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المؤلفون: Phedra Marius, Lynne Grundy, Nabeela Nazir Ahmed, Margaret Irwin, Jeanette Thorpe, Hannah Robinson, Helen Thorp, Maria Moon, Sadaf Farooqi, Nick Andrews, Louise Haskell, Bea Choi, Helen Beckett, Sharon Davies-Dear, Victoria Cornelius, Tracey Dare, Sunder Chita, Stephen Singh, Chris Twelves, John Haughney, Patrick S. Moore, Maja dabagh, Xinxue Liu, S Bibi, Suzanne Wilkins, Mohammed Khan, Charlotte Trinham, Emily Brunt, Edwin Justice, Hanna Nguyen, Andrew Gowland, Andrew Riordan, Tanveer Bawa, Daniel Pan, Ceri Davies, Suahil Aslam, Chris A Rogers, Dileep Kumar, Yvanne Enever, Siobhan Roche, Karen Bisnauthsing, Hayley Tulloch, Andrew Ustianowski, Steve Hurdover, Ehsaan Qureshi, Akamino Egbo, Ingrid Seath, Jo Salkeld, Carla Ferreira Da Silva, Ray Sheridan, Samantha Keenan, Shama Hamal, Jo Piper, Kerry Godwin, Sara Bennett, Liliana Cifuentes, Nicholas Ronan, Nicki Lakeman, Lona Tudor Jones, Ian Bentley, Rachel White, Chloe McDonnell, Nina Parungao, Emma Plested, Kyra Holliday, Lisa Berry, Christine Minnis, Victoria Graham, Christopher J Edwards, Beth Giddins, Tara Watson, Suzie Colquhoun, Johanna Mouland, Marion K Campbell, Rostam Osanlou, Carlota Pereira Dias Alves, Simon Fowler, Becky Mansfield, Sally Batham, Orod Osanlou, Arpan Guha, Stephen Saich, Kush Naker, Marcin Bula, Igor Starinskij, Bassam Hallis, Sonia Baryschpolec, Shirley Todd, Agatha A. van der Klaauw, Claire Brown, Emma Snashall, Andrew Seaton, Helen Radford, John Hladkiwskyj, Rachael Drake-Brockman, Matilda lang, Linda Harndahl, Holly Burton, Tim Whitbred, Sue Charlton, Mushiya Mpelembue, Anna Stewart, Anil Shenoy, Zalina Rashid-Gardner, Joseph Newman, John Gavin, Mary Savage, Julie Evans, Aidan Lingwood, Lauren Allen, Parvinder K. Aley, Rebecca Lyon, Rachel Bousfield, Robert C. Read, Joanne Spencer, David Baxter, Anastasia de la Haye, James Calderwood, Emily Chiplin, Evgenia Kourampa, Helen Gutteridge, Jade Gouriet, Trishna Champaneri, Javier Magan, Luke Vamplew, Abigail Oliver, Sally Reeder, Sunil Sharma, Nicola Turner, Yukari Sakagami, Mikayala King, Steve Thomas, Chanice Knight, Samantha Broadhead, Erica Peters, Dennyl Vail, Marta Merida-Morillas, Emily Locke, Krishna Chatterjee, Debbie Suggitt, Sara Fraser, Mihaela Pacurar, Kerry Hughes, Jessica Hailstone, Eleni Ladikou, Leah Richmond, Wythehi Ambihapathy, Kari Nightingale, Chris Cooper, Victoria Wenn, Kimberley Driver, Rachel Hughes, Filipa Dos Santos, Michael Singh, Ben Gardside, Donna Wixted, Jessica Lewis-Taylor, Jason Domingo, Scott Elliott, Wiesia Woodyatt, Jonathan Kwok, Subarna Roy, Amisha Desai, Iryna Boubriak, Helen Haydock, Arabella Stuart, Amy Ross-Russell, Rossana Romani, Lauren Fox, Gillian McMillan, Angela M. Minassian, Ann Sturdy, R. A. James, Valerie Renals, Stephanie Leung, Lillian Goncalves cordeiro, Fran Westwell, Robert Shaw, Anna L. Goodman, Katrina Cathie, Ryan Stephen Elliott, Adrian Palfreeman, Phillip Brown, Kim En Lee, Farida khan, Suzanne Tasker, Anna Hardy, Elisa Nanino, Donald van Welsenes, Adam Farrier, Antonette Andrews, Jacqueline Brandon, Alicja Kownacka, Jennifer Murira, Kate Dodd, Emily Horsfall, Chantelle Moorbey, Alison Hogan, Lynda Wagstaff, Gita Patel, Rebecca Cutts, Matthew D. Snape, Karen Regan, Beverley Longhurst, Saul N. Faust, Vincenzo Libri, Andrea Mazzella, Michael Stackpoole, Carool Osuji, Jonathan