Search

Your search keyword '"Shier, A."' showing total 189 results
Start Over Author "Shier, A." Topic female
189 results on '"Shier, A."'

1. The availability of support and peritoneal dialysis survival: A cohort study

Author

Danielle E Fox, Kathryn M King-Shier, Matthew T James, Lorraine Venturato, Alix Clarke, Pietro Ravani, Matthew J Oliver, and Robert R Quinn

Subjects
Cohort Studies, Male, Renal Dialysis, Risk Factors, Nephrology, Humans, Kidney Failure, Chronic, Female, General Medicine, Middle Aged, Peritoneal Dialysis, Alberta, Retrospective Studies
Abstract

Background: Providing support is important to maintain a patient on peritoneal dialysis (PD), though its impact on outcomes has not been investigated thoroughly. We examined the association between having support and risk of a transfer to hemodialysis. Methods: In this retrospective observational cohort study, we used data captured in the Dialysis Measurement Analysis and Reporting system about patients who started PD in Alberta, Canada, between 1 January 2013 and 30 September 2018. Support was defined as the availability of a support person in the home who was able, willing and available to provide support for PD in the patient’s residence. The outcome of interest was a transfer to hemodialysis for at least 90 days. We estimated the cumulative incidence of a transfer over time accounting for competing risks and hazard ratios to summarise the association between support and a transfer. We split follow-up time as hazard ratios varied over time. Results: Six hundred and eighty-three incident PD patients, median age 58 years ( IQR: 47–68) and 35% female, were followed for a median of 15 months. The cumulative incidence of a transfer to hemodialysis at 24 months was 26%. Having support was associated with a reduced risk of a transfer between 3 and 12 months after the start of dialysis (HR3-12mo: 0.44; 95% CI: 0.25–0.78), but not earlier (hazard ratio (HR): 0.96; 95% confidence interval (CI): 0.55–1.69) or later (HR>12mo: 1.19; 95% CI: 0.65–2.17). Conclusions: A transfer to hemodialysis is common. Having a support person at home is associated with a short-term protective effect after the initiation of PD.

Published
2022

2. Heterogeneity in grocery shopping patterns among low-income minority women in public housing

Author

Victoria, Shier, Sydney, Miller, and Ashlesha, Datar

Subjects
Male, Public Housing, Residence Characteristics, Commerce, Public Health, Environmental and Occupational Health, Humans, Female, Longitudinal Studies, Poverty, Food Supply
Abstract

Background Public housing residents, who tend to be predominantly female and racial/ethnic minorities, are at a particularly high risk for chronic health conditions. Prior studies have suggested that a lack of access to healthy and affordable food may be an important barrier in public housing communities, but evidence is mixed on the association between the neighborhood food environment and dietary quality, suggesting the need to examine food access patterns in low-income, minority communities more deeply. The purpose of this study was to examine the variability in grocery shopping patterns, and the factors that predict them, among low-income minority women in public housing. Methods Interviewer-administered surveys and body composition measurements were collected in the Watts Neighborhood Health Study, an ongoing longitudinal cohort study of low-income urban public housing residents located in South Los Angeles. Descriptive analyses were conducted to understand the variation in grocery shopping patterns among women. Logistic and ordered logistic regression models were estimated to examine the association between resident characteristics and grocery shopping patterns. Results There was considerable variability in grocery shopping patterns, including the types of grocery stores accessed, distance travelled, frequency of shopping, and reasons behind grocery store choice. Grocery shopping patterns were associated with several participant characteristics, including race/ethnicity, working status, access to a car, income, and education. Hispanic participants were less likely to shop at a supermarket, travel further distances to shop, shop more frequently, and were more likely to prioritize price in their choice of primary grocery store than non-Hispanic Black women participants. Conclusions There was considerable variability in grocery shopping patterns, even within this low-income, minority community despite access to the same neighborhood food environment. Convenience and quality, in addition to price, were priorities for choice of primary grocery store, and differences by race/ethnicity suggest that initiatives to improve the neighborhood food environment should consider quality of food, cultural factors, and availability of foods desired by the surrounding community, in addition to price and proximity of grocery stores.

