Royal Infirmary; Manchester; UK
| | - R. Wynn
- Blood and Marrow Transplant Unit; Royal Manchester Childrens Hospital; Manchester; UK
| | - K. Poulton
- Transplantation Laboratory; Manchester Royal Infirmary; Manchester; UK
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23
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Rickard C, Webster J, Wallis M, Marsh N, McGrail M, French V, Foster L, Gallagher P, Gowardman J, McClymont A, Whitby M. Peripheral intravenous catheters can be left in situ until clinically indicated for removal: Randomised controlled trial. Aust Crit Care 2012. [DOI: 10.1016/j.aucc.2011.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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24
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Foster L, Clark T, Patrick T, Foster M, Comadira G. Central line associated bloodstream infection (CLABSI) at gold coast hospital (GCH) intensive care unit. Aust Crit Care 2012. [DOI: 10.1016/j.aucc.2011.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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25
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Hamilton B, Lazaryan A, McLellan L, Rybicki L, Foster L, Cooper M, Dabney J, Tench S, Sobecks R, Duong H, Kalaycio M, Bolwell B, Copelan E. Quality of Life and Psychosocial Functioning After Allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT) from Matched Sibling Compared to Unrelated Donors. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Kerr J, Foster L. Sustainable consumption - UK Government activity. NUTR BULL 2011. [DOI: 10.1111/j.1467-3010.2011.01928.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Young LB, Foster L, Silander A, Wakefield BJ. Home Telehealth: Patient Satisfaction, Program Functions, and Challenges for the Care Coordinator. J Gerontol Nurs 2011; 37:38-46. [DOI: 10.3928/00989134-20110706-02] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 02/10/2011] [Indexed: 11/20/2022]
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Penny A, Foster L, Robinson K, Sutliffe C, Jones J. 57 Are Research Participants Truly Informed? Changes in Readability of Informed Consent Over Time. Ann Emerg Med 2011. [DOI: 10.1016/j.annemergmed.2011.06.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Engman M, Bystrom B, Varghese S, Lalitkumar PGL, Gemzell-Danielsson K, Romeu C, Urries A, Lierta M, Sanchez Rubio J, Sanz B, Perez I, Casis L, Salerno A, Nazzaro A, Di Iorio L, Bonassisa P, Van Os L, Vink-Ranti CQJ, de Haan-Cramer JH, Rijnders PM, Jansen CAM, Nazzaro A, Salerno A, Marino S, Granato C, Pastore E, Brandes M, Hamilton CJCM, de Bruin JP, Bots RSGM, Nelen WLDM, Kremer JAM, Szkodziak P, Wozniak S, Czuczwar P, Paszkowski T, Wozniak S, Szkodziak P, Czuczwar P, Paszkowski T, Agirregoitia N, Peralta L, Mendoza R, Exposito A, Matorras R, Agirregoitia E, Chuderland D, Ben-Ami I, Kaplan-Kraicer R, Grossman H, Satchi- Fainaro R, Eldar-Boock A, Ron-El R, Shalgi R, Custers IM, Scholten I, Moolenaar LM, Flierman PA, Dessel TJHM, Gerards MH, Cox T, Janssen CAH, van der Veen F, Mol BWJ, Wathlet S, Adriaenssens T, Verheyen G, Coucke W, Smitz J, Feliciani E, Ferraretti AP, Paesano C, Pellizzaro E, Magli MC, Gianaroli L, Hernandez J, Rodriguez-Fuentes A, Garcia-Guzman R, Palumbo A, Radunovic N, Tosic T, Djukic S, Lockwood JC, Adriaenssens T, Wathlet S, Van Landuyt L, Verheyen G, Coucke W, Smitz J, Karayalcin R, Ozcan SARP, Ozyer S, Gurlek B, Kale I, Moraloglu O, Batioglu S, Chaudhury K, Narendra Babu K, Mamata Joshi V, Srivastava S, Chakravarty BN, Viardot-Foucault V, Prasath EB, Tai BC, Chan JKY, Loh SF, Cordeiro I, Leal F, Soares AP, Nunes J, Sousa S, Aguiar A, Carvalho M, Calhaz-Jorge C, Karkanaki A, Piouk A, Katsikis I, Mousatat T, Koiou E, Daskalopoulos GN, Panidis D, Tolikas A, Tsakos E, Gerou S, Prapas Y, Loufopoulos A, Abanto E, Barrenetxea G, Agirregoikoa J, Anarte C, De Pablo JL, Burgos J, Komarovsky D, Friedler S, Gidoni Y, Ben-ami I, Strassburger D, Bern O, Kasterstein E E, Komsky A, Maslansky B, Ron-El R, Raziel A, Fuentes A, Argandona