Baker, Teona Serafimova, Tumena Corrah, Sophie E. Moore, Sarah Warren, Christopher Herbert, Laura Presland, Daniel R. Owens, Colin Hale, Beth Jackson, Fran Hall, Debbie Branney, Martha Nabunjo, Mehmood Mughal, Laura Longshaw, Holly Baker, Elizabeth A. Clutterbuck, Eloise Summerton, Rowena Weighell, Fiona Makia, Alexander Hicks, Leila Janani, Matthew Stokes, Amanda Buadi, E. Thomson, Jennifer Gibney, Jane Hall, Tricia Coughlan, Bridget Tandy, Kelly Littlewood, Christopher A Green, Mary Ramsay, Lorinda Pickup, Karren Buttigieg, Gavin Babbage, Todd Rawlins, Simon Tunstall, Dominique Barker, Martin J. Llewelyn, James Cullinane, Judith Bell, Elizabeth Gordon, Andrew L. Freedman, Martin Wiselka, Mohammed Kamal, Sarah Whittley, Natalie Baker, Jorden Frankham, Malathi Munusamy, Karen Underwood, Dinesh Saralaya, Olivia Chalwin, Tommy Rampling, Rachael Phillips, Sarah Garrahy, Yee Ting Nicole Yim, Charlotte Sabine, Haniah Habash-Bailey, Ashley Whittington, Benjamin Welham, Patrick Kinch, Avril Bonnaud, Jonathan Macdonald, NinaSimone Hopkins, Kim Storton, Stephen Hughes, Enya Cooney, Alasdair Munro, Christine Cole, John Paul Seenan, Kim Appleby, Laurence John, David J. Smith, Lara Barcella, Imam Shaik, Kate Ellis, Olumide Adebambo, Jane Stockport, Gertraud Morshead, Paminder Lall, Stephen E. Cox, Daniel Hansen, Jonathan Perkins, Yama F Mujadidi, Thomas Honey, Alan Magee, Jonathan S. Nguyen-Van-Tam, Mwila Kasanyinga, Marivic Ricamara, Jaimie Wilson-Goldsmith, Alastair McGregor, Djamila Shamtally, Helena Baker, Tom Eadsforth, Dee Mullan, Karishma Gokani, Kirsty Adams, Dominic Galvin
المصدر: Lancet (London, England)
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Population, Immunization, Secondary, Department of Error, Group A, Group B, COV-BOOST study group, Medicine, General & Internal, Immunogenicity, Vaccine, General & Internal Medicine, ChAdOx1 nCoV-19, Internal medicine, Safety, immunogenicity, COVID-19, vaccines, booster, Humans, Medicine, Adverse effect, education, Pandemics, BNT162 Vaccine, 11 Medical and Health Sciences, Aged, Aged, 80 and over, education.field_of_study, Science & Technology, Booster (rocketry), Reactogenicity, SARS-CoV-2, business.industry, Immunogenicity, COVID-19, General Medicine, Articles, Middle Aged, United Kingdom, Female, Patient Safety, business, Life Sciences & Biomedicine
الوصف: Background: \ud Few data exist on the comparative safety and immunogenicity of different COVID-19 vaccines given as a third (booster) dose. To generate data to optimise selection of booster vaccines, we investigated the reactogenicity and immunogenicity of seven different COVID-19 vaccines as a third dose after two doses of ChAdOx1 nCov-19 (Oxford–AstraZeneca; hereafter referred to as ChAd) or BNT162b2 (Pfizer–BioNtech, hearafter referred to as BNT).\ud \ud Methods: \ud COV-BOOST is a multicentre, randomised, controlled, phase 2 trial of third dose booster vaccination against COVID-19. Participants were aged older than 30 years, and were at least 70 days post two doses of ChAd or at least 84 days post two doses of BNT primary COVID-19 immunisation course, with no history of laboratory-confirmed SARS-CoV-2 infection. 