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Lynsey Northeast, Charlotte N Gautrey, Lindsay Bottoms, Gerwyn Hughes, Andrew C S Mitchell, Andrew Greenhalgh
BACKGROUND: Chronic ankle instability (CAI) has previously been linked to altered lower limb kinematics and muscle activation characteristics during walking, though little research has been performed analysing the full time-series across the stance and swing phases of gait. RESEARCH QUESTION: The aim of this study was to compare trunk and lower limb kinematics and muscle activity between those with chronic ankle instability and healthy controls. METHODS: Kinematics and muscle activity were measured in 18 (14 males, 4 females) healthy controls (age 22...
June 7, 2018: Gait & Posture
Pinar Ulug, Robert J Hinchliffe, Michael J Sweeting, Manuel Gomes, Matthew T Thompson, Simon G Thompson, Richard J Grieve, Raymond Ashleigh, Roger M Greenhalgh, Janet T Powell
BACKGROUND: Ruptured abdominal aortic aneurysm (AAA) is a common vascular emergency. The mortality from emergency endovascular repair may be much lower than the 40-50% reported for open surgery. OBJECTIVE: To assess whether or not a strategy of endovascular repair compared with open repair reduces 30-day and mid-term mortality (including costs and cost-effectiveness) among patients with a suspected ruptured AAA. DESIGN: Randomised controlled trial, with computer-generated telephone randomisation of participants in a 1 : 1 ratio, using variable block size, stratified by centre and without blinding...
May 2018: Health Technology Assessment: HTA
Alastair Macfarlane, Trisha Greenhalgh
BACKGROUND: Despite significant teratogenic risks, sodium valproate is still widely prescribed in many countries to women of childbearing age, as a mood stabiliser in bipolar disorder and also in epilepsy. The UK has recently banned valproate use in women who are not in a pregnancy prevention programme. Whilst this ruling reflects prevailing clinical practice, it also highlights an ongoing debate about when (if ever) a woman who is or could become pregnant should be allowed to choose to take valproate...
June 1, 2018: BMC Pregnancy and Childbirth
E K Bancroft, S Saya, E C Page, K Myhill, S Thomas, J Pope, A Chamberlain, R Hart, W Glover, J Cook, D J Rosario, B T Helfand, C Hutten Selkirk, R Davidson, M Longmuir, D M Eccles, N Gadea, C Brewer, J Barwell, M Salinas, L Greenhalgh, M Tischkowitz, A Henderson, D G Evans, S S Buys, R A Eeles, N K Aaronson
OBJECTIVES: To report the baseline results of a longitudinal psychosocial study that forms part of the IMPACT study, a multi-national investigation of targeted prostate cancer (PCa) screening among men with a known pathogenic germline mutation in the BRCA1 or BRCA2 genes. PATIENTS AND METHODS: Men enrolled in the IMPACT study were invited to complete a questionnaire at collaborating sites prior to each annual screening visit. The questionnaire included sociodemographics and the following measures: Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), Short Form 36 (SF36), Memorial Anxiety Scale for PCa (MAX-PC), Cancer Worry Scale (CWS), risk perception and knowledge...
May 26, 2018: BJU International
J H Holmes, J A Molnar, J E Carter, J Hwang, B A Cairns, B T King, D J Smith, C W Cruse, K N Foster, M D Peck, R Sood, M J Feldman, M H Jordan, D W Mozingo, D G Greenhalgh, T L Palmieri, J A Griswold, S Dissanaike, W L Hickerson
Introduction: Early excision and autografting are standard care for deeper burns. However, donor sites are a source of significant morbidity. To address this, the ReCell® Autologous Cell Harvesting Device (ReCell) was designed for use at the point-of-care to prepare a non-cultured, autologous skin cell suspension (ASCS) capable of epidermal regeneration utilizing minimal donor skin. Methods: A prospective study was conducted to evaluate the clinical performance of ReCell versus meshed split-thickness skin grafts (STSG, Control) for the treatment of deep partial-thickness (DPT) burns...
