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Murray ET, Shelton N, Norman P, Head J. Health of older people in places and work-related outcomes: are all health indicators equal? Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Health has been posited as an explanation for why older people who live in more disadvantaged areas have worse work-related outcomes. The policy implication being that if a higher proportion of older persons in a place had better health, those labour markets would be better for everyone. No literature exists on this topic.
Methods
Data was used from 428,646 members of the Office for National Statistics Longitudinal Study (LS) who were 16-74y at the 2011 census and had information on employment status, economic activity and occupational socioeconomic classification. Generalised Structural Equation Modelling was used to examine whether each of the three work-related outcomes were equally related to nine 2011 local authority district (LAD)-level older adult health indicators.
Results
In age-adjusted analysis, all nine LAD-level health indicators (modelled in terciles) were associated with all three work outcomes. However, strengths of association varied both across and within each outcome. For example, the strongest associations were for being ‘sick or disabled' versus ‘In employment'. If an LS member lived in the ‘unhealthiest' versus ‘healthiest' third of LADs, associations varied between a high of 2.74 higher odds (95% CI: 2.53,2.95) for long-term illness and a low of 2.10 higher odds (1.89,2.32) for disease-free life expectancy at age 50y. The weakest associations were for part-time versus full-time employment: ranging from life expectancy at birth at 1.29 (1.21,1.38) to healthy-life expectancy at age 50y: 1.18 (1.10,1.27). Adjustment for individual health reduced, but did not eliminate, associations. Sensitivity analysis showed robustness to area health indicators being assessed for sub-groups of older people (ages 50-64 & 65-74), genders and a reduced sample of older persons (50-74y) only.
Conclusions
Health of older people in places is associated with work outcomes of people in those places; both the older people themselves and the wider community.
Key messages
At a place level, health and work outcomes are linked. Strengths of association between place-level health and work outcomes will depend on the health measure used.
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Affiliation(s)
- ET Murray
- Epidemiology and Public Health, University College London, London, UK
| | - N Shelton
- Epidemiology and Public Health, University College London, London, UK
| | - P Norman
- School of Geography, University of Leeds, Leeds, UK
| | - J Head
- Epidemiology and Public Health, University College London, London, UK
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Hassan S, Stambulic T, King M, Norman P, Payne D, Derry K, El Diasty M. POST-OPERATIVE PAIN AND ANALGESIC USE FOR CARDIAC SURGERY WITH MEDIAN STERNOTOMY. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.206] [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: 10/20/2022] Open
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Norman P. 6th RSC/SCI Symposium on Ion Channels as Therapeutic Targets. Cambridge, UK - February 24-25, 2020. DRUG FUTURE 2020. [DOI: 10.1358/dof.2020.45.4.3148889] [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: 10/24/2022]
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Johnson B, Norman P, Sanders T, Elliott J, Whitehead V, Campbell F, Hammond P, Ajjan R, Heller S. Working with Insulin, Carbohydrates, Ketones and Exercise to Manage Diabetes (WICKED): evaluation of a self-management course for young people with Type 1 diabetes. Diabet Med 2019; 36:1460-1467. [PMID: 31295354 DOI: 10.1111/dme.14077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/09/2019] [Indexed: 12/22/2022]
Abstract
AIMS To evaluate a 5-day self-management education course for young people with Type 1 diabetes and assess its effects on knowledge, self-efficacy, beliefs, distress, self-management behaviours and HbA1c . METHODS This is an evaluation of a structured education course. Young people (aged 16-24 years) with Type 1 diabetes were recruited from three diabetes centres. In the first centre, participants completed self-report measures of knowledge, self-efficacy, positive and negative outcome expectancies, and hypoglycaemic worries at baseline (n=47) and the end of the course (n=42). In two additional centres, participants completed these and other measures assessing self-management behaviours, cognitive adaptation to diabetes and diabetes distress at baseline (n=32), the end of the course (n=27) and 3-month follow-up (n = 27). HbA1c levels were recorded at baseline (n=79), 6 months (n=77) and 12 months (n=65). RESULTS There were statistically significant increases in self-report knowledge, self-efficacy, positive outcome expectancies and self-management behaviours, and a statistically significant decrease in negative outcome expectances, between baseline and the end of the course. There were also statistically significant increases in self-report knowledge, self-efficacy, self-management behaviours and cognitive adaptation to diabetes between baseline and 3-month follow-up. Compared with baseline, HbA1c levels decreased by a mean (sd) of 5.44 (19.93) mmol/mol (0.48%) at 6 months (P=0.019), and by 5.98 (23.32) mmol/mol (0.54%) at 12 months (P =0.043). DISCUSSION The results indicate the potential benefits of a self-management course designed to address the developmental needs and challenges faced by young people with Type 1 diabetes. Further studies with larger numbers and appropriate controls are required to confirm these initial findings.
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Affiliation(s)
- B Johnson
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - P Norman
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - T Sanders
- Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - J Elliott
- Academic Unit of Diabetes, Endocrinology and Metabolism, University of Sheffield, Sheffield, UK
| | - V Whitehead
- Diabetes Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - F Campbell
- Children's Diabetes Centre, Leeds Children's Hospital, Leeds Teaching Hospitals, Leeds, UK
| | - P Hammond
- Diabetes Resource Centre, Harrogate District Hospital, Harrogate, UK
| | - R Ajjan
- Division of Cardiovascular and Diabetes Research, Leeds Institute for Genetics, Health and Therapeutics, Leeds, UK
| | - S Heller
- Academic Unit of Diabetes, Endocrinology and Metabolism, University of Sheffield, Sheffield, UK
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Johri A, Hetu MF, Heyland DK, Herr JE, Norman P, Matangi MF, Lahaye A, Saunders FW, Spence JD. P4402Effect of carnitine supplementation on progression of carotid plaque in the metabolic syndrome: the ECoM study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
L-carnitine (L-C) has been investigated as a potential therapy for cardiovascular (CV) disease, but its direct effects on human atherosclerosis are unknown. Epidemiological studies suggest a possible reduction of CV risk factors following treatment, whereas animal studies have shown that L-C may increase pro-atherogenic metabolites.