18 sites were split into three groups (A, B, and C). Within each site group (A, B, or C), participants were randomly assigned to an experimental vaccine or control. Group A received NVX-CoV2373 (Novavax; hereafter referred to as NVX), a half dose of NVX, ChAd, or quadrivalent meningococcal conjugate vaccine (MenACWY) control (1:1:1:1). Group B received BNT, VLA2001 (Valneva; hereafter referred to as VLA), a half dose of VLA, Ad26.COV2.S (Janssen; hereafter referred to as Ad26) or MenACWY (1:1:1:1:1). Group C received mRNA1273 (Moderna; hereafter referred to as m1273), CVnCov (CureVac; hereafter referred to as CVn), a half dose of BNT, or MenACWY (1:1:1:1). Participants and all investigatory staff were blinded to treatment allocation. Coprimary outcomes were safety and reactogenicity and immunogenicity of anti-spike IgG measured by ELISA. The primary analysis for immunogenicity was on a modified intention-to-treat basis; safety and reactogenicity were assessed in the intention-to-treat population. Secondary outcomes included assessment of viral neutralisation and cellular responses. This trial is registered with ISRCTN, number 73765130.\ud \ud Findings: \ud Between June 1 and June 30, 2021, 3498 people were screened. 2878 participants met eligibility criteria and received COVID-19 vaccine or control. The median ages of ChAd/ChAd-primed participants were 53 years (IQR 44–61) in the younger age group and 76 years (73–78) in the older age group. In the BNT/BNT-primed participants, the median ages were 51 years (41–59) in the younger age group and 78 years (75–82) in the older age group. In the ChAd/ChAD-primed group, 676 (46·7%) participants were female and 1380 (95·4%) were White, and in the BNT/BNT-primed group 770 (53·6%) participants were female and 1321 (91·9%) were White. Three vaccines showed overall increased reactogenicity: m1273 after ChAd/ChAd or BNT/BNT; and ChAd and Ad26 after BNT/BNT. For ChAd/ChAd-primed individuals, spike IgG geometric mean ratios (GMRs) between study vaccines and controls ranged from 1·8 (99% CI 1·5–2·3) in the half VLA group to 32·3 (24·8–42·0) in the m1273 group. GMRs for wild-type cellular responses compared with controls ranged from 1·1 (95% CI 0·7–1·6) for ChAd to 3·6 (2·4–5·5) for m1273. For BNT/BNT-primed individuals, spike IgG GMRs ranged from 1·3 (99% CI 1·0–1·5) in the half VLA group to 11·5 (9·4–14·1) in the m1273 group. GMRs for wild-type cellular responses compared with controls ranged from 1·0 (95% CI 0·7–1·6) for half VLA to 4·7 (3·1–7·1) for m1273. The results were similar between those aged 30–69 years and those aged 70 years and older. Fatigue and pain were the most common solicited local and systemic adverse events, experienced more in people aged 30–69 years than those aged 70 years or older. Serious adverse events were uncommon, similar in active vaccine and control groups. In total, there were 24 serious adverse events: five in the control group (two in control group A, three in control group B, and zero in control group C), two in Ad26, five in VLA, one in VLA-half, one in BNT, two in BNT-half, two in ChAd, one in CVn, two in NVX, two in NVX-half, and one in m1273.\ud \ud Interpretation: \ud All study vaccines boosted antibody and neutralising responses after ChAd/ChAd initial course and all except one after BNT/BNT, with no safety concerns. Substantial differences in humoral and cellular responses, and vaccine availability will influence policy choices for booster vaccination.\ud \ud Funding: \ud UK Vaccine Taskforce and National Institute for Health Research.