May 24, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Christopher Gillespie, Melissa Holstein, Lori Mullin, Kristen Cotoni, Ronald Tuccelli, John Caulmare, Patricia Greenhalgh
Viral inactivation plays a critical role in assuring the safety of monoclonal antibody (mAb) therapeutics. Traditional viral inactivation involves large holding tanks in which product is maintained at a target low pH for a defined hold time, typically 30 to 60 minutes. The drive toward continuous processing and improved facility utilization has provided motivation for development of a continuous viral inactivation process. To this end, a lab-scale prototype viral inactivation system was designed, built, and characterized...
May 24, 2018: Biotechnology Journal
Janette Greenhalgh, Jennifer Weston, Yenal Dundar, Sarah J Nevitt, Anthony G Marson
BACKGROUND: This is an updated version of the Cochrane Review previously published in Issue 3, 2015.The incidence of seizures following supratentorial craniotomy for non-traumatic pathology has been estimated to be between 15% to 20%; however, the risk of experiencing a seizure appears to vary from 3% to 92% over a five-year period. Postoperative seizures can precipitate the development of epilepsy; seizures are most likely to occur within the first month of cranial surgery. The use of antiepileptic drugs (AEDs) administered pre- or postoperatively to prevent seizures following cranial surgery has been investigated in a number of randomised controlled trials (RCTs)...
May 23, 2018: Cochrane Database of Systematic Reviews
Amalia Cochran, David G Greenhalgh
American Burn Association Past President Palmer Q. Bessey, MD, orchestrated a Burn Workforce Conference in Washington, DC in February, 2014, with the goal of evaluating the workforce needs for doctors, nurses and occupational/physical therapists. This report summarizes the issues related to the need for training future surgeons to manage burn patients. General surgery and plastic surgery residents currently have minimal requirements for burn experience during their training. The respective Boards, however, do require knowledge in the management of burn care...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Y Akter, S Greenhalgh, M R Islam, C Hutchison, C J O'Shea
The shelf-life of eggs which contain elevated levels of polyunsaturated fatty acids (PUFA) is compromised due to the relative instability and therefore greater potential for lipid peroxidation of unsaturated fatty acids (FA). Poultry that are highly feed efficient (HFE) exhibit higher systemic levels of antioxidant enzymes, and therefore may produce eggs with improved albumen quality and favorable FA profiles that are stable over time. We tested the hypothesis that HFE laying hens produce eggs with improved internal egg quality and a favorable yolk FA profile prior to and following storage...
May 12, 2018: Journal of Animal Science
Trisha Greenhalgh, Joe Wherton, Chrysanthi Papoutsi, Jenni Lynch, Gemma Hughes, Christine A'Court, Sue Hinder, Rob Procter, Sara Shaw
BACKGROUND: Failures and partial successes are common in technology-supported innovation programmes in health and social care. Complexity theory can help explain why. Phenomena may be simple (straightforward, predictable, few components), complicated (multiple interacting components or issues) or complex (dynamic, unpredictable, not easily disaggregated into constituent components). The recently published NASSS framework applies this taxonomy to explain Non-adoption or Abandonment of technology by individuals and difficulties achieving Scale-up, Spread and Sustainability...
May 14, 2018: BMC Medicine
Trisha Greenhalgh, Sally Thorne, Kirsti Malterud
Faggion's claim that narrative reviews necessarily lack a predefined methodology is incorrect; in our paper we refer to (and reference) three specific methodological approaches to narrative review. He appears to have erroneously conflated our acknowledgement that narrative reviews may sometimes be done badly with the conclusion that they cannot be done well. He offers no evidence to substantiate his assertion that reproducibility should always be privileged over clarity and comprehensiveness (though as we said in the paper, we agree it sometimes should)...