Purpose
The purpose of this study was to determine whether L-C therapy led to atherosclerosis progression or regression by direct quantification of carotid atherosclerotic lesions in patients with metabolic syndrome (MetS).
Methods
This study was a Phase 2, prospective, parallel, double blinded, randomized, placebo-controlled, two-center trial. MetS was defined according to the International Diabetes Federation harmonized definition, where presence of any 3 of the 5 following risk factors constituted a diagnosis: elevated waist circumference; elevated triglycerides; reduced HDL or treated; elevated blood pressure or treated; elevated glucose or HbA1c or treated. Participants with a baseline carotid total plaque volume (TPV) ≥50 mm3 were randomized to placebo or 2 g L-C daily for 6 months. Plaque progression was quantified by 3D carotid ultrasound for change in TPV and reduction in vessel lumen area (% area stenosis, Fig. 1). Absolute differences were assessed on the raw scale, while percent change on the log scale. Analysis of covariance (ANCOVA) was used to assess within- and between-arm differences.
Results
Of the 177 participants randomized, 157 completed the study (L-C n=76, placebo n=81). No statistically significant difference between arms was found in the primary outcome (TPV). However, there was progression of plaque stenosis in the treatment arm: the L-C group had an increase in stenosis of 9.8% (p=0.01) higher than the placebo arm, and a 2.7% (p=0.03) greater absolute change. Total cholesterol and LDL levels (0.10 mmol/L and 0.05 mmol/L, respectively) were higher in the intervention arm compared to the placebo arm (−0.06 mmol/L and −0.07 mmol/L).
Figure 1
Conclusions
We observed progression of atherosclerosis with L-C therapy compared to placebo in patients with MetS. The clear lack of benefit of L-C therapy in this population raises serious concerns for its further use as a potential therapy. Given its association with pro-atherogenic metabolites our study offers further understanding of the atherosclerotic process.
Acknowledgement/Funding
Heart and Stroke Foundation of Canada
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Affiliation(s)
- A Johri
- Queen's University, Medicine, Kingston, Canada
| | - M F Hetu
- Queen's University, Medicine, Kingston, Canada
| | - D K Heyland
- Queen's University, Critical Care Medicine, Kingston, Canada
| | - J E Herr
- Queen's University, Medicine, Kingston, Canada
| | - P Norman
- Kingston Health Sciences Centre, Kingston, Canada
| | | | - A Lahaye
- Queen's University, Medicine, Kingston, Canada
| | - F W Saunders
- Kingston Health Sciences Centre, Kingston, Canada
| | - J D Spence
- Stroke Prevention & Atherosclerosis Research Centre, London, Canada
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Dimou A, Grewe P, Campbell M, Brunetti T, Sidney J, Sette A, Van Bokhoven A, Norman P, Doebele R. P1.04-03 HLA Affinity for Mutant EGFR Derived Peptides Identifies a Group of Patients with EGFR Driven NSCLC and Favorable Prognosis. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Norman P. 2nd SCI/RSC Symposium on Antimicrobial Drug Discovery. London, UK - November 12-13, 2018. DRUG FUTURE 2019. [DOI: 10.1358/dof.2019.44.3.2978745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sanders T, Elliott J, Norman P, Johnson B, Heller S. Experiences of self-management among young adults with Type 1 diabetes in the context of a structured education programme: a qualitative study. Diabet Med 2018; 35:1531-1537. [PMID: 30030858 DOI: 10.1111/dme.13784] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2018] [Indexed: 12/11/2022]
Abstract
AIMS To explore the experiences of young adults with regard to self-management of Type 1 diabetes in the context of a structured education programme. METHODS Qualitative interviews and focus groups were conducted with young adults attending a structured education course promoting a flexible and self-directed format. Participants attending the structured education courses were recruited using purposive sampling to acquire a broad mix of participants based on age and equal numbers of young men and women. Fifteen interviews were conducted 12 weeks after each course, whilst seven focus groups and observations of the course delivery were conducted at two course sites and were led by nurse/dietitian educators representing two different diabetes centres (paediatric and adult). The interview and focus group data were audio recorded and transcribed, coded, and analysed thematically to identify similarities and differences. RESULTS The analysis revealed three themes, 'we're in it together', 'tacit benefits' and 'transitions beyond the structured education programme'. The findings show that structured education programmes can facilitate reflective critical thinking and greater engagement with diabetes self-management if they: a) foster maximal learning from fellow participants to decrease feelings of isolation, b) maximize engagement during the course by delivering the content in a flexible manner, and c) recognize the social and emotional needs of young adults. CONCLUSION Structured education courses can result in improved critical thinking and engagement with diabetes self-management by empowering young adults through a flexible and self-directed learning style that encourages peer group discussion.
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Affiliation(s)
- T Sanders
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - J Elliott
- Academic Unit of Diabetes, Endocrinology and Metabolism, University of Sheffield, Sheffield, UK
| | - P Norman
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - B Johnson
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - S Heller
- Academic Unit of Diabetes, Endocrinology and Metabolism, University of Sheffield, Sheffield, UK
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Walsh D, Buchanan D, Douglas A, Erdman J, Fischbacher C, McCartney G, Norman P, Whyte B. 5.3-O6The changing ethnic profiles of Scotland and Glasgow, and the implications for population health. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Walsh
- Glasgow Centre for Population Health, Scotland
| | | | | | - J Erdman
- NHS Greater Glasgow & Clyde, Scotland
| | | | | | | | - B Whyte
- Glasgow Centre for Population Health, Scotland
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Lan N, Bell D, McCaul K, Vasikaran S, Yeap B, Norman P, Almeida O, Golledge J, Hankey G, Flicker L. High-Sensitivity Cardiac Troponin I Augments Cardiovascular Risk-Stratification in Older Men: Results From the Health in Men Study. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Martinez-Fernandez L, Fahleson T, Norman P, Santoro F, Coriani S, Improta R. Optical absorption and magnetic circular dichroism spectra of thiouracils: a quantum mechanical study in solution. Photochem Photobiol Sci 2017; 16:1415-1423. [DOI: 10.1039/c7pp00105c] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The excited electronic states of thiouracils, the analogues of uracil where the carbonyl oxygens are substituted by sulphur atoms, have been investigated by computing the magnetic circular dichroism (MCD) and one-photon absorption (OPA) spectra at the TD-DFT level of theory.