وصف الملف: text;
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المؤلفون: Sharon J. Hutchinson, Chris Robertson, Rachael Wood, Martin Reid, Ciara Gribben, Jane White, Marion K Campbell, J. L. Bishop, Paul M. McKeigue, Helen M. Colhoun, Lynda Fenton, David H Caldwell, Sam Colville, David A. McAllister
المصدر: Fenton, L, Gribben, C, Caldwell, D, Colville, S, Bishop, J, Reid, M, White, J, Campbell, M, Hutchinson, S, Robertson, C, Colhoun, H M, Wood, R, McKeigue, P M & McAllister, D A 2021, ' Risk of hospital admission with covid-19 among teachers compared with healthcare workers and other adults of working age in Scotland, March 2020 to July 2021 : population based case-control study ', British Medical Journal (BMJ), vol. 374, pp. n2060 . https://doi.org/10.1136/bmj.n2060
Fenton, L, Gribben, C, Caldwell, D, Colville, S, Bishop, J, Reid, M, White, J, Campbell, M, Hutchinson, S, Robertson, C, Colhoun, H M, Wood, R, McKeigue, P M & McAllister, D A 2021, ' Risk of hospital admission with covid-19 among teachers compared with healthcare workers and other adults of working age in Scotland, March 2020 to July 2021 : population based case-control study ', BMJ (Clinical research ed.), vol. 374, pp. n2060 . https://doi.org/10.1136/bmj.n2060
The BMJمصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Health Personnel, Population, Datasets as Topic, Lower risk, Risk Assessment, Young Adult, RA0421, Intensive care, Health care, Medicine, Humans, Cumulative incidence, Young adult, education, Pandemics, Cause of death, Aged, education.field_of_study, business.industry, SARS-CoV-2, Research, COVID-19, General Medicine, Middle Aged, Hospitalization, Scotland, Family medicine, Case-Control Studies, Communicable Disease Control, Female, School Teachers, business, Risk assessment
الوصف: Objective To determine the risk of hospital admission with covid-19 and severe covid-19 among teachers and their household members, overall and compared with healthcare workers and adults of working age in the general population. Design Population based nested case-control study. Setting Scotland, March 2020 to July 2021, during defined periods of school closures and full openings in response to covid-19. Participants All cases of covid-19 in adults aged 21 to 65 (n=132 420) and a random sample of controls matched on age, sex, and general practice (n=1 306 566). Adults were identified as actively teaching in a Scottish school by the General Teaching Council for Scotland, and their household members were identified through the unique property reference number. The comparator groups were adults identified as healthcare workers in Scotland, their household members, and the remaining general population of working age. Main outcome measures The primary outcome was hospital admission with covid-19, defined as having a positive test result for SARS-CoV-2 during hospital admission, being admitted to hospital within 28 days of a positive test result, or receiving a diagnosis of covid-19 on discharge from hospital. Severe covid-19 was defined as being admitted to intensive care or dying within 28 days of a positive test result or assigned covid-19 as a cause of death. Results Most teachers were young (mean age 42), were women (80%), and had no comorbidities (84%). The risk (cumulative incidence) of hospital admission with covid-19 was Conclusion Compared with adults of working age who are otherwise similar, teachers and their household members were not found to be at increased risk of hospital admission with covid-19 and were found to be at lower risk of severe covid-19. These findings should reassure those who are engaged in face-to-face teaching.