F, Gabler F, Galleguillos A, Torres A, Palomino WA, Gonzalez-Fernandez R, Pena O, Hernandez J, Palumbo A, Avila J, Talebi Chahvar S, Biondini V, Battistoni S, Giannubilo S, Tranquilli AL, Stensen MH, Tanbo T, Storeng R, Abyholm T, Fedorcsak P, Johnson SR, Foster L, Ellis J, Choi JR, Joo JK, Son JB, Lee KS, Helmgaard L, Klein BM, Arce JC, Sanhueza P, Donoso P, Salinas R, Enriquez R, Saez V, Carrasco I, Rios M, Gonzalez P, Macklon N, Guo M, Richardson M, Wilson P, Chian RC, Eapen A, Hrehorcak M, Campbell S, Nargund G, Oron G, Fisch B, Ao A, Freidman O, Zhang XY, Ben-Haroush A, Abir R, Hantisteanu S, Ellenbogen A, Hallak M, Michaeli M, Fainaru O, Maman E, Yong G, Kedem A, Yeruahlmi G, Konopnicki S, Cohen B, Dor J, Hourvitz A, Moshin V, Croitor M, Hotineanu A, Ciorap Z, Rasohin E, Aleyasin A, Agha Hosseini M, Mahdavi A, Safdarian L, Fallahi P, Mohajeri MR, Abbasi M, Esfahani F, Elnashar A, Badawy A, Totongy M, Mohamed H, Mustafa F, Seidman DS, Tadir Y, Goldchmit C, Gilboa Y, Siton A, Mashiach R, Rabinovici J, Yerushalmi GM, Inoue O, Kuji N, Fukunaga T, Ogawa S, Sugawara K, Yamada M, Hamatani T, Hanabusa H, Yoshimura Y, Kato S, Casarini L, La Marca A, Lispi M, Longobardi S, Pignatti E, Simoni M, Halpern G, Braga DPAF, Figueira RCS, Setti AS, Iaconelli Jr. A, Borges Jr. E, Vingris L, Setti AS, Braga DPAF, Figueira RCS, Iaconelli Jr. A, Pasqualotto FF, Borges Jr. E, Collado-Fernandez E, Harris SE, Cotterill M, Elder K, Picton HM, Serra V, Garrido N, Casanova C, Lara C, Remohi J, Bellver J, Steiner HP, Kim CH, You RM, Nah HY, Kang HJ, Kim S, Chae HD, Kang BM, Reig Viader R, Brieno Enriquez MA, Toran N, Cabero L, Giulotto E, Garcia Caldes M, Ruiz-Herrera A, Brieno-Enriquez M, Reig-Viader R, Toran N, Cabero L, Martinez F, Garcia-Caldes M, Velthut A, Zilmer M, Zilmer K, Haller T. Kaart E, Karro H, Salumets A, Bromfield JJ, Sheldon IM, Rezacova J, Madar J, Cuchalova L, Fiserova A, Shao R, Billig H. POSTER VIEWING SESSION - FEMALE (IN) FERTILITY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.82] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Darkins A, Ryan P, Kobb R, Foster L, Edmonson E, Wakefield B, Lancaster AE. Care Coordination/Home Telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions. Telemed J E Health 2009; 14:1118-26. [PMID: 19119835 DOI: 10.1089/tmj.2008.0021] [Citation(s) in RCA: 290] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Between July 2003 and December 2007, the Veterans Health Administration (VHA) introduced a national home telehealth program, Care Coordination/Home Telehealth (CCHT). Its purpose was to coordinate the care of veteran patients with chronic conditions and avoid their unnecessary admission to long-term institutional care. Demographic changes in the veteran population necessitate VHA increase its noninstitutional care (NIC) services 100% above its 2007 level to provide care for 110,000 NIC patients by 2011. By 2011, CCHT will meet 50% of VHA's anticipated NIC provision. CCHT involves the systematic implementation of health informatics, home telehealth, and disease management technologies. It helps patients live independently at home. Between 2003 and 2007, the census figure (point prevalence) for VHA CCHT patients increased from 2,000 to 31,570 (1,500% growth). CCHT is now a routine NIC service provided by VHA to support veteran patients with chronic conditions as they age. CCHT patients are predominantly male (95%) and aged 65 years or older. Strict criteria determine patient eligibility for enrollment into the program and VHA internally assesses how well its CCHT programs meet standardized clinical, technology, and managerial requirements. VHA has trained 5,000 staff to provide CCHT. Routine analysis of data obtained for quality and performance purposes from a cohort of 17,025 CCHT patients shows the benefits of a 25% reduction in numbers of bed days of care, 19% reduction in numbers of hospital admissions, and mean satisfaction score rating of 86% after enrolment into the program. The cost of CCHT is $1,600 per patient per annum, substantially less than other NIC programs and nursing home care. VHA's experience is that an enterprise-wide home telehealth implementation is an appropriate and cost-effective way of managing chronic care patients in both urban and rural settings.