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Affiliation(s)
| | - T. Fahleson
- KTH Royal Institute of Technology
- SE-10044 Stockholm
- Sweden
| | - P. Norman
- KTH Royal Institute of Technology
- SE-10044 Stockholm
- Sweden
| | - F. Santoro
- Istituto di Chimica dei Composti Organometallici (ICCOM-CNR)
- Area della Ricerca del CNR
- I-56124 Pisa
- Italy
| | - S. Coriani
- Department of Chemistry
- Technical University of Denmark
- Denmark
| | - R. Improta
- Istituto di Biostrutture e Bioimmagini-CNR
- I-80134 Napoli
- Italy
- LIDYL
- CEA
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Montgomery K, Norman P, Messenger AG, Thompson AR. The importance of mindfulness in psychosocial distress and quality of life in dermatology patients. Br J Dermatol 2016; 175:930-936. [PMID: 27169607 PMCID: PMC5091630 DOI: 10.1111/bjd.14719] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mindfulness, defined as purposively and nonjudgementally paying attention in the present moment, could be used within psychosocial interventions to reduce the distress associated with social anxiety and avoidance found in many skin conditions. However, little is known about the relationship between naturally occurring levels of mindfulness and distress in dermatology patients. OBJECTIVES To examine the relationship between mindfulness and psychosocial distress in a dermatological population. It was hypothesized that higher levels of mindfulness would be associated with lower levels of social anxiety, anxiety, depression and skin shame, and with better quality of life. METHODS Adult dermatology outpatients (n = 120) from one hospital completed items assessing subjective severity, skin shame, fear of negative evaluation, anxiety and depression, quality of life, and levels of mindfulness. RESULTS Considering depression, 14% reported mild, 5% moderate and 2·5% severe symptoms. For anxiety, 22% reported mild, 23% moderate and 6% severe symptoms. In addition, 33·4% reported clinically significant social anxiety. After controlling for subjective severity, mindfulness explained an additional 19% of the variance in depression, 39% in anxiety, 41% in social anxiety, 13% in skin shame and 6% in dermatological quality of life. One specific facet of mindfulness (acting with awareness) was found to be the most consistent predictor of distress. CONCLUSIONS The findings indicate that higher levels of mindfulness are associated with lower distress. This suggests that facilitating mindfulness may be helpful in reducing distress in dermatology patients, and the use of mindfulness techniques warrants further investigation.
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Affiliation(s)
- K Montgomery
- Department of Psychology, University of Sheffield, Western Bank, Sheffield, S10 2TP, U.K..
| | - P Norman
- Department of Psychology, University of Sheffield, Western Bank, Sheffield, S10 2TP, U.K
| | - A G Messenger
- Department of Dermatology, Royal Hallamshire Hospital, Sheffield, U.K
| | - A R Thompson
- Department of Psychology, University of Sheffield, Western Bank, Sheffield, S10 2TP, U.K
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Rebello E, Kowalski A, Kee S, Goravanchi F, Norman P, Ruiz J, Hernandez M, Rahlfs T. Abstract PR073. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492481.52868.8a] [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: 11/05/2022]
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Dondo TB, Hall M, Timmis AD, Yan AT, Batin PD, Oliver G, Alabas OA, Norman P, Deanfield JE, Bloor K, Hemingway H, Gale CP. Geographic variation in the treatment of non-ST-segment myocardial infarction in the English National Health Service: a cohort study. BMJ Open 2016; 6:e011600. [PMID: 27406646 PMCID: PMC4947744 DOI: 10.1136/bmjopen-2016-011600] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To investigate geographic variation in guideline-indicated treatments for non-ST-elevation myocardial infarction (NSTEMI) in the English National Health Service (NHS). DESIGN Cohort study using registry data from the Myocardial Ischaemia National Audit Project. SETTING All Clinical Commissioning Groups (CCGs) (n=211) in the English NHS. PARTICIPANTS 357 228 patients with NSTEMI between 1 January 2003 and 30 June 2013. MAIN OUTCOME MEASURE Proportion of eligible NSTEMI who received all eligible guideline-indicated treatments (optimal care) according to the date of guideline publication. RESULTS The proportion of NSTEMI who received optimal care was low (48 257/357 228; 13.5%) and varied between CCGs (median 12.8%, IQR 0.7-18.1%). The greatest geographic variation was for aldosterone antagonists (16.7%, 0.0-40.0%) and least for use of an ECG (96.7%, 92.5-98.7%). The highest rates of care were for acute aspirin (median 92.8%, IQR 88.6-97.1%), and aspirin (90.1%, 85.1-93.3%) and statins (86.4%, 82.3-91.2%) at hospital discharge. The lowest rates were for smoking cessation advice (median 11.6%, IQR 8.7-16.6%), dietary advice (32.4%, 23.9-41.7%) and the prescription of P2Y12 inhibitors (39.7%, 32.4-46.9%). After adjustment for case mix, nearly all (99.6%) of the variation was due to between-hospital differences (median 64.7%, IQR 57.4-70.0%; between-hospital variance: 1.92, 95% CI 1.51 to 2.44; interclass correlation 0.996, 95% CI 0.976 to 0.999). CONCLUSIONS Across the English NHS, the optimal use of guideline-indicated treatments for NSTEMI was low. Variation in the use of specific treatments for NSTEMI was mostly explained by between-hospital differences in care. Performance-based commissioning may increase the use of NSTEMI treatments and, therefore, reduce premature cardiovascular deaths. TRIAL REGISTRATION NUMBER NCT02436187.
