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https://www.readbyqxmd.com/read/28806989/maximising-value-from-a-united-kingdom-biomedical-research-centre-study-protocol
#1
Trisha Greenhalgh, Pavel V Ovseiko, Nick Fahy, Sara Shaw, Polly Kerr, Alexander D Rushforth, Keith M Channon, Vasiliki Kiparoglou
BACKGROUND: Biomedical Research Centres (BRCs) are partnerships between healthcare organisations and universities in England. Their mission is to generate novel treatments, technologies, diagnostics and other interventions that increase the country's international competitiveness, to rapidly translate these innovations into benefits for patients, and to improve efficiency and reduce waste in healthcare. As NIHR Oxford BRC (Oxford BRC) enters its third 5-year funding period, we seek to (1) apply the evidence base on how best to support the various partnerships in this large, multi-stakeholder research system and (2) research how these partnerships play out in a new, ambitious programme of translational research...
August 14, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28802720/application-of-green-fluorescent-protein-to-measure-antimicrobial-efficacy-and-the-kinetics-of-cell-death-against-escherichia-coli
#2
Richard Greenhalgh, Malcolm Greenhalgh, Fadwa Alshareef, Geoffrey D Robson
Industrial antimicrobials have been extensively used to control unwanted microbial growth by incorporation into a variety of products such as plastics and paints, reducing biodeterioration and biofouling and extending the lifespan of the product. Industrial antimicrobials generally have broad sites of action affecting core cellular functions such as central metabolism, enzyme function, cell wall or DNA synthesis and can either be biocidal or biostatic. In addition, susceptibility can be affected by the metabolic state of the microbe, with metabolically inactive cells generally more resistant than metabolically active cells...
August 9, 2017: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/28801403/equipping-community-pharmacy-workers-as-agents-for-health-behaviour-change-developing-and-testing-a-theory-based-smoking-cessation-intervention
#3
Liz Steed, Ratna Sohanpal, Wai-Yee James, Carol Rivas, Sandra Jumbe, Angel Chater, Adam Todd, Elizabeth Edwards, Virginia Macneil, Fraser Macfarlane, Trisha Greenhalgh, Chris Griffiths, Sandra Eldridge, Stephanie Taylor, Robert Walton
OBJECTIVE: To develop a complex intervention for community pharmacy staff to promote uptake of smoking cessation services and to increase quit rates. DESIGN: Following the Medical Research Council framework, we used a mixed-methods approach to develop, pilot and then refine the intervention. METHODS: Phase I: We used information from qualitative studies in pharmacies, systematic literature reviews and the Capability, Opportunity, Motivation-Behaviour framework to inform design of the initial version of the intervention...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28795054/sepsis-in-the-burn-patient-a-different-problem-than-sepsis-in-the-general-population
#4
REVIEW
David G Greenhalgh
Sepsis has recently been defined as "life-threatening organ dysfunction caused by a dysregulated host response to infection". A great amount of effort has been made to develop early treatments for sepsis through the Surviving Sepsis Campaign. There are similar but slightly different recommendations for the treatment of sepsis in the pediatric population. These international efforts have led to earlier diagnosis and treatments for sepsis that have led to improvements in survival. Sepsis is also the leading cause of death in the burn patient but most clinical sepsis studies have excluded burns...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28791763/aryloxide-facilitated-catalyst-turnover-in-enantioselective-%C3%AE-%C3%AE-unsaturated-acyl-ammonium-catalysis
#5
Anastassia Matviitsuk, Mark Greenhalgh, Diego Barrios Antunez, Alexandra Slawin, Andrew David Smith
A new general concept for α,β-unsaturated acyl ammonium catalysis is reported that uses p-nitrophenoxide release from an α,β-unsaturated p-nitrophenyl ester substrate to facilitate catalyst turnover. This method was used for the enantioselective isothiourea-catalyzed Michael addition of nitroalkanes to α,β-unsaturated p-nitrophenyl esters in generally good yield and with excellent enantioselectivity (27 examples, up to 79% yield, 99:1 er). Mechanistic studies identified rapid and reversible catalyst acylation by the α,β-unsaturated p-nitrophenyl ester, and a recently-reported variable time normalization kinetic analysis method was used to delineate the complex reaction kinetics...