May 3, 2018: European Journal of Clinical Investigation
Clovis Mariano Faggion
Greenhalgh et al. argued that narrative reviews provide 'interpretation and critique',1 which should be seen as 'complementary' to systematic reviews. While narrative reviews can facilitate discussion of relevant topics, they should not be used to support important policy and clinical decisions that address human disease2 because they lack a pre-defined methodology. This makes reproduction of the course taken by the authors impossible, which prevents a systematic check for biases that might affect both the results and the conclusions...
May 3, 2018: European Journal of Clinical Investigation
Trisha Greenhalgh
No abstract text is available yet for this article.
May 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Trisha Greenhalgh
BACKGROUND: Evidence-based medicine is the application of research findings to inform individual clinical decisions. There is a tension-both philosophical and practical-between the average result from a population study and the circumstances and needs of an individual patient. This personal account of "evidence-based" trauma care illustrates and explores this tension. THE CASE: The author, a keen athlete, describes her experience of a high-impact cycle accident that led to limb fractures (which were diagnosed and treated according to evidence-based guidelines) and also an occult injury to the cervical spine (which was not diagnosed at the time)...
April 15, 2018: Journal of Evaluation in Clinical Practice
Raymond B Flannery, Thomas Greenhalgh
Experimental studies have documented the development of posttraumatic stress disorder (PTSD) in first responders. These studies have routinely included police, firefighters, and paramedics. However, there is another group of first responders that are at risk for PTSD but that has received less research attention. This group is comprised of coroners. This paper reviewed the published data concerning coroners and PTSD and outlined various treatments for addressing coronial PTSD. The findings, the differing treatments, and a detailed methodological inquiry are presented...
April 13, 2018: Psychiatric Quarterly
Trisha Greenhalgh, Sara Shaw, Joseph Wherton, Shanti Vijayaraghavan, Joanne Morris, Satya Bhattacharya, Philippa Hanson, Desirée Campbell-Richards, Seendy Ramoutar, Anna Collard, Isabel Hodkinson
BACKGROUND: There is much interest in virtual consultations using video technology. Randomized controlled trials have shown video consultations to be acceptable, safe, and effective in selected conditions and circumstances. However, this model has rarely been mainstreamed and sustained in real-world settings. OBJECTIVE: The study sought to (1) define good practice and inform implementation of video outpatient consultations and (2) generate transferable knowledge about challenges to scaling up and routinizing this service model...
April 17, 2018: Journal of Medical Internet Research
Susan Greenhalgh
No abstract text is available yet for this article.
April 2018: Demography
Jesus I Ramirez, Soman Sen, Tina L Palmieri, David G Greenhalgh
BACKGROUND: Survival of burn patients with abdominal compartment syndrome (ACS) is uniformly reported to be poor, averaging just 16% after laparotomy. We hypothesize that better outcomes can be achieved with a strategy of immediate laparotomy and early fascial closure. STUDY DESIGN: Patients with burn injury who were diagnosed with ACS between 2005 and 2016 were identified through a search of databases. Data were gathered from electronic medical records. Timing of laparotomy and closure were calculated for each patient...
June 2018: Journal of the American College of Surgeons
Angela Stainthorpe, Janette Greenhalgh, Adrian Bagust, Marty Richardson, Angela Boland, Sophie Beale, Rui Duarte, Eleanor Kotas, Lindsay Banks, Daniel Palmer
As part of the single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited Celgene Ltd to submit clinical and cost-effectiveness evidence for paclitaxel as albumin-bound nanoparticles (Nab-Pac) in combination with gemcitabine (Nab-Pac + Gem) for patients with untreated metastatic pancreatic cancer. The STA was a review of NICE's 2015 guidance (TA360) in which Nab-Pac + Gem was not recommended for patients with untreated metastatic pancreatic cancer...
March 29, 2018: PharmacoEconomics
Trisha Greenhalgh, Sally Thorne, Kirsti Malterud
No abstract text is available yet for this article.
March 26, 2018: European Journal of Clinical Investigation
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