وصف الملف: application/pdf
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::73062db30807a187dc2a5b1c18d89ee2
https://www.pure.ed.ac.uk/ws/files/228400355/Risk_of_hospital_admission_with_covid_19_among_teachers_compared_with_healthcare_workers_and_other_adults_of_working_age_in_Scotland_March_2020_to_July_2021.pdf -
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المؤلفون: Marion K Campbell, Heidi Gardner, Shaun Treweek, Vikki Entwistle, Katie Gillies, Paula R Williamson
المصدر: Journal of Clinical Epidemiology
مصطلحات موضوعية: Epidemiology, International Cooperation, education, Delphi method, Psychological intervention, decision making, law.invention, research waste, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Informed consent, law, Health care, Humans, 030212 general & internal medicine, Set (psychology), Randomized Controlled Trials as Topic, Medical education, clinical trials, Informed Consent, business.industry, Therapeutic misconception, methodology, core outcome sets, Clinical trial, Treatment Outcome, Original Article, Psychology, business, 030217 neurology & neurosurgery
الوصف: Highlights • First internationally agreed minimum set of outcomes deemed essential to be measured in all future studies evaluating interventions to improve decisions about participating in an randomized controlled trial. • Broad stakeholder involvement, including; potential trial participants (e.g., patients or others who could provide a lay perspective), trialists, research nurses, social scientists, clinicians, bioethicists, and research ethics committee members. • Represents outcomes that are of core importance to multiple stakeholders and, if adopted, will improve the relevance of future trials in this field.
Objective To develop a core outcome set for the evaluation of interventions that aim to improve how people make decisions about whether to participate in randomized controlled trials (of healthcare interventions), the ELICIT Study. Study Design International mixed-method study involving a systematic review of existing outcomes, semi-structured interviews, an online Delphi survey, and a face-to-face consensus meeting. Results The literature review and stakeholder interviews (n = 25) initially identified 1045 reported outcomes that were grouped into 40 individually distinct outcomes. These 40 outcomes were scored for importance in two rounds of an online Delphi survey (n = 79), with 18 people attending the consensus meeting. Consensus was reached on 12 core outcomes: therapeutic misconception; comfort with decision; authenticity of decision; communication about the trial; empowerment; sense of altruism; equipoise; knowledge; salience of questions; understanding, how helpful the process was for decision making; and trial attrition. Conclusion The ELICIT core outcome set is the first internationally agreed minimum set of outcomes deemed essential to be measured in all future studies evaluating interventions to improve decisions about participating in an randomized controlled trial. Use of the ELICIT core set will ensure that results from these trials are comparable and relevant to all stakeholders. Registration COMET database - http://www.comet-initiative.org/Studies/Details/595. -
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المؤلفون: Marion K Campbell, Julia L. Allan, Kirsty Kiezebrink, Brian Power
المصدر: Pilot and Feasibility Studies, Vol 7, Iss 1, Pp 1-14 (2021)
Pilot and Feasibility Studiesمصطلحات موضوعية: Behaviour change, media_common.quotation_subject, Population, Applied psychology, Psychological intervention, Physical activity, Nurses, Medicine (miscellaneous), 030209 endocrinology & metabolism, Context (language use), 03 medical and health sciences, 0302 clinical medicine, Optimism, Healthcare professionals, Intervention (counseling), Quality (business), 030212 general & internal medicine, education, Exercise, media_common, lcsh:R5-920, education.field_of_study, Behavioural interventions, Research, Diet, Programme, lcsh:Medicine (General), Psychology
الوصف: Background There is a critical need for an intervention to improve nurses’ eating and physical activity behaviours. As nurses spend a substantial proportion of their waking hours at work, concerted efforts to deliver such interventions in the workplace is growing. This study formed part of a multiphase programme of research that aimed to systematically develop an evidence-based and theory-informed workplace intervention to promote changes in eating and physical activity among nurses. Methods The intervention was developed iteratively, in line with Medical Research Council complex intervention guidelines. It involved four activities: (1) identifying the evidence base, (2) understanding the determinants of nurses’ eating and physical activity behaviour change through theory-based qualitative interviews and survey, (3) identifying intervention options using the Behaviour Change Wheel, and (4) specifying intervention content and implementation options using a taxonomy of behaviour change techniques. Results Data from 13 randomised controlled trials indicated that workplace-based behaviour change interventions targeted to this population are effective in changing behaviour. The evidence base was, however, limited in quantity and quality. Nurses’ beliefs about important factors determining their eating and physical activity behaviour were identified across 16 qualitative interviews and 245 survey responses, and key determinants included environmental context and resources, behavioural regulation, emotion, beliefs about consequences, knowledge and optimism. Based on these findings, 22 behaviour change techniques suitable for targeting the identified determinants were identified and combined into a potential workplace intervention. Conclusions An evidence-based and theory-informed intervention tailored to the target population and setting has been explicitly conceptualised using a systematic approach. The proposed intervention addresses previous evidence gaps for the user population of nurses. Further to this, such an intervention, if implemented, has the potential to impact nurses’ eating and physical activity behaviours and in turn, the health of nurses and the quality of healthcare delivery.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d8ecd9ef580de65d475962ae38574e61