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Affiliation(s)
- T B Dondo
- Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UK
| | - M Hall
- Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UK
| | - A D Timmis
- The National Institute for Health Biomedical Research Unit, Barts Health, London, UK
| | - A T Yan
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - P D Batin
- Department of Cardiology, The Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - G Oliver
- National Health Service cardiac service user, West Yorkshire, UK
| | - O A Alabas
- Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UK
| | - P Norman
- School of Geography, University of Leeds, Leeds, UK
| | - J E Deanfield
- National Institute for Cardiovascular Outcomes Research, University College London, London, UK
| | - K Bloor
- Department of Health Sciences, University of York, York, UK
| | - H Hemingway
- The Farr Institute, University College London, London, UK
| | - C P Gale
- Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UK
- York Teaching Hospital NHS Foundation Trust, York, UK
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Hall M, Laut K, Dondo TB, Alabas OA, Brogan RA, Gutacker N, Cookson R, Norman P, Timmis A, de Belder M, Ludman PF, Gale CP. Patient and hospital determinants of primary percutaneous coronary intervention in England, 2003-2013. Heart 2016; 102:313-319. [PMID: 26732182 PMCID: PMC4752647 DOI: 10.1136/heartjnl-2015-308616] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI) is insufficiently implemented in many countries. We investigated patient and hospital characteristics associated with PPCI utilisation. METHODS Whole country registry data (MINAP, Myocardial Ischaemia National Audit Project) comprising PPCI-capable National Health Service trusts in England (84 hospital trusts; 92 350 hospitalisations; 90 489 patients), 2003-2013. Multilevel Poisson regression modelled the relationship between incidence rate ratios (IRR) of PPCI and patient and trust-level factors. RESULTS Overall, standardised rates of PPCI increased from 0.01% to 86.3% (2003-2013). While, on average, there was a yearly increase in PPCI utilisation of 30% (adjusted IRR 1.30, 95% CI 1.23 to 1.36), it varied substantially between trusts. PPCI rates were lower for patients with previous myocardial infarction (0.95, 0.93 to 0.98), heart failure (0.86, 0.81 to 0.92), angina (0.96, 0.94 to 0.98), diabetes (0.97, 0.95 to 0.99), chronic renal failure (0.89, 0.85 to 0.90), cerebrovascular disease (0.96, 0.93 to 0.99), age >80 years (0.87, 0.85 to 0.90), and travel distances >30 km (0.95, 0.93 to 0.98). PPCI rates were higher for patients with previous percutaneous coronary intervention (1.09, 1.05 to 1.12) and among trusts with >5 interventional cardiologists (1.30, 1.25 to 1.34), more visiting interventional cardiologists (1-5: 1.31, 1.26 to 1.36; ≥6: 1.42, 1.35 to 1.49), and a 24 h, 7-days-a-week PPCI service (2.69, 2.58 to 2.81). Half of the unexplained variation in PPCI rates was due to between-trust differences. CONCLUSIONS Following an 8 year implementation phase, PPCI utilisation rates stabilised at 85%. However, older and sicker patients were less likely to receive PPCI and there remained between-trust variation in PPCI rates not attributable to differences in staffing levels. Compliance with clinical pathways for STEMI is needed to ensure more equitable quality of care.
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Affiliation(s)
- M Hall
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - K Laut
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - T B Dondo
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - O A Alabas
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - R A Brogan
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK York Teaching Hospital NHS Foundation Trust, York, UK
| | - N Gutacker
- Centre for Health Economics, University of York, York, UK
| | - R Cookson
- Centre for Health Economics, University of York, York, UK
| | - P Norman
- School of Geography, University of Leeds, Leeds, UK
| | - A Timmis
- NIHR Biomedical Research Unit at Barts Health, Queen Mary University, London, UK
| | - M de Belder
- The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - P F Ludman
- Queen Elizabeth Hospital, Birmingham, UK
| | - C P Gale
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK York Teaching Hospital NHS Foundation Trust, York, UK
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Pierotti L, Mohammed MA, Wildman M, Bilton D, Boote J, Carr SB, Collins K, Cullinan P, Elston C, Harrison S, Norman P, MacNeill SJ. P220 Using funnel plots to make meaningful centre comparisons. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pierotti L, Mohammed M, Wildman M, Bilton D, Boote J, Carr S, Cullinan P, Elston C, Harrison S, Allen J, Norman P, MacNeill S. WS18.2 Using funnel plots to make meaningful centre comparisons. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30104-1] [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: 11/25/2022]
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Norman P. CNS Drug Discovery, Cambridge, UK - November 26, 2014. DRUG FUTURE 2015. [DOI: 10.1358/dof.2015.040.02.2286990] [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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Webster R, Norman P, Goodacre S, Thompson A, McEachan R. Illness representations, psychological distress and non-cardiac chest pain in patients attending an emergency department. Psychol Health 2014; 29:1265-82. [PMID: 24831735 PMCID: PMC4192860 DOI: 10.1080/08870446.2014.923885] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 05/07/2014] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Many patients who attend an emergency department (ED) with chest pain receive a diagnosis of non-cardiac chest pain (NCCP), and often suffer poor psychological outcomes and continued pain. This study assessed the role of illness representations in explaining psychological distress and continued chest pain in patients attending an ED. METHODS ED NCCP patients (N = 138) completed measures assessing illness representations, anxiety, depression and quality of life (QoL) at baseline, and chest pain at one month. RESULTS Illness representations explained significant amounts of the variance in anxiety (Adj. R² = .38), depression (Adj. R² = .18) and mental QoL (Adj. R² = .36). A belief in psychological causes had the strongest associations with outcomes. At one month, 28.7% of participants reported experiencing frequent pain, 13.2% infrequent pain and 58.1% no pain. Anxiety, depression and poor QoL, but not illness representations, were associated with continued chest pain. CONCLUSIONS The findings suggest that (i) continued chest pain is related to psychological distress and poor QoL, (ii) interventions should be aimed at reducing psychological distress and improving QoL and (iii) given the associations between perceived psychological causes and psychological distress/QoL, NCCP patients in the ED might benefit from psychological therapies to manage their chest pain.