August 9, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/28742684/endovascular-repair-of-abdominal-aortic-aneurysm-in-patients-physically-ineligible-for-open-repair-very-long-term-follow-up-in-the-evar-2-randomized-controlled-trial
#6
Michael J Sweeting, Rajesh Patel, Janet T Powell, Roger M Greenhalgh
OBJECTIVE: The aim of the study was to compare long-term total and aneurysm-related mortality in physically frail patients with abdominal aortic aneurysm (AAA) randomized to either early endovascular aneurysm repair (EVAR) or no-intervention. SUMMARY BACKGROUND DATA: EVAR-2 remains the sole randomized trial to identify whether EVAR reduces mortality in patients physically ineligible for open repair. METHODS: Between September 1999 and August 2004, 404 patients from 33 centers in the United Kingdom aged ≥60 years with AAA >5...
August 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28707098/creating-environments-to-support-breastfeeding-the-challenges-and-facilitators-of-policy-development-in-hospitals-clinics-early-care-and-education-and-worksites
#7
Victoria A Bradford, Lina P Walkinshaw, Lesley Steinman, Jennifer J Otten, Kari Fisher, Amy Ellings, Jean O'Leary, Donna B Johnson
Objectives Supportive organizational breastfeeding policies can establish enabling environments for breastfeeding. In this qualitative study we identify facilitators and barriers to the development, adoption, and implementation of supportive breastfeeding policies and practices in four influential sectors for breastfeeding women: hospitals, clinics, early care and education settings, and worksites. Methods We interviewed 125 individuals representing 110 organizations in Washington State about their breastfeeding policy development and implementation process between August 2014 and February 2015...
July 13, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28697050/transfusion-requirement-in-burn-care-evaluation-tribe-a-multicenter-randomized-prospective-trial-of-blood-transfusion-in-major-burn-injury
#8
Tina L Palmieri, James H Holmes, Brett Arnoldo, Michael Peck, Bruce Potenza, Amalia Cochran, Booker T King, William Dominic, Robert Cartotto, Dhaval Bhavsar, Nathan Kemalyan, Edward Tredget, Francois Stapelberg, David Mozingo, Bruce Friedman, David G Greenhalgh, Sandra L Taylor, Brad H Pollock
OBJECTIVE: Our objective was to compare outcomes of a restrictive to a liberal red cell transfusion strategy in 20% or more total body surface area (TBSA) burn patients. We hypothesized that the restrictive group would have less blood stream infection (BSI), organ dysfunction, and mortality. BACKGROUND: Patients with major burns have major (>1 blood volume) transfusion requirements. Studies suggest that a restrictive blood transfusion strategy is equivalent to a liberal strategy...
July 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28687532/studying-scale-up-and-spread-as-social-practice-theoretical-introduction-and-empirical-case-study
#9
James Shaw, Sara Shaw, Joseph Wherton, Gemma Hughes, Trisha Greenhalgh
BACKGROUND: Health and care technologies often succeed on a small scale but fail to achieve widespread use (scale-up) or become routine practice in other settings (spread). One reason for this is under-theorization of the process of scale-up and spread, for which a potentially fruitful theoretical approach is to consider the adoption and use of technologies as social practices. OBJECTIVE: This study aimed to use an in-depth case study of assisted living to explore the feasibility and usefulness of a social practice approach to explaining the scale-up of an assisted-living technology across a local system of health and social care...
July 7, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28674017/disruption-of-a-horizontally-transferred-phytoene-desaturase-abolishes-carotenoid-accumulation-and-diapause-in-tetranychus-urticae
#10
Astrid Bryon, Andre H Kurlovs, Wannes Dermauw, Robert Greenhalgh, Maria Riga, Miodrag Grbić, Luc Tirry, Masahiro Osakabe, John Vontas, Richard M Clark, Thomas Van Leeuwen
Carotenoids underlie many of the vibrant yellow, orange, and red colors in animals, and are involved in processes ranging from vision to protection from stresses. Most animals acquire carotenoids from their diets because de novo synthesis of carotenoids is primarily limited to plants and some bacteria and fungi. Recently, sequencing projects in aphids and adelgids, spider mites, and gall midges identified genes with homology to fungal sequences encoding de novo carotenoid biosynthetic proteins like phytoene desaturase...