Published
2022

3. Initial Invasive or Conservative Strategy for Stable Coronary Disease

Author

Maron D. J., Hochman J. S., Reynolds H. R., Bangalore S., O'Brien S. M., Boden W. E., Chaitman B. R., Senior R., Lopez-Sendon J., Alexander K. P., Lopes R. D., Shaw L. J., Berger J. S., Newman J. D., Sidhu M. S., Goodman S. G., Ruzyllo W., Gosselin G., Maggioni A. P., White H. D., Bhargava B., Min J. K., John Mancini G. B., Berman D. S., Picard M. H., Kwong R. Y., Ali Z. A., Mark D. B., Spertus J. A., Krishnan M. N., Elghamaz A., Moorthy N., Hueb W. A., Demkow M., Mavromatis K., Bockeria O., Peteiro J., Miller T. D., Szwed H., Doerr R., Keltai M., Selvanayagam J. B., Gabriel Steg P., Held C., Kohsaka S., Mavromichalis S., Kirby R., Jeffries N. O., Harrell F. E., Rockhold F. W., Broderick S., Bruce Ferguson T., Williams D. O., Harrington R. A., Stone G. W., Rosenberg Y, ISCHEMIA Research Group: Joseph Ricci, A Tello Montoliu, A I Robero Aniorte, Abbey Mulder, Abhay A Laddu, Abhinav Goyal, Abhishek Dubey, Abhishek Goyal, Abigail Knighton, Abraham Oomman, Adam J Jaskowiak, Adam Kolodziej, Adam Witkowski, Adnan Hameed, Adriana Anesini, Afshan Hussain, Agne Juceviciene, Agne Urboniene, Agnes Jakal, Agnieszka Szramowska, Ahmad Khairuddin, Ahmed Abdel-Latif, Ahmed Adel, Ahmed Aljzeeri, Ahmed Kamal, Ahmed Talaat, Aimee Mann, Aira Contreras, Ajit Kumar, V K Kumar, Akemi Furukawa, Akshay Bagai, Akvile Smigelskaite, Alain Furber, Alain Rheault, Alaine Melanie Loehr, Alan Rosen, Albert Varga, Albertina Qelaj, Alberto Barioli, Aldo Russo, Alec Moorman, Alejandro Gisbert, Aleksandra Fratczak, Aleksandras Laucevicius, Alena Kuleshova, Alessandro Sionis, Alexander A Sirker, Alexander M Chernyavskiy, Alexandra Craft, Alexandra Vazquez, Alexandre Ciappina Hueb, Alexandre S Colafranseschi, Alexandre Schaan de Quadros, Alexandre Tognon, Ali Alghamdi, Alice Manica Muller, Aline Nogueira Rabaça, Aline Peixoto Deiro, Alison Hallam, Allegra Stone, Allison Schley, Almudena Castro, Alvaro Rabelo Ales, Amanda Germann, Amanda O'Malley, Amar Uxa, Amarachi Ojajuni, Amarino C Oliveira Jr, Amber B Hull, Ambuj Roy, Amer Zarka, Amir Janmohamed, Ammani Brown, Ammy Malinay, Amparo Martinez Monzonis, Amy J Richards, Amy Iskandrian, Amy Ollinger, Ana D Djordjevic-Dikic, Ana Fernández Martínez, Ana Gomes Almeida, Ana Paula Batista, Ana Rita Francisco, Ana S Mladenovic, Ana Santana, Anam Siddiqui, Anastasia M Kuzmina-Krutetskaya, Andras Vertes, Andre S Sousa, Andre Gabriel, André Schmidt, Andrea M Lundeen, Andrea Bartykowszki, Andrea Lorimer, Andrea Mortara, Andrea Pascual, Andreia Coelho, Andreia Rocha, Andrés García-Rincón, Andrew G Howarth, Andrew J Moriarty, Andrew Docherty, Andrew Starovoytov, Andrew Zurick, Andrzej Łabyk, Andrzej Swiatkowski, Andy Lam, Anelise Kawakami, Angela Hoye, Angela Kim, Angelique Smit, Angelo Nobre, Anil V Shah, Anja Ljubez, Anjali Anand, Ankush Sachdeva, Ann Greenberg, Ann Luyten, Ann Ostrander, Anna Di Donato, Anna Cichocka-Radwan, Anna Fojt, Anna Plachcinska, Anna Proietti, Anna Teresinska, Anne Marie Webb, Anne Cartwright, Anne Heath, Anne Mackin, Anong Amaritakomol, Anong Chaiyasri, Anoop Chauhan, Anoop Mathew, Anthony Gemignani, Anto Luigi Andres, Antonia Vega, Antonietta Hansen, Antonino Ginel Iglesias, Antonio Carlos Carvalho, Antonio Di Chiara, Antonio Serra Peñaranda, Antonio Carvalho, Antonio Colombo, Antonio Fiarresga, Anupama Rao, Aquiles Valdespino-Estrada, Araceli Boan, Areef Ishani, Ariel Diaz, Arijit Ghosh, Arintaya Prommintikul, Arline Roberts, Arnold H Seto, Arnold P Good, Arshed Quyyumi, Arthur J Labovitz, Arthur Kerner, Arturo S Campos-Santaolalla, Arunima Misra, Ashok Mukherjee, Ashok Seth, Ashraf Seedhom, Asim N Cheema, Asker Ahmed, Atul Mathur, Atul Verma, Audrey W Leong, Axel Åkerblom, Axelle Fuentes, Aynun Naher, Badhma Valaiyapathi, Baljeet Kaur, Bandula Guruge, Barbara Brzezińska, Barbara Nardi, Bartosz Czarniak, Bebek Singh, Begoña Igual, Bela Merkely, Belen Cid Alvarez, Benjamin J Spooner, Benjamin J W Chow, Benjamin Cheong, Benoy N Shah, Bernard de Bruyne, Bernardas Valecka, Bernhard Jäger, Beth A Archer, Beth Abramson, Beth Jorgenson, Bethany Harvey, Betsy O'Neal, Bev Atkinson, Bev