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Affiliation(s)
- Adam Darkins
- Department of Veterans Affairs, Office of Care Coordination Services, Washington, D.C. 20420, USA.
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Mitton C, Macnab YC, Smith N, Foster L. Injury data in British Columbia: policy maker perspectives on knowledge transfer. Chronic Dis Can 2009; 29:70-79. [PMID: 19281692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Provincial and regional decision makers in the injury prevention field were interviewed in British Columbia (B.C.) to obtain their views about best processes for the transfer or dissemination of relevant data. These decision makers (n = 13) indicated that data should provide them with a holistic and comprehensive picture to support their decision processes. In addition, they felt information about injury types and rates should be linked backward to determinants or causes and forward to consequences or outcomes. This complete chain of data is needed for planning and evaluating health promotion interventions. It was also felt that data providers needed to devote more effort to fostering effective receptor capacity, so that injury prevention professionals will be better able to understand, interpret and apply the data. These findings can likely be generalized to other jurisdictions and policy areas, and offer additional insight into the practicalities of knowledge transfer and exchange in researcher/decision maker partnerships.
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Affiliation(s)
- C Mitton
- Faculty of Health and Social Development, University of British Columbia Okanagan, 3333 University Way, Kelowna, BC V1V 1V7.
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Bolton L, Girolami S, Slayton S, Berger TM, Foster L, Whittington KT, Merkle D. Assessing the need for developing a comprehensive content-validated pressure ulcer guideline. Ostomy Wound Manage 2008; 54:22-30. [PMID: 19037134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Healthcare professionals need evidence-based strategies and guidelines for care to optimize pressure ulcer prevention and management. Differences among pressure ulcer guidelines confuse caregivers, reducing consistency of care. To assess the need for a comprehensive content-validated guideline document, the Association for the Advancement of Wound Care Guideline Subcommittee evaluated current pressure ulcer guideline recommendations by compiling 10 pressure ulcer-specific guidelines existing before June 2008 on the National Guideline Clearinghouse website along with the National Pressure Ulcer Advisory Panel (draft), European Pressure Ulcer Advisory Panel (draft), and Wound Healing Society guidelines. Steps for each aspect of pressure ulcer management were compiled and inconsistent recommendations identified. Currently available pressure ulcer guidelines were found to differ in definitions, aspects of care, validation, evidence criteria, and procedural recommendations, potentially affecting consistency and quality of all aspects of pressure ulcer management, including diagnosis, prevention, treatment, and outcomes measurement. To address these inconsistencies, a comprehensive list of Pressure Ulcer Care Initiative (PUCI) steps was prepared for content validation and posted on www.aawconline.org, enabling healthcare professionals interested in improving the consistency and quality of pressure ulcer prevention and care to participate in this process. All steps with a content validity index > 0.75 (rated clinically relevant by survey respondents) and/or with A-level standardized clinical evidence support will be included in the comprehensive PUCI guideline. Content validation of recommendations is an important first step to improving the consistency of pressure ulcer care.