July 18, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28663428/books-challenging-perspectives-on-organizational-change-in-health-care-change-in-the-right-way
#11
Trisha Greenhalgh
No abstract text is available yet for this article.
July 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28647725/percutaneous-coronary-intervention-patients-and-cardiologists-experiences-of-the-informed-consent-process-in-northern-england-a-qualitative-study
#12
Joy Probyn, Joanne Greenhalgh, Janet Holt, Dwayne Conway, Felicity Astin
OBJECTIVE: Informed consent is central to ethical medical practice, but little is known about how the process takes place in clinical practice. Percutaneous coronary intervention (PCI) is a common revascularisation procedure. Studies report that patients overestimate benefits, forget the risks and are unaware of alternative treatments. The aim of this study was to describe PCI patients' and cardiologists' experiences of the informed consent process in acute care settings. DESIGN/SETTING/PARTICIPANTS: A qualitative study with a maximum variation sample of elective and acute PCI patients and cardiologists taking their consent, recruited from a district general hospital and tertiary centre...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28644205/the-unrecognized-epidemic-of-electronic-cigarette-burns
#13
Jesus I Ramirez, Catherine A Ridgway, Jeanne G Lee, Bruce M Potenza, Soman Sen, Tina L Palmieri, David G Greenhalgh, Pirko Maguina
Electronic cigarettes (e-cigarettes) are novel battery-operated devices that deliver nicotine as an inhaled aerosol. They originated from China in 2007 and their use has rapidly increased worldwide in the past decade, yet they remain largely unregulated. Reports of injuries associated with their use have appeared as unusual events in the news media and as case reports in the medical literature. This study was undertaken to explore e-cigarettes as a mechanism of burn injury. Referral records to three burn centers from January 2007 to July 2016 were searched to identify patients with injuries caused by e-cigarettes...
July 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28637744/group-clinics-for-young-adults-with-diabetes-in-an-ethnically-diverse-socioeconomically-deprived-setting-together-study-protocol-for-a-realist-review-co-design-and-mixed-methods-participatory-evaluation-of-a-new-care-model
#14
Chrysanthi Papoutsi, Dougal Hargreaves, Grainne Colligan, Ann Hagell, Anita Patel, Desirée Campbell-Richards, Russell M Viner, Shanti Vijayaraghavan, Martin Marshall, Trisha Greenhalgh, Sarah Finer
INTRODUCTION: Young adults with diabetes often report dissatisfaction with care and have poor diabetes-related health outcomes. As diabetes prevalence continues to rise, group-based care could provide a sustainable alternative to traditional one-to-one consultations, by engaging young people through life stage-, context- and culturally-sensitive approaches. In this study, we will co-design and evaluate a group-based care model for young adults with diabetes and complex health and social needs in socioeconomically deprived areas...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28615004/understanding-heart-failure-explaining-telehealth-a-hermeneutic-systematic-review
#15
Trisha Greenhalgh, Christine A'Court, Sara Shaw
BACKGROUND: Enthusiasts for telehealth extol its potential for supporting heart failure management. But randomised trials have been slow to recruit and produced conflicting findings; real-world roll-out has been slow. We sought to inform policy by making sense of a complex literature on heart failure and its remote management. METHODS: Through database searching and citation tracking, we identified 7 systematic reviews of systematic reviews, 32 systematic reviews (including 17 meta-analyses and 8 qualitative reviews); six mega-trials and over 60 additional relevant empirical studies and commentaries...