Bozek, Bevin Lang, Bijulal Sasidharan, Bin Yang, Bin Zhang, Binoy Mannekkattukudy Kurian, Bjoern Goebel, Bob Hu, Bogdan A Popescu, Bogdan Crnokrak, Bolin Zhu, Bonnie J Kirby, Brandi D Zimbelman, Brandy Starks, Branko D Beleslin, Brenda Hart, Brian P Shapiro, Brian McCandless, Brianna Wisniewski, Brigham R Smith, Brooks Mirrer, Bruce McManus, Bruce Rutkin, Bruna Edilena Paulino, Bruna Maria Ascoli, Bryn Smith, Byron J Allen, C Michael Gibson, C Noel Bairey Merz, Calin Pop, Cameron Hague, Camila Thais de Ormundo, Candace Gopaul, Candice P Edillo, Carísi A Polanczyk, Carita Krannila, Carla Vicente, Carl-Éric Gagné, Carlo Briguori, Carlos Peña Gil, Carlos Alvarez, Carly Ohmart, Carmen C Beladan, Carmen Ginghina, Carol M Kartje, Caroline Alsweiler, Caroline Brown, Caroline Callison, Caroline Pinheiro, Caroline Rodgers, Caroline Spindler, Carolyn Corbett, Carrie Drum, Casey Riedberger, Catherine Bone, Catherine Fleming, Catherine Gordon, Catherine Jahrsdorfer, Catherine Lemay, Catherine Weick, Cathrine Patten, Cecilia Goletto, Cezary Kepka, Chandini Suvarna, Chang Xu, Chantale Mercure, Charle A Viljoen, Charlene Wiyarand, Charles Jia-Yin Hou, Charles Y Lui, Charles Cannan, Charles Cornet, Charlotte Pirro, Chataroon Rimsukcharoenchai, Chen Wang, Cheng-Ting Tsai, Chen-Yen Chien, Cheryl A Allardyce, Chester M Hedgepeth, Chetan Patel, Chiara Attanasio, Chih-Hsuan Yen, Chi-Ming Chow, Ching Min Er, Ching-Ching Ong, Cholenahally Nanjappa Manjunath, Chris Beck, Chris Buller, Christel Vassaliere, Christian Hamm, Christiano Caldeira, Christie Ballantyne, Christina Björklund, Christine R Hinton, Christine Bergeron, Christine Masson, Christine Roraff, Christine Shelley, Christophe Laure, Christophe Thuaire, Christopher Kinsey, Christopher McFarren, Christopher Spizzieri, Christopher Travill, Chun-Chieh Liu, Chung-Lieh Hung, Chunguang Li, Chun-Ho Yun, Chunli Xia, Ciarra Heard, Cidney Schultz, Clare Venn-Edmonds, Claudia P Hochberg, Claudia Wegmayr, Claudia Cortés, Claudia Escobar, Cláudia Freixo, Claudio T Mesquita, Clemens T Kadalie, Colin Berry, Constance Philander, Corine Thobois, Costantino Costantini, Courtney Page, Craig Atkinson, Craig Barr, Craig Paterson, Cristina Bare, Cynthia Baumann, Cynthia Burman, Dalisa Espinosa, Damien Collison, Dan Deleanu, Dan Elian, Dan Gao, Dana Oliver, Daniel P Vezina, Daniel O'Rourke, Daniele Komar, Danielle Schade, Darrel P Francis, Dastan Malaev, David A Bull, David E Winchester, David P Faxon, David Booth, David Cohen, David DeMets, David Foo, David Schlichting, David Taggart, David Waters, David Wohns, Davis Vo, Dawid Teodorczyk, Dawn Shelstad, Dawn Turnbull, Dayuan Li, Dean Kereiakes, Deborah O'Neill, Deborah Yip, Debra K Johnson, Debra Dees, Deepak L Bhatt, Deepika Gopal, Deepti Kumar, Deirdre Mattina, Deirdre Murphy, Delano R Small, Delsa K Rose, Dengke Jiang, Denis Carl Phaneuf, Denise Braganza, Denise Fine, Derek Cyr, Desiree Tobin, Diana Cukali, Diana Parra, Diane Camara, Diane Minshall Liu, Diego Adrián Vences, Diego Franca de Cunha, Dimitrios Stournaras, Dipti Patel, Dongze Li, Donna Exley, Dorit Grahl, Dragana Stanojevic, Duarte Cacela, Dwayne S G Conway, E Pinar Bermudez, Eapen Punnoose, Edgar L Tay, Edgar Karanjah, Edoardo Verna, Eduardo Hernandez-Rangel, Edward D Nicol, Edward O McFalls, Edward T Martin, Edyta Kaczmarska, Ekaterina I Lubinskaya, Elena A Demchenko, Elena Refoyo Salicio, Eli Feen, Elihú Durán-Cortés, Elisabeth M Janzen, Elise L Hannemann, Elise van Dongen, Elissa Restelli Piloto, Eliza Kaplan, Elizabeta Srbinovska Kostovska, Elizabeth Capasso-Gulve, Elizabeth Congdon, Elizabeth Ferguson, Elizaveta V Zbyshevskaya, Ellen Magedanz, Ellie Fridell, Ellis W Lader, Elvin Kedhi, Emanuela Racca, Emilie Tachot, Emily DeRosa, Encarnación Alonso-Álvarez, Eric Nicollet, Eric Peterson, Erick Alexánderson Rosas, Erick Donato Morales, Erin Orvis, Ermina Moga, Estelle Montpetit, Estevao Figueiredo, Eugene Passamani, Eugenia Nikolsky, Eunice Yeoh, Evgeniy I Kretov, Ewa Szczerba, Ewelina Wojtala, Expedito Eustáquio Ribeiro Silva, F Marin Ortuño, Fabio R Farias, Fabio Fimiani, Fabrizio Rolfo, Fa-Chang Yu, Fadi Hage, Fadi Matar, Fahim Haider Jafary, Fang Feng, Fang