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Affiliation(s)
- Laura Bolton
- Department of Surgery, Robert Wood Johnson University Medical School, New Brunswick, New Jersey, USA.
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Abstract
We have reviewed the data from our regional Bone Tumour Registry on patients with osteosarcoma diagnosed between 1933 and 2004 in order to investigate the relationship between survival and changes in treatment. There were 184 patients with non-metastatic appendicular osteosarcoma diagnosed at the age of 18 or under. Survival was calculated using Kaplan-Meier curves, and multivariate analysis was performed using the Cox regression proportional hazards model. The five-year survival improved from 21% between 1933 and 1959, to 62% between 1990 and 1999. During this time, a multi-disciplinary organisation was gradually developed to manage treatment. The most significant variable affecting outcome was the date of diagnosis, with trends in improved survival mirroring the introduction of increasingly effective chemotherapy. Our experience suggests that the guidelines of the National Institute for Clinical Excellence on the minimum throughput of centres for treatment should be enforced flexibly in those that can demonstrate that their historical and contemporary results are comparable to those published nationally and internationally.
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Affiliation(s)
- L Foster
- Department of Paediatric Oncology, University of Edinburgh, Royal Hospital for Sick Children, Sciennes Road, Edinburgh EH9 1LW, UK
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Townsend A, Ohlén C, Bastin J, Ljunggren HG, Foster L, Kärre K. Pillars article: Association of class I major histocompatibility heavy and light chains induced by viral peptides. Nature 1989. 340: 443-448. J Immunol 2007; 179:4301-6. [PMID: 17878323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
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Earl H, Hiller L, Dunn JA, Bathers S, Grieve RJ, Spooner D, Agrawal RK, Foster L, Twelves C, Poole CJ. The National Epirubicin Adjuvant Trial (NEAT) and Scottish Cancer Trials Breast Group (SCTBG) br9601 randomized phase III adjuvant early breast cancer trials: The updated definitive joint analysis. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
534 Background: NEAT and the SCTBG BR9601 trial address the role of Epirubicin (E) as an adjunct to CMF in adjuvant chemotherapy for women with early breast cancer (EBC). Methods: NEAT compared E (100mg/m2 x4cycles) followed by classical (c)CMF (x4cycles) with cCMF (x6cycles); BR9601 compared E (100mg/m2 × 4cycles) followed by iv dose modified CMF q3w (750:50:600 ×4cycles) with iv CMF (x8cycles). Eligibility was completely excised EBC, requiring adjuvant chemotherapy, and start of treatment <10 wks from surgery. Primary outcome measures were relapse-free-survival (RFS) and overall survival (OS). A joint efficacy analysis of NEAT (n=2,021) and BR9601 (n=370) triggered by planned 5-year median follow-up (FU) and estimated 800 RFS events and 600 deaths has 85% power to detect 5% two-sided differences. Results: In 2,391 eligible patients, characteristics were balanced across treatments: 72% node +ve; 59% <50 years old; 47% pre-menopausal; 58% tumours grade 3; 55% >2cms; 32% ER-ve, 50% ER+ve (18% NA). At a median FU of 6.2 yrs, 710 relapses or deaths without relapse and 570 deaths are observed. Despite lower than anticipated event rates in the control arm, these updated results confirm a highly significant benefit in favour of ECMF for both RFS (HR 0.75 (95%CI 0.64–0.87) p=0.0002) and OS (HR 0.74 (0.62–0.87) p=0.0004), independent of trial and prognostic factors. In 1458 NEAT patients (in whom data are available), 68% were to receive tamoxifen; chemotherapy scheduling data is available for 843, of whom 46% were declared concurrent and 54% sequential. In a non-pre-planned retrospective analysis, sequential tamoxifen shows a trend for advantage on RFS (HR 0.78 (0.59–1.02) p=0.06). We have amenorrhoea data on 598 NEAT and BR9601 pre-menopausal women, of whom 72% became amenorrhoeic by the end of chemotherapy. In this instance, developing amenorrhoea showed no advantage for RFS (HR 0.90 (0.65–1.24) or OS (HR 0.99 (0.68–1.44)). Conclusions: This updated definitive analysis adds to the Overview in respect of an anthracycline advantage and confirms ECMF as an established and effective standard adjuvant therapy for EBC. [Table: see text]