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Affiliation(s)
- R. Webster
- Department of Psychology, University of Sheffield, Sheffield, UK
- e-Health Unit, Research Department of Primary Care and Population Health, University College London, London, UK
| | - P. Norman
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - S. Goodacre
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - A.R. Thompson
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - R.R.C. McEachan
- Bradford Institute for Health Research, Bradford Teaching Hopsitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, UK
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Basta NO, James PW, Gomez-Pozo B, Craft AW, Norman P, McNally RJQ. Survival from teenage and young adult cancer in Northern England, 1968-2008. Pediatr Blood Cancer 2014; 61:901-6. [PMID: 24436167 DOI: 10.1002/pbc.24939] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 12/20/2013] [Indexed: 01/21/2023]
Abstract
BACKGROUND Although cancer is relatively rare in teenagers and young adults (TYAs) aged 15-24 years, it is a major cause of death in this age group. This study investigated survival trends in TYA cancer diagnosed in Northern England, 1968-2008. METHODS Five-year survival was analyzed using Kaplan-Meier estimation for four successive time periods. Cox regression analysis was used to investigate associations with demographic factors. RESULTS The study included 2,987 cases (1,634 males, 1,353 females). Five-year survival for all patients with cancer improved greatly from 46% in 1968-1977 to 84% in 1998-2008 (P < 0.001), for patients with leukemia from 2% to 71% (P < 0.001), lymphoma from 66% to 86% (P < 0.001), central nervous system tumors from 53% to 84% (P < 0.001), bone tumors from 29% to 72% (P < 0.001), germ cell tumors from 39% to 94% (P < 0.001), melanoma and skin cancer from 64% to 100% (P < 0.001), and carcinomas from 48% to 80% (P < 0.001). Cox analysis showed that for all patients with cancer, survival was better for females than males (HR = 0.83; 95% CI 0.74-0.94, P < 0.001), for patients aged 20-24 years compared with those aged 15-19 years (HR = 0.84; 95% CI 0.75-0.94, P = 0.002), but survival was worse for patients who resided in more deprived areas (HR = 1.06; 95% CI 1.01-1.11, P = 0.025). CONCLUSION There have been large improvements in TYA cancer survival in Northern England over the last four decades. Future work should determine factors that could lead to even better survival, including possible links with delayed diagnosis.
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Affiliation(s)
- N O Basta
- Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
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22
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Norman P, Denham R, Calvert MJ. Life histories of two arid-zone shrubs change with differences in habitat, grazing and climate. Rangel J 2014. [DOI: 10.1071/rj14003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Shrubs are an important component of vegetation throughout the world. They are particularly significant in semiarid environments where they can dominate, driving ecosystem structure and functioning, and shaping land use. Life-history information was derived for Eremophila sturtii R.Br. and Dodonaea viscosa subsp. angustissima J.G.West, two widespread and common shrubs of semiarid eastern Australia. Plants growing under background climatic conditions took between 2 and 4 years to become established, attained the capacity to reproduce sexually at between 10 and 12 years, were in a sexually reproductive stage for between 17 and 28 years and lived an average maximum of 33–40 years. Under background climatic conditions between 70 and 80% of plants that entered the juvenile stage survived to sexual maturity while under severe drought this proportion fell to between 40 and 60%. Juvenile plants, particularly of E. sturtii, experienced the highest mortality under background conditions while, when exposed to severe drought, older plants, particularly D. viscosa subsp. angustissima in the intermediate stage, experienced the greatest increase in mortality, dying at more than twice the background rate. The high survival rates of E. sturtii and D. viscosa subsp. angustissima shown here, even under extreme drought conditions and in grazed- and ungrazed areas, help to explain why these shrub species have been observed to dominate vegetation in large areas of eastern Australia.
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Fowkes FGR, Murray GD, Butcher I, Folsom AR, Hirsch AT, Couper DJ, Debacker G, Kornitzer M, Newman AB, Sutton-Tyrrell KC, Cushman M, Lee AJ, Price JF, D'Agostino RB, Murabito JM, Norman P, Masaki KH, Bouter LM, Heine RJ, Stehouwer CDA, McDermott MM, Stoffers HEJH, Knottnerus JA, Ogren M, Hedblad B, Koenig W, Meisinger C, Cauley JA, Franco O, Hunink MGM, Hofman A, Witteman JC, Criqui MH, Langer RD, Hiatt WR, Hamman RF. Development and validation of an ankle brachial index risk model for the prediction of cardiovascular events. Eur J Prev Cardiol 2013; 21:310-20. [PMID: 24367001 DOI: 10.1177/2047487313516564] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [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: 11/16/2022]
Abstract
BACKGROUND The ankle brachial index (ABI) is related to risk of cardiovascular events independent of the Framingham risk score (FRS). The aim of this study was to develop and evaluate a risk model for cardiovascular events incorporating the ABI and FRS. DESIGN An analysis of participant data from 18 cohorts in which 24,375 men and 20,377 women free of coronary heart disease had ABI measured and were followed up for events. METHODS Subjects were divided into a development and internal validation dataset and an external validation dataset. Two models, comprising FRS and FRS + ABI, were fitted for the primary outcome of major coronary events. RESULTS In predicting events in the external validation dataset, C-index for the FRS was 0.672 (95% CI 0.599 to 0.737) in men and 0.578 (95% CI 0.492 to 0.661) in women. The FRS + ABI led to a small increase in C-index in men to 0.685 (95% CI 0.612 to 0.749) and large increase in women to 0.690 (95% CI 0.605 to 0.764) with net reclassification improvement (NRI) of 4.3% (95% CI 0.0 to 7.6%, p = 0.050) and 9.6% (95% CI 6.1 to 16.4%, p < 0.001), respectively. Restricting the FRS + ABI model to those with FRS intermediate 10-year risk of 10 to 19% resulted in higher NRI of 15.9% (95% CI 6.1 to 20.6%, p < 0.001) in men and 23.3% (95% CI 13.8 to 62.5%, p = 0.002) in women. However, incorporating ABI in an improved newly fitted risk factor model had a nonsignificant effect: NRI 2.0% (95% CI 2.3 to 4.2%, p = 0.567) in men and 1.1% (95% CI 1.9 to 4.0%, p = 0.483) in women. CONCLUSIONS An ABI risk model may improve prediction especially in individuals at intermediate risk and when performance of the base risk factor model is modest.