https://doi.org/10.21203/rs.3.rs-44886/v1 -
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المؤلفون: Brian Power, Kirsty Kiezebrink, Julia L. Allan, Marion K Campbell
المصدر: BMC Obesity, Vol 4, Iss 1, Pp 1-12 (2017)
BMC obesityمصطلحات موضوعية: Enablers, medicine.medical_specialty, Epidemiology, Endocrinology, Diabetes and Metabolism, Population, lcsh:Special situations and conditions, Physical Therapy, Sports Therapy and Rehabilitation, Qualitative property, Interpersonal communication, Theoretical domains framework, Developmental psychology, Shift work, 03 medical and health sciences, 0302 clinical medicine, Healthcare professionals, medicine, 030212 general & internal medicine, Psychiatry, education, Exercise, education.field_of_study, 030504 nursing, business.industry, Health Policy, Public health, lcsh:RC952-1245, Perspective (graphical), Public Health, Environmental and Occupational Health, Diet, Mood, 0305 other medical science, business, Barriers, Intrapersonal communication, Research Article
الوصف: Background Unhealthy eating and physical activity behaviours are common among nurses but little is known about determinants of eating and physical activity behaviour in this population. The present study used a theoretical framework which summarises the many possible determinants of different health behaviours (the Theoretical Domains Framework; TDF) to systematically explore the most salient determinants of unhealthy eating and physical activity behaviour in hospital-based nurses. Methods Semi-structured qualitative interviews based on the TDF were conducted with nurses (n = 16) to explore factors that behavioural theories suggest may influence nurses’ eating and physical activity behaviour. Important determinants of the target behaviours were identified using both inductive coding (of categories emerging from the data) and deductive coding (of categories derived from the TDF) of the qualitative data. Results Thirteen of the fourteen domains in the TDF were found to influence nurses’ eating and physical activity behaviour. Within these domains, important barriers to engaging in healthy eating and physical activity behaviour were shift work, fatigue, stress, beliefs about negative consequences, the behaviours of family and friends and lack of planning. Important factors reported to enable engagement with healthy eating and physical activity behaviours were beliefs about benefits, the use of self-monitoring strategies, support from work colleagues, confidence, shift work, awareness of useful guidelines and strategies, good mood, future holidays and receiving compliments. Conclusions This study used a theory-informed approach by applying the TDF to identify the key perceived determinants of nurses’ eating and physical activity behaviour. The findings suggest that future efforts to change nurses’ eating and physical activity behaviours should consider targeting a broad range of environmental, interpersonal and intrapersonal level factors, consistent with a socio-ecological perspective. Electronic supplementary material The online version of this article (doi:10.1186/s40608-017-0154-4) contains supplementary material, which is available to authorized users.
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المؤلفون: Jonathan J. Morrison, Lorraine Smyth, Jan O. Jansen, Marion K Campbell
المصدر: The Surgeon. 14:7-12
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Time Factors, Critical Care, Population, Audit, 030230 surgery, law.invention, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Case mix index, Interquartile range, law, Outcome Assessment, Health Care, Humans, Medicine, Hospital Mortality, Registries, Intensive care medicine, education, APACHE, Retrospective Studies, education.field_of_study, APACHE II, business.industry, Incidence, 030208 emergency & critical care medicine, Retrospective cohort study, Length of Stay, Middle Aged, Intensive care unit, Intensive Care Units, Scotland, Wounds and Injuries, Female, Surgery, business, Predictive modelling, Follow-Up Studies
الوصف: Background The analysis of mortality is an integral part of the evaluation of trauma care. When specific data are not available, general prediction models can be used to adjust for case mix. The aim of this study was to evaluate the feasibility of conducting a population-based analysis of trends in trauma mortality, using critical care audit data, and to investigate whether such data could provide a benchmark for the assessment of service reconfiguration. Methods Retrospective cohort study of adult trauma patients, requiring admission to a critical care unit in Scotland, 2002–2011, using nationally collected data. Results are presented as standardised mortality ratios of observed mortality divided by APACHE II predicted mortality. Tests for trends in numbers and ratios over time were performed using linear regression. Findings 4503 patients were identified. There was a significant increase in the number of trauma patients admitted per year (p = 0.011). The median predicted probability of in-hospital death was 7% (interquartile range 1–13%), against an actual mortality was 11.6%. There was no significant change in the standardised mortality ratios of trauma patients (p = 0.1224). Conclusions This study demonstrated the feasibility of utilising critical care unit audit data for analysing outcomes from trauma care. It also showed the potential of such an approach to establish a baseline against which to compare the impact of future service reconfiguration. In contrast to healthcare systems with regionalised trauma care, there appears to have been little change in the mortality of trauma patients requiring critical care unit admission in Scotland.