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Affiliation(s)
- H. Earl
- University of Cambridge, Cambridge, United Kingdom; University of Warwick, Coventry, United Kingdom; Institute for Cancer Studies, Birmingham, United Kingdom; Walsgrave Hospital, Coventry, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; Royal Shrewsbury Hospital, Shropshire, United Kingdom; Scottish Cancer Therapy Network, Edinburgh, United Kingdom; Institute of Cancer Therapeutics, Bradford, United Kingdom
| | - L. Hiller
- University of Cambridge, Cambridge, United Kingdom; University of Warwick, Coventry, United Kingdom; Institute for Cancer Studies, Birmingham, United Kingdom; Walsgrave Hospital, Coventry, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; Royal Shrewsbury Hospital, Shropshire, United Kingdom; Scottish Cancer Therapy Network, Edinburgh, United Kingdom; Institute of Cancer Therapeutics, Bradford, United Kingdom
| | - J. A. Dunn
- University of Cambridge, Cambridge, United Kingdom; University of Warwick, Coventry, United Kingdom; Institute for Cancer Studies, Birmingham, United Kingdom; Walsgrave Hospital, Coventry, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; Royal Shrewsbury Hospital, Shropshire, United Kingdom; Scottish Cancer Therapy Network, Edinburgh, United Kingdom; Institute of Cancer Therapeutics, Bradford, United Kingdom
| | - S. Bathers
- University of Cambridge, Cambridge, United Kingdom; University of Warwick, Coventry, United Kingdom; Institute for Cancer Studies, Birmingham, United Kingdom; Walsgrave Hospital, Coventry, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; Royal Shrewsbury Hospital, Shropshire, United Kingdom; Scottish Cancer Therapy Network, Edinburgh, United Kingdom; Institute of Cancer Therapeutics, Bradford, United Kingdom
| | - R. J. Grieve
- University of Cambridge, Cambridge, United Kingdom; University of Warwick, Coventry, United Kingdom; Institute for Cancer Studies, Birmingham, United Kingdom; Walsgrave Hospital, Coventry, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; Royal Shrewsbury Hospital, Shropshire, United Kingdom; Scottish Cancer Therapy Network, Edinburgh, United Kingdom; Institute of Cancer Therapeutics, Bradford, United Kingdom
| | - D. Spooner
- University of Cambridge, Cambridge, United Kingdom; University of Warwick, Coventry, United Kingdom; Institute for Cancer Studies, Birmingham, United Kingdom; Walsgrave Hospital, Coventry, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; Royal Shrewsbury Hospital, Shropshire, United Kingdom; Scottish Cancer Therapy Network, Edinburgh, United Kingdom; Institute of Cancer Therapeutics, Bradford, United Kingdom
| | - R. K. Agrawal
- University of Cambridge, Cambridge, United Kingdom; University of Warwick, Coventry, United Kingdom; Institute for Cancer Studies, Birmingham, United Kingdom; Walsgrave Hospital, Coventry, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; Royal Shrewsbury Hospital, Shropshire, United Kingdom; Scottish Cancer Therapy Network, Edinburgh, United Kingdom; Institute of Cancer Therapeutics, Bradford, United Kingdom
| | - L. Foster
- University of Cambridge, Cambridge, United Kingdom; University of Warwick, Coventry, United Kingdom; Institute for Cancer Studies, Birmingham, United Kingdom; Walsgrave Hospital, Coventry, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; Royal Shrewsbury Hospital, Shropshire, United Kingdom; Scottish Cancer Therapy Network, Edinburgh, United Kingdom; Institute of Cancer Therapeutics, Bradford, United Kingdom
| | - C. Twelves
- University of Cambridge, Cambridge, United Kingdom; University of Warwick, Coventry, United Kingdom; Institute for Cancer Studies, Birmingham, United Kingdom; Walsgrave Hospital, Coventry, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; Royal Shrewsbury Hospital, Shropshire, United Kingdom; Scottish Cancer Therapy Network, Edinburgh, United Kingdom; Institute of Cancer Therapeutics, Bradford, United Kingdom
| | - C. J. Poole