Liu, Fatima Ranjbaran, Fatima Rodriguez, Fausto J Pinto, Fauzia Rashid, Federica Ramani, Fei Wang, Fernanda Igansi, Filipa Silva, Filippo Ottani, Fiona Haines, Firas Al Solaiman, Flávia Egydio, Flavio Lyra, Florian Egger, Fran Farquharson, Frances Laube, Francesc Carreras Costa, Francesca de Micco, Francesca Bianchini, Francesca Pezzetta, Francesca Pietrucci, Francesco Orso, Francesco Pisano, Francis Burt, Francisca Patuleia Figueiras, Francisco Fernandez-Aviles, Francois Pierre Mongeon, Frans Van de Werf, Franziska Guenther, Fraser N Witherow, Fred Mohr, Frederico Dall'Orto, Fumiyuki Otsuka, G De La Morena, G Karthikeyan, Gabor Dekany, Gabor Kerecsen, Gabriel Galeote, Gabriel Grossmann, Gabriel Vorobiof, Gabriela Sanchez de Souza, Gabriela Guzman, Gabriela Zeballos, Gabriele Gabrielli, Gabriele Jakl-Kotauschek, Gail A Shammas, Gail Brandt, Gang Chen, Gary E Lane, Gary J Luckasen, Gautam Sharma, Gelmina Mikolaitiene, Gennie Yee, Georg Nickenig, George E Revtyak, George J Juang, Gerald Fletcher, Gerald Leonard, Gerard Patrick Devlin, Gerard Esposito, Gergely Ágoston, Gervasio Lamas, Geza Fontos, Ghada Mikhail, Gia Cobb, Gian Piero Perna, Gianpiero Leone, Giles Roditi, Gilles Barone-Rochette, Girish Mishra, Giuseppe Tarantini, Glenda Wong, Glenn S Hamroff, Glenn Rayos, Gong Cheng, Gonzalo Barge-Caballero, Goran Davidović, Goran Stankovic, Gordana Stevanovic, Grace Jingyan Wang, Grace M Young, Graceanne Wayser, Graciela Scaro, Graham S Hillis, Graham Wong, Grazyna Anna Szulczyk, Gregor Simonis, Gregory Kumkumian, Gretchen Ann Peichel, Grzegorz Gajos, Gudrun Steinmaurer, Guilherme G Rucatti, Guilherme Portugal, Guilhermina Cantinho Lopes, Guillem Pons Lladó, Gunnar Frostfelt, Gurpreet S Wander, Gurpreet Gulati, Gustavo Pucci, Hafidz Abd Hadi, Haibo Zhang, Haitao Wang, Halina Marciniak, Han Chen, Hanan Kerr, Hani Najm, Hanna Douglas, Hannah Phillips, Hao Dai, Haojian Dong, Haqeel Jamil, Harikrishnan Sivadasanpillai, Harry Suryapranata, Hassan Reda, Hayley Pomeroy, Heather Barrentine, Heather Golden, Heather Hurlburt, Heidi Wilson, Helen C Tucker, Helene Abergel, Hemalata Siddaram, Hermine Osseni, Herwig Schuchlenz, Hesong Zeng, Hicham Skali, Hilda Solomon, Hollie Horton, Holly Hetrick, Holly Little, Holly Park, Hongjie Chi, Hossam Mahrous, Howard A Levite, Hristo Pejkov, Huajun Li, Hugo Bloise-Adames, Hugo Marques, Hui Zhong, Hui-Min Zhang, Humayrah Hashim, Hung-I Yeh, Hussien El Fishawy, Ian Webb, Iftikhar Kullo, Igor O Grazhdankin, Ihab Hamzeh, Ikraam Hassan, Ikuko Ueda, Ileana L Pina, Ilona Tamasauskiene, Ilse Bouwhuis, Imran Arif, Ina Wenzelburger, Inês Zimbarra Cabrita, Ines Rodrigues, Inga H Robbins, Inga Soveri, Ingela Schnittger, Iqbal Karimullah, Ira M Dauber, Iram Rehman, Irena Peovska Mitevska, Irene Marthe Lang, Irina Subbotina, Irma Kalibataite-Rutkauskiene, Irni Yusnida, Isabel Estela Carvajal, Isabella C Palazzo, Isabelle Hogan, Isabelle Roy, Ishba Syed, Ishita Tejani, Ivan A Naryshkin, Ivana Jankovic, Iwona Niedzwiecka, J David Knight, Jacek Kusmierek, Jackie M White, Jackie Chow, Jacob Udell, Jacqueline E Tamis-Holland, Jacqueline Fannon, Jacquelyn A Quin, Jacquelyn Do, Jaekyeong Heo, Jakub Maksym, James E Davies, James H O'Keefe Jr, James J Jang, James Cha, James Harrison, James Hirsch, James Stafford, James Tatoulis, Jamie Rankin, Jan Henzel, Jan Orga, Jana Tancredi, Janaina Oliveira, Jane Burton, Jane Eckstein, Jane Marucci, Janet P Knight, Janet Blount, Janet Halliday, Janetta Kourzenkova, Janitha Raj, Jan-Malte Sinning, Jaqueline Pozzibon, Jaroslaw Drozdz, Jaroslaw Karwowski, Jason D Glover, Jason Loh Kwok, Jason T Call, Jason Linefsky, Jassira Gomes, Jati Anumpa, Javier J Garcia, Javier Courtis, Jay Meisner, K Jayakumar, Jayne Scales, Jean E Denaro, Jean Michel Juliard, Jean Ho, Jeanette K Stansborough, Jean-Michel Juliard, Jeanne Russo, Jeannette J M Schoep, Jeet Thambyrajah, Jeff Leimberger, Jeffery A Breall, Jeffrey A Kohn, Jeffrey C Milliken, Jeffrey Anderson, Jeffrey Blume, Jeffrey Kanters, Jeffrey Lorin, Jeffrey Moses, Jelena J Stepanovic, Jelena Celutkiene, Jelena Djokic, Jelena Stojkovic, Jenne M Jose, Jenne Manchery, Jennifer A Mull, Jennifer H Czerniak, Jennifer L Stanford, Jennifer