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Affiliation(s)
- F G R Fowkes
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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De Santis D, Dinauer D, Duke J, Erlich HA, Holcomb CL, Lind C, Mackiewicz K, Monos D, Moudgil A, Norman P, Parham P, Sasson A, Allcock RJN. 16(th) IHIW : review of HLA typing by NGS. Int J Immunogenet 2013; 40:72-6. [PMID: 23302098 DOI: 10.1111/iji.12024] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 10/23/2012] [Accepted: 11/01/2012] [Indexed: 02/06/2023]
Abstract
Human leucocyte antigen (HLA) genes play an important role in the success of organ transplantation and are associated with autoimmune and infectious diseases. Current DNA-based genotyping methods, including Sanger sequence-based typing (SSBT), have identified a high degree of polymorphism. This level of polymorphism makes high-resolution HLA genotyping challenging, resulting in ambiguous typing results due to an inability to resolve phase and/or defining polymorphisms lying outside the region amplified. Next-generation sequencing (NGS) may resolve the issue through the combination of clonal amplification, which provides phase information, and the ability to sequence larger regions of genes, including introns, without the additional effort or cost associated with current methods. The NGS HLA sequencing project of the 16IHIW aimed to discuss the different approaches to (i) template preparation including short- and long-range PCR amplicons, exome capture and whole genome; (ii) sequencing platforms, including GS 454 FLX, Ion Torrent PGM, Illumina MiSeq/HiSeq and Pacific Biosciences SMRT; (iii) data analysis, specifically allele-calling software. The pilot studies presented at the workshop demonstrated that although individual sequencers have very different performance characteristics, all produced sequence data suitable for the resolution of HLA genotyping ambiguities. The developments presented at this workshop clearly highlight the potential benefits of NGS in the HLA laboratory.
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Affiliation(s)
- D De Santis
- Department of Clinical Immunology, PathWest, Royal Perth Hospital, Perth, WA, Australia.
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van Laar M, McKinney PA, Parslow RC, Glaser A, Kinsey SE, Lewis IJ, Picton SV, Richards M, Shenton G, Stark D, Norman P, Feltbower RG. Erratum: Cancer incidence among the south Asian and non-south Asian population under 30 years of age in Yorkshire, UK. Br J Cancer 2013. [PMCID: PMC3619078 DOI: 10.1038/bjc.2013.67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Booth AR, Harris PR, Goyder E, Norman P. Beliefs about chlamydia testing amongst young people living in relatively deprived areas. J Public Health (Oxf) 2012; 35:213-22. [DOI: 10.1093/pubmed/fds082] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [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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Abstract
A representative sample of 11,632 people completed a questionnaire measuring health locus of control, health value and a number of health behaviours as part of the 1989 Health in Wales Survey. Measures of smoking, alcohol consumption, exercise and diet were combined to form a health behaviour index, representing key 'lifestyle' indicators. In line with predictions, scores on this measure were positively associated with internal health locus of control scores, and negatively associated with scores on the chance and powerful others dimensions. Classifying respondents according to Wallston and Wallston's (1981) health locus of control typology revealed that 'pure internals' performed the most health behaviours. Some evidence was found to suggest that health value moderates the relationship between health locus of control and health behaviour, although overall the health locus of control construct was found to be a weak predictor of health behaviour. The results are discussed in relation to the need to consider other expectancy beliefs when predicting health behaviour.
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Affiliation(s)
- P Norman
- Department of Psychology, University of Sheffield, Sheffield, UK
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Ford AH, Flicker L, Hankey GJ, Norman P, van Bockxmeer FM, Almeida OP. Homocysteine, methylenetetrahydrofolate reductase C677T polymorphism and cognitive impairment: the health in men study. Mol Psychiatry 2012; 17:559-66. [PMID: 21358708 PMCID: PMC3335075 DOI: 10.1038/mp.2011.18] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
High total plasma homocysteine (tHcy) has been associated with cognitive impairment in later life, but it is unclear if this association is causal or is due to confounding. The C677T polymorphism of the 5,10 methylenetetrahydrofolate reductase gene (MTHFR) increases basal tHcy, but its contribution to cognitive impairment has not been established. We designed this study to determine if tHcy is causally related to cognitive impairment in later life by investigating its association with high tHcy and the MTHFR-C677T polymorphism. We recruited 1778 older men from the Health in Men Study cohort and established caseness on the basis of the participants' scores on a Telephone Interview for Cognitive Status score 27 in 2008. Exposure to tHcy, gene status and other variables of interest were obtained from assessments 4-7 years earlier. Multivariate logistic regression showed that the odds of cognitive impairment increased with a doubling of tHcy (adjusted odds ratio, OR 1.36; 95% confidence interval, 95% CI 1.02-1.82). Compared with the wild CC genotype, participants with the MTHFR-TT genotype had 46% greater odds of cognitive impairment (OR 1.46, 95% CI 1.01-2.11, P=0.043). The results of this study are consistent with, but do not prove the hypothesis that high tHcy causes cognitive impairment in later life.
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Affiliation(s)
- A H Ford
- WA Centre for Health and Ageing, Centre for Medical Research and School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia
| | - L Flicker
- WA Centre for Health and Ageing, Centre for Medical Research and School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | - G J Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
| | - P Norman
- School of Surgery, University of Western Australia, Perth, WA, Australia
| | - F M van Bockxmeer
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia
| | - O P Almeida
- WA Centre for Health and Ageing, Centre for Medical Research and School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia,School of Psychiatry and Clinical Neurosciences (M573), University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia. E-mail:
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Briffa T, Nedkoff L, Kniuman M, Norman P, Hung J, Hankey G, Thompson P, Geelhoed E, Hickling S, Sanfilippo F, Bremner A, Hobbs M. Contemporary Sex-age Specific Rate Ratios for Incident and Recurrent Atherothrombotic Disease Hospitalisations. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.759] [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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Niskanen J, Norman P, Aksela H, Agren H. Relativistic contributions to single and double core electron ionization energies of noble gases. J Chem Phys 2011; 135:054310. [PMID: 21823703 DOI: 10.1063/1.3621833] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Niskanen
- Department of Physics, University of Oulu, Oulu, Finland.