- University of Cambridge, Cambridge, United Kingdom; University of Warwick, Coventry, United Kingdom; Institute for Cancer Studies, Birmingham, United Kingdom; Walsgrave Hospital, Coventry, United Kingdom; Queen Elizabeth Hospital, Birmingham, United Kingdom; Royal Shrewsbury Hospital, Shropshire, United Kingdom; Scottish Cancer Therapy Network, Edinburgh, United Kingdom; Institute of Cancer Therapeutics, Bradford, United Kingdom
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MacNab YC, Hu W, Barnard KD, Shep S, Lin Y, Foster L, Mitton C. Bayesian Disease Mapping and Gis-Based Spatiotemporal Iatrogenic Injury Surveillance. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s28-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Amphlett G, Cacia J, Callahan W, Cannova-Davis E, Chang B, Cleland JL, Darrington T, DeYoung L, Dhingra B, Everett R, Foster L, Frenz J, Garcia A, Giltinan D, Gitlin G, Gombotz W, Hageman M, Harris R, Heller D, Herman A, Hershenson S, Hora M, Ingram R, Janes S, Watanabe C. A compendium and hydropathy/flexibility analysis of common reactive sites in proteins: reactivity at Asn, Asp, Gln, and Met motifs in neutral pH solution. Pharm Biotechnol 2002; 9:1-140. [PMID: 8914190 DOI: 10.1007/0-306-47452-2_1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- G Amphlett
- Department of pharmaceutical Research and Development, Genentech, Inc., South San Francisco, California 94080, USA
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Abstract
This article describes a case of necrotizing fasciitis in a 52-year-old man with previously undiagnosed diabetes. Treatment involved massive debridement and subsequent dressing of the open surgical wound. A modern hydrofibre dressing (Aquacel) was inserted intraoperatively and subsequently continued postoperatively. Wound healing occurred over 3 months and the patient was discharged with no disability. The dressing managed the exudate level and kept the wound moist. It also was well tolerated by the patient, was comfortable and easy for the nurses to remove and apply.
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Affiliation(s)
- L Foster
- Department of Effective Healthcare, Scunthorpe and Goole Hospitals NHS Trust, North Lincolnshire
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40
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Abstract
OBJECTIVES To investigate the efficacy of botulinum toxin A in chronic low back pain and associated disabilities. METHODS Thirty-one consecutive patients with chronic low back pain who met the inclusion criteria were studied: 15 received 200 units of botulinum toxin type A, 40 units/site at five lumbar paravertebral levels on the side of maximum discomfort, and 16 received normal saline. Each patient's baseline level of pain and degree of disability was documented using the visual analogue scale (VAS) and the Oswestry Low Back Pain Questionnaire (OLBPQ). The authors reevaluated the patients at 3 and 8 weeks (visual analogue scale) and at 8 weeks (OLBPQ). RESULTS At 3 weeks, 11 of 15 patients who received botulinum toxin (73.3%) had >50% pain relief vs four of 16 (25%) in the saline group (p = 0.012). At 8 weeks, nine of 15 (60%) in the botulinum toxin group and two of 16 (12.5%) in the saline group had relief (p = 0.009). Repeat OLBPQ at 8 weeks showed improvement in 10 of 15 (66.7%) in the botulinum toxin group vs three of 16 (18.8%) in the saline group (p = 0.011). No patient experienced side effects. CONCLUSION Paravertebral administration of botulinum toxin A in patients with chronic low back pain relieved pain and improved function at 3 and 8 weeks after treatment.
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Affiliation(s)
- L Foster
- Department of Physical Medicine & Rehabilitation, Walter Reed Army Medical Center, Washington, DC, USA
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41
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Neal DE, Foster L. Southern Illinois University (SIU) sling-bone anchored semitendinosus. Tech Urol 2001; 7:62-3. [PMID: 11272682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
We describe a new type of pubovaginal sling that uses autologous fascia and minimizes the discomfort of harvest. The harvest is technically easy. The results are comparable to those of other slings previously described.