June 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28594637/applying-a-potential-difference-to-minimise-damage-to-carbon-fibres-during-carbon-nanotube-grafting-by-chemical-vapour-deposition
#16
David Benbow Anthony, Hui Qian, Adam Clancy, Alexander Bismarck, Emile Greenhalgh, Milo Shaffer
The application of an in-situ potential difference between carbon fibres and a graphite foil counter electrode (300 V, generating an electric field <i>ca.</i> 0.3 V µm<sup>-1</sup> to 0.7 V µm<sup>-1</sup>) during the chemical vapour deposition synthesis of carbon nanotube (CNT) grafted carbon fibres, significantly improves the uniformity of growth without reducing the tensile properties of the underlying carbon fibres. Grafted carbon nanotubes with diameters around 55 nm and lengths around 10 µm were well attached to the carbon fibre surface, and were grown without the requirement for protective barrier coatings...
June 8, 2017: Nanotechnology
https://www.readbyqxmd.com/read/28567263/non-bonding-1-5-s%C3%A2-%C3%A2-%C3%A2-o-interactions-govern-chemo-and-enantioselectivity-in-isothiourea-catalyzed-annulations-of-benzazoles
#17
Emily R T Robinson, Daniel M Walden, Charlene Fallan, Mark D Greenhalgh, Paul Ha-Yeon Cheong, Andrew D Smith
Isothiourea-catalyzed annulations between 2-acyl benzazoles and α,β-unsaturated acyl ammonium intermediates are selectively tuned to form either lactam or lactone heterocycles in good yields (up to 95%) and high ee (up to 99%) using benzothiazole or benzoxazole derivatives, respectively. Computation gives insight into the significant role of two 1,5-S···O interactions in controlling the structural preorganization and chemoselectivity observed within the lactam synthesis with benzothiazoles as nucleophiles...
December 1, 2016: Chemical Science
https://www.readbyqxmd.com/read/28552971/qualitative-analysis-of-how-patients-decide-that-they-want-risk-reducing-mastectomy-and-the-implications-for-surgeons-in-responding-to-emotionally-motivated-patient-requests
#18
Stephen L Brown, Demian Whiting, Hannah G Fielden, Pooja Saini, Helen Beesley, Christopher Holcombe, Susan Holcombe, Lyn Greenhalgh, Louise Fairburn, Peter Salmon
OBJECTIVE: Contemporary approaches to medical decision-making advise that clinicians should respect patients' decisions. However, patients' decisions are often shaped by heuristics, such as being guided by emotion, rather than by objective risk and benefit. Risk-reducing mastectomy (RRM) decisions focus this dilemma sharply. RRM reduces breast cancer (BC) risk, but is invasive and can have iatrogenic consequences. Previous evidence suggests that emotion guides patients' decision-making about RRM...
2017: PloS One
https://www.readbyqxmd.com/read/28508440/has-evidence-based-medicine-ever-been-modern-a-latour-inspired-understanding-of-a-changing-ebm
#19
Sietse Wieringa, Eivind Engebretsen, Kristin Heggen, Trish Greenhalgh
Evidence-based health care (EBHC), previously evidence-based medicine (EBM), is considered by many to have modernized health care and brought it from an authority-based past to a more rationalist, scientific grounding. But recent concerns and criticisms pose serious challenges and urge us to look at the fundamentals of a changing EBHC. In this paper, we present French philosopher Bruno Latour's vision on modernity as a framework to discuss current changes in the discourse on EBHC/EBM. Drawing on Latour's work, we argue that the early EBM movement had a strong modernist agenda with an aim to "purify" clinical reality into a dichotomy of objective "evidence" from nature and subjective "preferences" from human society and culture...
May 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28498244/identifying-lynch-syndrome-in-women-presenting-with-endometrial-carcinoma-under-the-age-of-50-years
#20
Antonios Anagnostopoulos, Vicky H McKay, Iris Cooper, Fiona Campbell, Lynn Greenhalgh, John Kirwan
BACKGROUND: Lynch syndrome (LS) is an inherited disorder associated with genetic predisposition to endometrial, colorectal, ovarian, and other cancers. There is consensus for the necessity of assessment for LS in view of the established survival benefits for identified patients and affected family members. The debate regarding the best screening policy is far from being concluded. OBJECTIVES: The aim of this study was to evaluate a realistic protocol for identifying LS families by assessing young women with a diagnosis of endometrial cancer (EC)...
June 2017: International Journal of Gynecological Cancer
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