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Blakey K, Feltbower R, Parslow R, James P, Pozo BG, Stiller C, Vincent T, Norman P, McKinney P, Murphy M, Craft A, McNally R. P1-96 Primary bone cancer in 0-49 year olds in great britain, 1980-2005 and fluoride in drinking water: a case of inequalities? Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976c.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mnatzaganian G, Ryan P, Norman P, Davidson D, Hiller J. P2-196 Smoking, body weight, physical exercise and risk of lower limb total joint replacement in a population-based cohort of men. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976j.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mnatzaganian G, Ryan P, Norman P, Davidson D, Hiller J. P2-195 A propensity score for predicting major adverse outcomes after total joint replacement in men. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976j.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Blakey K, Feltobower R, Parslow R, James P, Pozo BG, Stiller C, Vincent T, Norman P, McKinney P, Murphy M, Craft A, McNally R. P1-97 Demographic analysis of osteosarcoma and ewing sarcoma family of tumours in 0-49 year olds in Great Britain, 1980-2005: a small-area approach. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976c.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Norman P. Royal Society of Chemistry's 22nd Symposium on Medicinal Chemistry in Eastern England, Hatfield, UK, May 19, 2011. DRUG FUTURE 2011. [DOI: 10.1358/dof.2011.036.11.1688491] [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: 10/24/2022]
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36
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Briffa T, Nedkoff L, Knuiman M, Norman P, Hung J, Hankey G, Thompson P, Geelhoed E, Hickling S, Sanfilippo F, Bremner A, Hobbs M. Falling Trends in the Prevalence, Incidence and Recurrence of Atherothrombotic Vascular Disease. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.607] [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: 11/30/2022]
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Shi D, Zheng Q, Chen D, Zhu L, Qin A, Fan J, Liao J, Xu Z, Lin Z, Norman P, Xu J, Nakamura T, Dai K, Zheng M, Jiang Q. Association of single-nucleotide polymorphisms in HLA class II/III region with knee osteoarthritis. Osteoarthritis Cartilage 2010; 18:1454-7. [PMID: 20691797 DOI: 10.1016/j.joca.2010.07.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Revised: 07/18/2010] [Accepted: 07/20/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE A genome-wide association study and a replication using Japanese, Spanish and Greek Caucasian populations have recently indicated two single-nucleotide polymorphisms (SNPs) (rs7775228 and rs10947262) associated with knee Osteoarthritis (OA) susceptibility. We have further evaluated the association in knee OA subjects from Han Chinese and Australian Caucasian origin. METHODS Two independent case-control association studies were performed using Han Chinese and Australian Caucasian populations. The two SNPs were genotyped in patients who had primary symptomatic knee OA with radiographic confirmation and/or received total knee replacement surgery as well as in matched controls. They were subjected to statistic analyses. RESULTS A total of 991 OA patients and 1536 controls were genotyped. No significant difference was detected in genotype or allele frequencies of the two SNPs between knee OA and control groups in the two populations (all P>0.05). The association was also negative even after stratification by sex, body mass index (BMI) and Kellgren/Lawrence scores. The significant heterogeneity was detected between Chinese and Japanese (both P<0.05). In the Caucasian samples, no significant heterogeneity was detected (both P>0.05). The result of meta-analysis showed significant association between knee OA and rs10947262 in total subjects [summary OR=1.26, 95%confidence intervals (CI)=1.07-1.27, P=3 × 10(-8)] and in Caucasian samples (summary OR=1.28, 95%CI=1.04-1.57, P=0.02). CONCLUSION We demonstrated no association between the two SNPs in human leukocyte antigen (HLA) class II/III region and knee OA in Han Chinese population. A significant association was detected between SNP rs10947262 and knee OA in Caucasian subjects. Further replication studies are required to identify the impact of controversial association.
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Affiliation(s)
- D Shi
- The Center of Diagnosis and Treatment for Joint Disease, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing 210008, Jiangsu, China
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van Laar M, McKinney PA, Parslow RC, Glaser A, Kinsey SE, Lewis IJ, Picton SV, Richards M, Shenton G, Stark D, Norman P, Feltbower RG. Cancer incidence among the south Asian and non-south Asian population under 30 years of age in Yorkshire, UK. Br J Cancer 2010; 103:1448-52. [PMID: 20842119 PMCID: PMC2990599 DOI: 10.1038/sj.bjc.6605903] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [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] [Indexed: 11/30/2022] Open
Abstract
Background: Few studies have examined epidemiological differences between ethnic groups for children and young adults with cancer. Methods: Subjects aged 0–29 years, diagnosed between 1990 and 2005 in the former Yorkshire Regional Health Authority, were included in the analysis. Ethnicity (south Asian or not) was assigned using name analysis program and Hospital Episode Statistics data. Differences in incidence (per 1 000 000 person-years) rates and trends were analysed using joinpoint and Poisson regression analysis. Results: Overall cancer incidence was similar for south Asians (12.1, 95% CI: 10.7–13.5; n=275) and non-south Asians (12.6, 95% CI: 12.2–13.1; n=3259). Annual incidence rates increased significantly by 1.9% per year on average (95% CI: 1.2–2.6%), especially for south Asians (7.0% 95% CI: 4.2–9.9%). Conclusion: If present trends continue, the higher rate of increase seen among south Asians aged 0–29 years in Yorkshire will result in three times higher cancer incidence than non-south Asians by 2020.