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Affiliation(s)
- D E Neal
- Division of Urology, SIU School of Medicine, Springfield, Illinois, USA
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42
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Meadows KA, Greene T, Foster L, Beer S. The impact of different response alternatives on responders' reporting of health-related behaviour in a postal survey. Qual Life Res 2001; 9:385-91. [PMID: 11131931 DOI: 10.1023/a:1008971602505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Previous experimental research in other topic areas has shown that the choice of response alternatives can influence respondents' reporting of the frequency of vaguely defined events and that the set of response alternatives is treated as information in the interpretation of the question. The aim of this study was to examine whether such affects would occur in the context of respondents reporting of health-related events using high and medium frequency closed format response categories, which might be used interchangeably by researchers. The study consisted of a postal survey of n = 518 patients aged > or = 18 years randomly selected from the patient list of a diabetes centre and who were equally and randomly allocated to one of three conditions (Condition A: high frequency response alternatives/horizontal orientation; condition B: medium frequency response alternatives/horizontal orientations; condition C: high frequency response alternatives/vertical orientation). Testing for the effect of response alternatives for the combined responses of five vaguely defined questions between conditions A and B was chi 2 = 5.5, p = 0.019, for the difference in proportions, indicating that overall, those respondents presented with response alternatives discriminating at medium frequency, reported significantly fewer target events than those presented with high frequency response alternatives. Testing for the effect of orientation of the combined question responses between conditions A and C, differences in proportions between conditions, did not reach statistical significance (p > 0.05). Findings from this and previous studies indicate that response alternatives provide information on the interpretation of vaguely defined questionnaire items and that their choice should not be left to intuition alone when designing questionnaire items.
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Affiliation(s)
- K A Meadows
- Health and Survey Research Unit, Applied Statistics Centre, University of Hull, UK.
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43
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Foster L, James S. Human resources. Getting even. Health Serv J 2001; 111:28-9. [PMID: 11256116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
A trust where a third of the workforce is a member of ethnic minority groups has set up a programme to enhance career advancement for this group. The programme aims to celebrate the achievements of ethnic minority staff and give them greater visibility within the organisation. Mentoring programmes and learning sets have been established with the support of senior.
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Copeland RA, Marcinkeviciene J, Haque TS, Kopcho LM, Jiang W, Wang K, Ecret LD, Sizemore C, Amsler KA, Foster L, Tadesse S, Combs AP, Stern AM, Trainor GL, Slee A, Rogers MJ, Hobbs F. Helicobacter pylori-selective antibacterials based on inhibition of pyrimidine biosynthesis. J Biol Chem 2000; 275:33373-8. [PMID: 10938275 DOI: 10.1074/jbc.m004451200] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
We report the discovery of a class of pyrazole-based compounds that are potent inhibitors of the dihydroorotate dehydrogenase of Helicobacter pylori but that do not inhibit the cognate enzymes from Gram-positive bacteria or humans. In culture these compounds inhibit the growth of H. pylori selectively, showing no effect on other Gram-negative or Gram-positive bacteria or human cell lines. These compounds represent the first examples of H. pylori-specific antibacterial agents. Cellular activity within this structural class appears to be due to dihydroorotate dehydrogenase inhibition. Minor structural changes that abrogate in vitro inhibition of the enzyme likewise eliminate cellular activity. Furthermore, the minimum inhibitory concentrations of these compounds increase upon addition of orotate to the culture medium in a concentration-dependent manner, consistent with dihydroorotate dehydrogenase inhibition as the mechanism of cellular inhibition. The data presented here suggest that targeted inhibition of de novo pyrimidine biosynthesis may be a valuable mechanism for the development of antimicrobial agents selective for H. pylori.
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Affiliation(s)
- R A Copeland
- Department of Chemical Enzymology, the Department of Chemical and Physical Sciences, and the Antimicrobials Group, DuPont Pharmaceuticals Company, Wilmington, Delaware 19880-0400, USA
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Abstract
This study aimed to compare the performance of a hydrofibre (Aquacel) and an alginate (Sorbsan) dressing on acute surgical wounds left to heal by secondary intention. A total of 100 patients were prospectively randomised pre-operatively to receive either the hydrofibre or the alginate dressing. Dressing performance was measured at operation, at 24 hours and seven days. Parameters measured included ease of: application and removal of the first dressing; re-application on the first postoperative day; and removal and re-application one week postoperatively. The hydrofibre dressing received higher scores for all of these categories. Patients in this group also experienced less pain (mild or none) on removal of the first dressing and at one week. However, these results did not achieve statistical significance, and should be seen as a trend. Nevertheless, the authors recommend the use of hydrofibre dressings on open acute surgical wounds.