Gillis, Jennifer Horst, Jennifer Isaacs, Jennifer Langdon, Jennifer Thomson, Jennifer Tomfohr, Jennifer White, Jen-Yuan Kuo, Jeremy Rautureau, Jerome Fleg, Jessica Berg, Jessica Rodriguez, Jessica Waldron, Jhina Patro, Jia Li, Jiajia Mao, Jiamin Liu, Jian'an Wang, Jianhua Li, Jianxin Zhang, Jie Qi, Jihyun Lyo, Jill Marcus, Jim Blankenship, Jing Zhang, Jingjing Liu, Jing-Yao Fan, Jiun-Yi Li, Jiwan Pradhan, Jiyan Chen, J M Rivera Caravaca, Jo Evans, Joan Garcia Picart, Joan Hecht, Joanna Jaroch, Joanna Zalewska, Joanne Kelly, Joanne Taaffe, João Reynaldo Abbud, João V Vitola, Joaquín V Peñafiel, Jocelyne Benatar, Jody Bindeman, Joe Sabik, Joel Klitch, Johann Christopher, Johannes Aspberg, John D Friedman, John F Beltrame, John F Heitner, John Joseph Graham, John R Davies, John Doan, John Kotter, John Kurian, John Mukai, John Pownall, Jolanta Sobolewska, Jon Kobashigawa, Jonathan L Goldberg, Jonathan W Bazeley, Jonathan Byrne, Jonathan Himmelfarb, Jonathan Leipsic, Jonean Thorsen, Jorge F Trejo Gutierrez, Jorge Escobedo, Jorik Timmer, José A Ortega-Ramírez, José Antonio Marin-Neto, Jose D Salas, Jose Enrique Castillo, Jose Francisco Saraiva, José J Cuenca-Castillo, Jose L Diez, José Luis Narro Villanueva, José Luiz da Vieira, José M Flores-Palacios, Jose Ramon Gonzalez, Jose Seijas Amigo, Jose Fragata, Josep Maria Padró, Josheph F X McGarvey Jr, Joseph Hannan, Joseph Sacco, Joseph Sweeny, Joseph Wiesel, Josephine D Abraham, Joshua P Loh, Joy Burkhardt, Joyce R White, Joyce Riestenberg-Smith, Judit Sebo, Judith L Meadows, Judith Wright, Judy Mae Foltz, Judy Hung, Judy Otis, Juergen Stumpf, Jui-Peng Tsai, Julia S Dionne, Julia de Aveiro Morata, Julie Bunke, Julie Morrow, Julio César Figal, Jun Fujita, Jun Jiang, Junhua Li, Junqing Yang, Juntima Euathrongchit, Jyotsna Garg, K Manjula Rani, K Preethi, Kaatje Goetschalckx, Kai Eggers, Kamalakar Surineni, Kanae Hirase, T R Kapilamoorthy, Karen Calfas, Karen Gratrix, Karen Hallett, Karen Hultberg, Karen Nugent, Karen Petrosyan, Karen Swan, Karolina Kryczka, Karolina Wojtczak-Soska, Karolina Wojtera, Karsten Lenk, Karthik Ramasamy, Katarzyna Łuczak, Katarzyna Malinowska, Kate Pointon, Kate Robb, Katherine Martin, Kathleen Claes, Kathryn Carruthers, Kathy E Siegel, Katia Drouin, Katie Fowler-Lehman, Kavita Rawat, Kay Rowe, Keiichi Fukuda, Keith A A Fox, Ken Mahaffey, Kendra Unterbrink, Kenneth Giedd, Kerrie Van Loo, Kerry Lee, Kerstin Bonin, Kevin R Bainey, Kevin T Harley, Kevin Anstrom, Kevin Chan, Kevin Croce, Kevin Landolfo, Kevin Marzo, Keyur Patel, Khaled Abdul-Nour, Khaled Alfakih, Khaled Dajani, Khaled Ziada, Khaula Baloch, Khrystyna Kushniriuk, Kian-Keong Poh, Kim F Ireland, Kim Holland, Kimberly Ann Byrne, Kimberly E Halverson, Kimberly Elmore, Kimberly Miller-Cox, Kiran Reddy, Kirsten J Quiles, Kirsty Abercrombie, Klaus Matschke, Konrad Szymczyk, Koo Hui Chan, Kotiboinna Preethi, Kozhaya Sokhon, Krissada Meemuk, Kristian Thygesen, Kristin M Salmi, Kristin Newby, Kristina Wippler, Kristine Arges, Kristine Teoh, Krystal Etherington, Krystyna Łoboz-Grudzień, Krzysztof W Reczuch, Krzysztof Bury, Krzysztof Drzymalski, Krzysztof Kukuła, Kuo-Tzu Sung, Kurt Huber, Ladda Douangvila, Lance Sullenberger, Larissa Miranda Trama, Laszlone Matics, Laura Drew, Laura Flint, Laura Keinaite, Laura Sarti, Laurel Kolakaluri, Lawrence M Phillips, Lawrence Friedman, Lawrence Phillips, Lazar Velicki, Leah Howell, Leandro C Maranan, Leanne Cox, Ledjalem Daba, Lei Zhang, Lekshmi Dharmarajan, Leo Bockeria, Leonardo Pizzol Caetano, Leonardo Bridi, Leonid L Bershtein, Leszek Sokalski, Li Hai Yan, Li Li, Lia Nijmeijer, Lidia Sousa, Lihong Xu, Lihua Zhang, Lili Zhang, Lilia Schiavi, Lilian Mazza Barbosa, Lillian L Khor, Lina Felix-Stern, Linda L Hall, Linda M Hollenweger, Linda Arcand, Linda Davidson-Ray, Linda Schwarz, Lindsey N Sikora, Lingping Chi, Lino Patricio, Liping Zhang, Lisa Chaytor, Lisa Hatch, Lisa McCloy, Lisa Wong, Liselotte Persson, Lixin Jiang, Liz Low, Ljiljana Pupic, Loïc Bière, Lorenzo Monti, Lori Christensen, Lori Pritchard, Loriane Black, Lori-Ann Desimone, Lori-Ann Larmand, Lorraine McGregor, Louise Morby, Louise Thomson, Luc Harvey, Luciana de Pádua