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Affiliation(s)
- M van Laar
- Paediatric Epidemiology Group, Division of Epidemiology, University of Leeds, Leeds LS2 9NL, UK
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Harron K, McKinney PA, Feltbower RG, Stephenson CR, Bodansky HJ, Norman P, Parslow RC. 020 Incidence rate trends in childhood type 1 diabetes in Yorkshire, 1978-2007: effects of ethnicity and age at diagnosis. Br J Soc Med 2010. [DOI: 10.1136/jech.2010.120956.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bajekal M, Scholes S, O'Flaherty M, Raine R, Norman P, Capewell S. 005 Trends in coronary heart disease mortality in England by socio-economic circumstances, 1982-2006. Br J Soc Med 2010. [DOI: 10.1136/jech.2010.120956.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Blakey K, Feltbower RG, Parslow RC, James PW, Pozo BG, Stiller C, Vincent TJ, Norman P, McKinney PA, Murphy MF, Craft AW, McNally RJQ. 003 Demographic analyses of primary bone cancer in 0-49 year olds in Great Britain, 1980-2005: a small-area approach. Br J Soc Med 2010. [DOI: 10.1136/jech.2010.120956.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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van Laar M, McKinney PA, Parslow RC, Glaser A, Kinsey SE, Lewis IJ, Picton SV, Richards M, Shenton G, Stark D, Norman P, Feltbower RG. 078 Incidence rates and survival trends of cancer in 0-29-year-olds by ethnic group in Yorkshire, UK. Br J Soc Med 2010. [DOI: 10.1136/jech.2010.120956.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Searle A, Vedhara K, Norman P, Frost A, Harrad R. Compliance with eye patching in children and its psychosocial effects: A qualitative application of protection motivation theory. PSYCHOL HEALTH MED 2010. [DOI: 10.1080/135485000105990] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
Bone cements produced by different manufacturers vary in their mechanical properties and antibiotic elution characteristics. Small changes in the formulation of a bone cement, which may not be apparent to surgeons, can also affect these properties. The supplier of Palacos bone cement with added gentamicin changed in 2005. We carried out a study to examine the mechanical characteristics and antibiotic elution of Schering-Plough Palacos, Heraeus Palacos and Depuy CMW Smartset bone cements. Both Heraeus Palacos and Smartset bone cements performed significantly better than Schering-Plough Palacos in terms of mechanical characteristics, with and without additional vancomycin (p < 0.001). All cements show a deterioration in flexural strength with increasing addition of vancomycin, albeit staying above ISO minimum levels. Both Heraeus Palacos and Smartset elute significantly more gentamicin cumulatively than Schering-Plough Palacos. Smartset elutes significantly more vancomycin cumulatively than Heraeus Palacos. The improved antibiotic elution characteristics of Smartset and Heraeus Palacos are not associated with a deterioration in mechanical properties. Although marketed as the 'original' Palacos, Heraeus Palacos has significantly altered mechanical and antibiotic elution characteristics compared with the most commonly-used previous version.
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Affiliation(s)
- J Bridgens
- Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
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46
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Lindholt J, Norman P. Screening for Abdominal Aortic Aneurysm Reduces Overall Mortality in Men. A Meta-analysis of the Mid- and Long-term Effects of Screening for Abdominal Aortic Aneurysms. Eur J Vasc Endovasc Surg 2008; 36:167-171. [DOI: 10.1016/j.ejvs.2008.03.006] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2007] [Accepted: 03/06/2008] [Indexed: 10/22/2022]
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47
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Stockley I, Mockford BJ, Hoad-Reddick A, Norman P. The use of two-stage exchange arthroplasty with depot antibiotics in the absence of long-term antibiotic therapy in infected total hip replacement. ACTA ACUST UNITED AC 2008; 90:145-8. [DOI: 10.1302/0301-620x.90b2.19855] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We present a series of 114 patients with microbiologically-proven chronically-infected total hip replacement, treated between 1991 and 2004 by a two-stage exchange procedure with antibiotic-loaded cement, but without the use of a prolonged course of antibiotic therapy. The mean follow-up for all patients was 74 months (2 to 175) with all surviving patients having a minimum follow-up of two years. Infection was successfully eradicated in 100 patients (87.7%), a rate which is similar to that reported by others, but where prolonged adjuvant antibiotic therapy has been used. Using the technique described, a prolonged course of systemic antibiotics does not appear to be essential and the high cost of the administration of antibiotics can be avoided.
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Affiliation(s)
- I. Stockley
- Sheffield Teaching Hospitals Trust, Herries Road, Sheffield, S5 7AU, UK
| | - B. J. Mockford
- Sheffield Teaching Hospitals Trust, Herries Road, Sheffield, S5 7AU, UK
| | - A. Hoad-Reddick
- Wrightington Hospital, Hall Lane, Appley Bridge, Wigan WN6 9EP, UK
| | - P. Norman
- Sheffield Teaching Hospitals Trust, Herries Road, Sheffield, S5 7AU, UK
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48
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Abstract
OBJECTIVES To describe the range and frequency of cytotoxic drugs prescribed within UK veterinary practices to treat dogs and cats with cancer, determine the effect of practice demographic variables on this practice and determine the frequency with which intravenous catheters were used during administration of parenteral cytotoxic drugs. METHODS A postal survey of 1838 veterinary practices providing care for dogs and cats within the UK. RESULTS Prescription of cytotoxic drugs to treat dogs and cats with cancer during the preceding 12 months was reported by 70.8 per cent practices. The most widely prescribed agents were cyclophosphamide (65.4 per cent) and vincristine (63.5 per cent). Twenty-three per cent of responding practices had prescribed an antitumour antibiotic and 8.3 per cent had prescribed a platinum agent. The median frequency of prescription was between once a month and once every three months. Increasing frequency and range of cytotoxic drug prescription were associated with practice employment of higher numbers of veterinary surgeons and increased levels of pet insurance among practice clients. Almost a quarter of practices administering vesicant parenteral cytotoxic drugs failed to always use intravenous catheters to do so. CLINICAL SIGNIFICANCE Prescription of cytotoxic drugs, and therefore the potential for occupational exposure of staff, was widespread among UK veterinary practices providing care for dogs and cats.
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Affiliation(s)
- T A Cave
- Cave Referrals, 7 Hectors Stones, Woolavington, Somerset TA7 8EG, UK
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49
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Norman P, Ponosh S, Broadhurst R, Semmens J. VS20P TRENDS IN EMBOLECTOMY OF THE EXTREMITIES: A POPULATION-BASED STUDY. ANZ J Surg 2007. [DOI: 10.1111/j.1445-2197.2007.04134_20.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: 11/28/2022]
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50
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Abstract
This paper examines the area-level relationships in England and Wales between sickness absence ('incapacity benefit'), mortality and morbidity. It uses a random sample of incapacity benefit claims, and population counts of mortality and Census morbidity for local government districts. Although there is little correspondence between sickness absence claims by specific cause and mortality, all cause sickness absence has a strong relationship with all cause mortality (male r 0.74, p=0.00; female r 0.64, p=0.00) and it also has a very strong relationship with the Census measures of morbidity: LLTI (male r 0.98, p=0.00; female r 0.97, p=0.00) and 'not good health' (male r 0.99, p=0.00; female r 0.96, p=0.00). Incapacity benefit claims by all causes has the potential to provide an ongoing measure of area-level health in England and Wales.
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Affiliation(s)
- C Bambra
- Sociology and Social Policy, Sheffield Hallam University, Sheffield S10 2BP, UK.
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