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Affiliation(s)
- L Foster
- Department of Effective Health Care, Scunthorpe and Goole Hospitals NHS Trust, UK
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46
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Abstract
In this prospective randomized controlled trial of the cost benefits of the choice of dressings in acute surgical wounds left to heal by secondary intention, patients had their wounds dressed with either a traditional dressing (ribbon gauze soaked in proflavine) or a modern hydrofibre dressing. Results showed that the hydrofibre dressing, although more expensive than the ribbon gauze, facilitated an earlier discharge from hospital (P = 0.001). The total cost of the patient episode was less in the hydrofibre group (P = 0.01). In an average UK health authority of 300,000 population, 100 bed days a year could be saved releasing an overall potential saving of 55,000 Pounds. A modern hydrofibre dressing allows more effective use of scarce hospital beds and precious financial resources, while still maintaining high quality patient care. It is important that clinical specialists and purchasers of health care should be aware of this clinical and cost-effective advance in the management of acute surgical wounds.
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Affiliation(s)
- P J Moore
- Department of Effective Healthcare, Scunthorpe and Goole Hospitals NHS Trust, Cliff Gardens, Scunthorpe, North Lincolnshire
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47
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Abstract
This report describes an unusual presentation of squamous cell carcinoma of the anal canal involving the vagina; radical surgery resulted in a large cavity wound.
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Affiliation(s)
- P Moore
- Department of Effective Healthcare, Scunthorpe & Goole Hospitals NHS Trust, UK
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Robertson J, Murdoch S, Foster L, Green S. Isolation and species typing of Lyme borreliosis spirochaetes from UK patients with erythema migrans. Eur J Epidemiol 1999; 15:499-500. [PMID: 10442477 DOI: 10.1023/a:1007591501411] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Skin biopsies taken from UK cases of erythema migrans rash were cultured for Borrelia burgdorferi sensu lato. Reverse line blotting was used to type the infecting genospecies in PCR-positive cultures and biopsies. B. garinii or B. afzelii was identified in 56% (5/9) of biopsies/cultures tested. All patients were tested by conventional serology. PCR confirmed infection in two patients where serological testing failed to detect antibody.
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Affiliation(s)
- J Robertson
- Lyme Disease Reference Unit, Public Health Laboratory, Southampton General Hospital, UK.
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Abstract
This article, the last in a series of four, discusses the importance of documenting wound care. Studies have shown that nurses do not document wound care as often, or as accurately, as they should in order to comply with the UKCC's (1998) Guidelines for Records and Record Keeping. Although some wound assessment charts have been published and are in use, there is still concern about the validity or reliability of some of these charts. Studies show that further research is necessary in order to validate the charts that are currently in use. An increase in litigation has placed more emphasis on accurate record keeping which shows, in detail, the wound care that is given to each patient. Patients also want to be more informed about their treatment, and this can be done through the use of clinical pathways or multidisciplinary documents. This article also discusses the factors that have to be considered when putting a wound care chart together and gives some examples of existing charts.
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Affiliation(s)
- L Foster
- Department of Effective Healthcare, Scunthorpe and Goole Hospitals NHS Trust, North Lincolnshire
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50
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Abstract
The third article in this series on surgical wound care discusses the types of dressings currently available, and selection of the correct dressing for a particular wound type. There is an abundance of information on the types of dressings available. Wound management for the individual patient must be decided using best evidence and taking into account patients' increased involvement in their care, new technology and the push to mobilize early, leading to early discharge from hospital. The nurse needs to have a good knowledge of the types of dressings available, the properties of individual dressings and a sound understanding of wound healing, in order to make an informed decision on wound management. General factors such as safety, comfort, pain management and convenience must be borne in mind when deciding which dressing is the best for individual patients, given that dressings now have to be cost-effective as well as clinically effective.
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Affiliation(s)
- L Foster
- Department of Effective Healthcare, Scunthorpe Hospital, NHS Trust, North Lincolnshire
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