Baptista, Lucilla Garcia, Ludivine Eliahou, Ludmila Helmer, Luis F Smidt, Luis Bernanrdes, Luis Guzman, Luiz A Carvalho, Luyang Xiong, Lynette L Teo, Lynn M Neeson, Lynne Winstanley, M Barbara Srichai-Parsia, M Quintana Giner, M Sowjanya Reddy, M Valdés Chávarri, M Grazia Rossi, Maarten Simoons, Maayan Konigstein, Maciej Lesiak, Maciej Olsowka, Mafalda Selas, Magalie Corfias, Magdalena Madero Rovalo, Magdalena Łanocha, Magdalena Miller, Magdalena Misztal-Teodorczyk, Magdalena Rantinella, Magdy Abdelhamid, Magnolia Jimenez, Mahboob Alam, Mahevamma Mylarappa, Mahfouz El Shahawy, Mahmoud Mohamed, Mahmud Al-Bustami, Majo X Joseph, Malgorzata Frach, Małgorzta Celińska-Spodar, Malte Helm, Manas Chacko, Mandy Murphy, Manitha Vinod, Manjula Rani, Manu Dhawan, Manuela Mombelli, Marcel Weber, Marcello Galvani, Marcelo Jamus Rodrigues, Marcia F Dubin, Marcia F Werner Bayer, Marcin Szkopiak, Marco Antonio Monsalve, Marco Bizzaro Santos, Marco Magnoni, Marco Marini, Marco Sicuro, Marco Zenati, Marcos Valério Coimbra Resende, Marek Roik, Margalit Bentzvi, Margaret Gilsenan, Margaret Iraola, Margot C Quinn, Maria A Alfonso, Maria Antonieta Pereira Moraes, María Dolores Martínez-Ruíz, María Fernanda Canales, Maria Inês Caetano, Maria P Corral, Maria Pérez García, Maria Victoria Actis, Maria Aguirre, Maria Andreasson, Maria Aprile, Maria Colton, Maria Eugenia Martin, Maria Lasala, Maria Lorenzo, Maria Posada, Maria Shier, Maria Thottam, Mariana V Furtado, Mariana Yumi Okada, Marianna D A Dracoulakis, Marianne De Andrade, Mariano Rubio, Marie Essermark, Marielle Scherrer-Crosbie, Marija T Petrovic, Marija Zdravkovic, Marilyn Black, Marina Garcia, Mario J Garcia, Mariola Szulik, Marisa Orgera, Mark A de Belder, Mark Harbinson, Mark Hyun, Mark Peterson, Mark Xavier, Marlowe Mosley, Marta Capinha, Marta Marcinkiewicz-Siemion, Marta Swiderek, Martha Meyer, Martina Ceseri, Martina Tricoli, Marvin Kronenberg, Mary Williams, Mary Ann Champagne, Mary Colleen Rogge, Mary R Soltau, Mary Streif, Massimo Villella, Massoud Leesar, Matei Claudia, Mateusz Solecki, Matías Nicolás Mungo, Matthew Wall Jr, Matthew Budoff, Matthew Jezior, Matthew Luckie, Matthias Friedrich, Mauren P Haeffner, Maximilian Tscharre, Max-Paul Winter, Mayana Almeida, Mayil S Krishnam, Mayuri Patel, Meenakshi Mishra, Megan Manocchia, Meghana Kakade, Melanie J Munro, Melissa D Chaplin, Melissa LeFevre, Mervyn Andiapen, Michael A Gibson, Michael B Rubens, Michael C Turner, Michael D Shapiro, Michael W Lee, Michael Berlowitz, Michael Davidson, Michael Mack, Michael McDaniel, Michael Mumma, Michal Wlodarczyk, Michel G Khouri, Michel S Slama, Michele Rawlins, Michelle M Bonner, Michelle M Seib, Michelle Chang, Michelle Crowder, Michelle Dixon, Michelle Mayon, Michelle McEvoy, Michelle Yee, Miguel M Fernandes, Miguel Nobre Menezes, Miguel Souto Bayarri, Miguel Barrero, Mikhail T Torosoff, Milan R Dobric, Milan Dobric, Milica Nikola Dekleva, Milind Avdhoot Gadkari, Millie Gomez, Min Tun Kyaw, Miriam Brooks, Miroslav Stevo Martinovic, Mitchel B Lustre, Mohammad Tariq Vakani, Mohammad El-Hajjar, Mohammed Al-Amoodi, Mohammed Hussain, Mohammed Saleem, Moisés Blanco-Calvo, Moisés Jiménez-Santos, Mona Bhatia, Monica Rosca, Monika Laukyte, Montserrat Gracida Blanca, Montserrat Vila Perales, Mouaz H Al-Mallah, Moysés de Oliveira Filho, Mpiko Ntsekhe, Muhamed Saric, Mulei Chen, Myriam Brousseau, Myrthes Emy Takiuti, Nada Cemerlic-Adjic, Nadia Asif, Nadia Gakou, Nafisa Hussain, Nana O Katamadze, Nancy L Clapp, Nancy Aedy, Nandita Nataraj, Nanette K Wenger, Naomi Uchida, Nasrul Ismail, Natalia S Oliveira, Natalia de Carvalho Maffei, Natalie Spitzer, Natasha C Putnam, Naved Aslam, Neamat Mowafy, Neeraj Pandit, Neeraj Parakh, Nevena Garcevic, Ngaire Meadows, Nhi N Tran, Nicholas Danchin, Nicki Lakeman, Nicola Johnston, Nicolas W Shammas, Nicole Saint Vrestil, Nicole Deming, Nier Zhong, Niket Patel, Nikola N Boskovic, Nikolaos Karogiannis, Nikos Werner, Nina Johnston, Ning Zhang, Ning Zhou, Niree Hindoyan, Nirmal Kumar, Nitika Chadha, Nitish Naik, Nodira Aripova, Noloyiso Mtana, Nona A Eskelson, Noor Syamira Mokhtar, Noppon Taksaudom, Nor Asiah Basri, Nora Marchelletta, Norma Hogg, Nungshi