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المؤلفون: Marion K Campbell, Jonathan J. Morrison, Gerry Egan, Handing Wang, Robin Lawrenson, Jan O. Jansen, Shan He
المصدر: Journal of Trauma and Acute Care Surgery. 76:1035-1040
مصطلحات موضوعية: medicine.medical_specialty, Geospatial analysis, Operations research, Population, Poison control, Efficiency, Organizational, Critical Care and Intensive Care Medicine, computer.software_genre, Multi-objective optimization, Trauma Centers, medicine, Humans, education, education.field_of_study, business.industry, Health services research, Trauma care, Surgery, Scotland, Traumatology, Systems design, Performance improvement, business, Delivery of Health Care, computer
الوصف: BACKGROUND: Trauma systems have been shown to reduce death and disability from injury but must be appropriately configured. A systematic approach to trauma system design can help maximize geospatial effectiveness and reassure stakeholders that the best configuration has been chosen. METHODS: This article describes the GEOS [Geospatial Evaluation of Systems of Trauma Care] methodology, a mathematical modeling of a population-based data set, which aims to derive geospatially optimized trauma system configurations for a geographically defined setting. GEOS considers a region's spatial injury profile and the available resources and uses a combination of travel time analysis and multiobjective optimization. The methodology is described in general and with regard to its application to our case study of Scotland. RESULTS: The primary outcome will be trauma system configuration. CONCLUSION: GEOS will contribute to the design of a trauma system for Scotland. The methodology is flexible and inherently transferable to other settings and could also be used to provide assurance that the configuration of existing trauma systems is fit for purpose.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7b3d10bbf255b1829d41e4caa73589b6
https://doi.org/10.1097/ta.0000000000000196 -
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المؤلفون: Marion K Campbell, Handing Wang, Jan O. Jansen, Jonathan J. Morrison, Robin Lawrenson, David R. Green, Shan He
المصدر: The journal of trauma and acute care surgery. 78(5)
مصطلحات موضوعية: Adult, Male, Emergency Medical Services, Geospatial analysis, Population, Ambulances, Poison control, Critical Care and Intensive Care Medicine, computer.software_genre, Geospatial predictive modeling, Trauma Centers, medicine, Emergency medical services, Humans, Prospective Studies, education, Aged, Aged, 80 and over, education.field_of_study, Trauma Severity Indices, business.industry, Major trauma, Incidence, Middle Aged, medicine.disease, Triage, Scotland, Population Surveillance, Feasibility Studies, Wounds and Injuries, Surgery, Female, Medical emergency, business, computer, Cohort study, Follow-Up Studies
الوصف: BACKGROUND: Geospatial analysis is increasingly being used to evaluate the design and effectiveness of trauma systems, but there are no metrics to describe the geographic distribution of incidents. The aim of this study, therefore, was to evaluate the feasibility and utility of using spatial analysis to characterize, at scale, the geospatial profile of an injured population. METHODS: This is a prospective national cohort study of all trauma patients attended to by the Scottish Ambulance Service in a complete year (between July 1, 2013, and June 30, 2014). Incident location and severity were collected at source. Incident distribution was evaluated using geostatistical techniques. RESULTS: There were 80,391 recorded incidents involving traumatic injury. Incident density was highest in the central Southern part of the country and along the East coast, broadly following the population distribution and road network. The overall distribution was highly clustered, and centered on the central Southern and Eastern parts of the country. When analyzed by triage category, the distribution of incidents triaged to major trauma center care was slightly less clustered than that of incidents triaged to trauma unit or local emergency hospital care, but the spread was similar. When analyzed by type of injury, assaults and falls were more clustered than incidents relating to traffic and transportation. CONCLUSION: This study demonstrates the feasibility and power of describing the geographic distribution of a group of injured patients. The methodology described has potential application for injury surveillance and trauma system design and evaluation. Language: en