Jungla, Nuno Ferreira, Oksana A Lubyanaya, Olga B Nikolaeva, Olga Cañavate, Olga Sobrino, Olga Walesiak, Olga Walter, Olga Zdończyk, Olivia J Lim, Olivia Anaya, Olivia Mancilla, Olivier Dubourg, Olugbenga Bello, Omar Almousalli, Omar Thompson, Oni Olurinde, Or Harel, Osama Raheem, Oscar Méndiz, Óscar Prada-Delgado, Oz Shapira, P Christian Schulze, Pachara Panpunuan, Pal Maurovich-Horvat, Pallav Garg, Paloma Moraga, Pam Singh, Pamela Julian, Pamela Ouyang, Pamela Sigel, Pamela Woodard, Panpan Zhou, Paola Emanuela Poggio, Paola Smanio, Paolo Calabro, Paramjit Jeetley, Pascal Goube, Patricia K Nguyen, Patricia Alarie, Patricia Arakelian, Patricia Arsenault, Patricia Blaise, Patricia Brito, Patricia Cowper, Patricia Endsley, Patricia Mieses, Patrick B Alexander, Patrick Donnelly, Patrick Wilmot, Patrycja Lebioda, Paul C Gordon, Paul Der Mesropian, Paul Galiwango, Paul Hauptman, Paul Kennedy, Paula Beardsley, Paula García-González, Paulo Cury Rezende, Paulo Ricardo Caramori, Pavel S Kozlov, Pedro Canas Silva, Pedro Gabriel Melo Barros E Silva, Pedro Píccaro de Oliveira, Pedro Carvalho, Pedro Modas, Pedro Rio, Peeyush Jain, Peiyu He, Peter A McCullough, Peter H Stone, Peter M Pollak, Peter Douglass, Peter Henriksen, Peter OKane, Peter Ong, Philip Jones, Philip Rogal, Philippe Généreux, Philippe Menasche, Philippe Rheault, Phoebe Goold, Pierre Gervais, Pierre Michaud, Pilar Calvillo, Ping Chai, Piotr Jakubowski, Piotr Pruszczyk, Piotr Slomka, Piyamitr Sritara, Poay-Huan Loh, Poonam Sonawane, Pouneh Samadi, Pragnesh P Parikh, Prakash Deedwania, Pranav M Patel, Praneeth Polamuri, Pratiksha Sharma, Precilia Vasquez, Preeti Kamath, Prince Thomas, Priyadarshani Arambam, Puja K Mehta, Purvez Grant, Pushpa Naik, Qi Zhong, Qian Zhao, Qiang Zhou, Qianqian Yuan, Qin Yu, Qingxian Li, Qiulan Xie, Qiutang Zeng, R J Vindhya, R James Gerlach, Rachel King, Rada Vučić, Radmila Lyubarova, Radoslaw Pracon, Raewyn Fisher, Rafael Beyar, Rafael Diaz, Rafael Selgas, Raffaele Bugiardini, Raffaele Fanelli, Raisa Kavalakkat, V S Rajalekshmi, Rajat S Barua, Rajeev Menon, Rajesh Gopalan Nair, Rajesh Francis, Rajiv Narang, Rakesh Yadav, Ralph Alan Huston, T Ramakrishnan, Ramesh de Silva, Rami El Mahmoud, Ramiro Carvalho, Ramon de Jesús-Pérez, Ramona Stevens, Ran Leng, Ranjan Kachru, Ranjit Kumar Nath, Raquel Sanchez, Raven R Dwyer, Raven Lee, Ray Wyman, Raymond C Wong, Raymond W Little, Raymundo Ocaranza Sanchez, Rebecca J Wimmer, Rebecca Bariciano, Rebecca Otis, Rebekah R Herrmann, Reem Yunis, Reinette Hampson, Renato Abdala Karam, Renee C Hessian, Renee Kaneshiro, Reshma Ravindran, Reto Andreas Gamma, Reyna Bhandari, Reza Arsanjani, Ricardo L Lopes, Ricardo Mendes Oliveira, Ricardo Costa, Richa Bhatt, Richard F Davies, Richard H J Trimlett, Richard Goldweit, Rik Hermanides, Rine Nakanishi, Rinu R Sidh, Risha Patel, Rita Coram, Rizwan A Siddiqui, Rob S Beanlands, Robert J Hamburger, Robert K Riezebos, Robert M Donnino, Robert Bojar, Robert Chilton, Robert Guyton, Robert Henderson, Robert Kornberg, Robert Leber, Robert Mao, Robert Stenberg, Roberta P Santos, Roberto René Favaloro, Roberto Amati, Rodolfo G S D Lima, Rodrigo J Cerci, Rogerio Tumelero, Rohit Tandon, Roma Tewari, Romalisa Miranda-Peats, Ron Wald, Ronald A Mastouri, Ronald G Morford, Ronald G Schwartz, Ronald P Pedalino, Rongrong Hu, Ronnell A Hansen, Ronny A Cohen, Rory Hachamovitch, Rosa Homem, Rosa Sandonato, Rosane Laimer, Rosann Gans, Roxanne Yost, Roy Mathew, Rubén Baleón-Espinosa, Ruben Ramos, Rubine Gevorgyan, Rui Ferreira, Rui Jing, Ruth Pérez-Fernández, S K Dwivedi, S Ramakrishnan, Saadat Khan, Sabahat Bokhari, Sabu Thomas, Sadath Lubna, Sajeeda Parveen Khan, Sajeev Chakanalil Govindan, Saket Girotra, Saleem Kassam, Sallie Canada, Salvador Cruz-Flores, Samaa Mohamed, Samantha Ly, Sameh El Kaffas, Samia Massalha, Sampoornima Setty, Samuel Nwosu, Sandeep Seth, Sandeep Singh, Sander R Niehe, Sandra M Rivest, Sandra S Zier, Sandra Ahoud, Sandy Carr, Sanjay Ganapathi, Sanjay Shetty, Sanjeev Sharma, Santa Jimenez, Santhosh Satheesh, Santiago A Garcia, Sara Fernandez, Sara Karlsson, Sara Salkind, Sara Temiyasathit, Sarah Medina Rodriguez, Sarah Beaudry, Sarah Hadjih, Sarah