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::63d7e915f142f2a9e11d89e407c18a70
https://pubmed.ncbi.nlm.nih.gov/25909416 -
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المؤلفون: Marion K Campbell, Jeremy M. Grimshaw, Martin P Eccles, Diana Elbourne
المصدر: The ANNALS of the American Academy of Political and Social Science. 599:71-93
مصطلحات موضوعية: Sociology and Political Science, business.industry, 030503 health policy & services, education, Behavior change, Psychological intervention, General Social Sciences, Consolidated Standards of Reporting Trials, Disease cluster, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Nursing, law, Organizational behavior, Health care, Medicine, 030212 general & internal medicine, Implementation research, 0305 other medical science, business
الوصف: Individual patient randomized trials are the gold standard for assessing the effects of health care evaluations. However, individual randomization may not be possible for practical, logistical, ethical, or political reasons, for example, when evaluating health care professional and organizational behavior change interventions. Under such circumstances, cluster randomized trials are commonly used. This article discusses the practical and ethical issues in the design, conduct, and analysis of cluster randomized trials of professional behavior and organizational change strategies using examples from two primary studies evaluating health care provider behavior change strategies. Cluster randomized trials are commonly used in health care. They raise distinct ethical and methodological issues that have rarely been adequately addressed in studies to date.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::5e800a6edeaea86142890d06d93b6b35
https://doi.org/10.1177/0002716205274576 -
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المؤلفون: S. A. New, Marion K Campbell, David M. Reid, Helen M. Macdonald
المصدر: Osteoporosis International. 16:163-171
مصطلحات موضوعية: medicine.medical_specialty, Hormone Replacement Therapy, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Population, Osteoporosis, Physiology, Weight Gain, Body Mass Index, Bone Density, Weight loss, Internal medicine, Weight Loss, medicine, Humans, education, Exercise, Osteoporosis, Postmenopausal, Bone mineral, Analysis of Variance, education.field_of_study, Chi-Square Distribution, Hip, business.industry, Body Weight, Weight change, Hormone replacement therapy (menopause), Middle Aged, medicine.disease, Spine, Physical activity level, Menopause, Endocrinology, Regression Analysis, Female, medicine.symptom, Energy Intake, business
الوصف: Weight is recognized as an important factor in determining an individual's risk of osteoporosis. However, little is known about whether weight or weight change influences bone loss around the time of the menopause, and the relationship with energy intake and physical activity level remains largely undefined. Healthy premenopausal women (1,064 selected from a random population of 5,119 women aged 45-54 years at baseline) each had bone mineral density (BMD), weight and height measurements, and completed a food frequency and physical activity questionnaire. Of the original participants, 907 women (85.2%) returned 6.3 +/- 0.6 years later for repeat BMD measurements, and 896 women completed the questionnaires. Bone loss at the hip (FN) and spine (LS) occurred before the menopause. Weight change rather than weight was associated with FN BMD loss (r=0.102, p=0.002), but weight at follow-up was associated with LS BMD change (r=0.105, p=0.002). Although an increase in physical activity level (PAL) appeared to be beneficial for FN BMD in women who were heavy weight gainers, PAL was associated with increased LS BMD loss in women who lost weight. For current HRT users, neither weight nor weight change was associated with change in BMD. Postmenopausal women not taking HRT should be made aware that low body weight or losing weight during this particularly vulnerable period may worsen bone loss.
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