Williams, Sarah Zahrani, Sarju Ralhan, Sasa Hinic, Sasko Kedev, Satinder Singh, Satoshi Yasuda, Satvic Cholenahally Manjunath, Sau Lee, Scott M Kaczkowski, Scott Kinlay, Sean W Hayes, Sebastian Sobczak, Senait Asier, Sergey A Sayganov, Seth I Sokol, Shaheen Pandie, Shaiful Azmi Yahaya, Shamir Mehta, Shao-Ping Nie, Sharad Chandra, Sharder Islam, Sharon Tai, Sheetal Rupesh Karwa, Sheri Ussery, Sheromani Bajaj, Sherron C Crook, Shigeyuki Nishimura, Shintaro Nakano, Shirin Heydari, Shiv Kumar Choudhary, Shivali Patel, Shobana Ganesan, Shruti Pandey, Shuyang Zhang, Shweta Hande, Siddharth Gadage, Sik-Yin V Tan, Silvia Zottis Poletti, Silvia Riera, Silvia Valbuena, Simon Walsh, Simona Maspoli, Simone Savaris, Si-Ting Feng, So Yang Cho, Solomon Yakubov, Songlin Zhu, Songtao Wang, Sonia Guerrero, Sonika Gupta, Sonja Salinger Martinovic, Sonya Brons, Sorin Brener, Sothinathan Gurunathan, Souheil Saba, Soundarya Nayak, Sowjanya Reddy, Srinivasa Potluri, Sriram Sudarshan, Srun Kuanprasert, Stacie Van Oosterhout, Stamatios Lerakis, Stanley E Cobos, Stefan C Bertog, Stefan M Simović, Stefan Weikl, Stefano Di Marco, Stefano Provasoli, Stephanie A Tirado, Stephanie C Boer, Stephanie M Lane, Stephanie Ferket, Stephanie Kelly, Stephanie Wasmiller, Stephen H McKellar, Stephen P Hoole, Stephen Fremes, Stephen Preston, Steve Leung, Steven A Fein, Steven J Lindsay, Steven P Sedlis, Steven Giovannone, Steven Michael, Steven Weitz, Stijn van Vugt, Subhash Banerjee, Sudhir Naik, Suellen Hosino, Sukie Desire, Sukit Yamwong, Suku T Thambar, Sulagna Mookherjee, Suman Singh, Sundeep Mishra, Sunil Kumar Verma, Supap Kulthawong, Supatchara Khwakhong, Surendra Naik, Suresh Babu, Surin Woragidpoonpol, Suryaprakash Narayanappa, Susan Derbyshire, Susan Gent, Susan Mathus, Susan Milbrandt, Susan Moore, Susan Regan, Susan Stinson, Susan Webber, Susana Silva, Susanna Stevens, Susanne Gruensfelder, Suthara Aramcharoen, Suvarna Kolhe, Suzana Tavares, Suzanne Arnold, Suzanne Welsh, Svetlana Apostolovic, Swapna Kunhunny, Ta-Chuan Hung, Taissa Zappernick, Tali Sharir, Talita Silva, Tamara Colaiácovo Soares, Tapan Umesh Pillay, Tarun K Mittal, Tatiana Trifonova, Tauane Bello Duarte, Tauqir Huk, Téodora Dutoiu, Terrance Chua, Terry Weyand, Thabitha Charles, Theodoros Kofidis, Theresa McCreary, Thierry Lefevre, Thippeekaa Arumairajah, Thitipong Tepsuwan, Thomas J Mulhearn, Thomas M Meyer, Thomas P Rocco, Thomas R Downes, Thomas Crain, Thomas Haldis, Thomas Mathew, Thomas Redick, Thounaojam Indira Devi, Thuraia Nageh, Tia Cauthren, Tiago Silva, Tiffany Little, Tijana Andric, Tina Harding, Titus Lau, Tiziana Formisano, Tiziano Moccetti, Tomasz Ciurus, Tomasz Mazurek, Tomasz Tarchalski, Toshiyuki Nagai, Tri Tran, Tricia Youn, Trish Tucker, Trudie Milner, Tuhina Bose, Tushar Kotecha, Udo Sechtem, Uma S Valeti, Umberto Cucchini, Umesh Badami, Upendra Kaul, V K Bahl, V S Narain, Valentina Casali, Valeria Godoy, Valerie Robesyn, Vamshi P Priya, Vandana Yadav, Vera McKinney, Veronica De Lenges, Veronica Tinnirello, Vicente Miro, Victor Navarro, Victoria Gumerova, Victoria Hernandez, Vidya Seeratan, Vijay Kumar, Vikentiy Y Kozulin, Viktoria Bulkley, Vilmar Veiga Jr, Vincent Setang, C P Vineeth, Virginai Pubull Nuñez, Virginia Fernández-Figares, Vitor Gomes, Viviana Gabriel, Viviane Dos Santos, Viviane Almeida, Vlad A Iliescu, Vladan Mudrenovic, Vladimir Dzavik, Vojislav L Giga, Walter Enrique Mogrovejo, Wan Xian Chan, Wanda C Marfori, Wanda Parker, Warangkana Mekara, Wassim Nona, Wayne Old, Wayne Pennachi, Weerachai Nawarawong, Wei Chen, Wei Su, Weibing Xing, Wei-Ren Lan, Wenda Crawford, Wendy L Stewart, Wendy Drewes, Wenhua Lin, William B Abernethy, William D Salerno, William F Fearon, William Vergoni, William Weintraub, Winnie C Sia, Wlodzimierz J Musial, Xacobe Flores-Ríos, Xavier Garcia-Moll Marimon, Xi Su, Xiang Ma, Xiangqiong Gu, Xiao Wang, Xiaomei Li, Xiaowei Yao, Xin Fu, Xin Su, Xin Zeng, Xinchun Yang, Xiuhong Li, Xuehua Fang, Xutong Wang, Yaming Geng, Yan Yan, Yanek Pépin-Dubois, Yanfu Wang, Yang Wang, Yanmeng Tian, Yaping Huang, Yechen Han, Yesenia Zambrano, Yi-Hsuan Yang, Ying Tung Sia, Yining Yang, Yitong Ma, Yolayfi Peralta, Yongjian Wu, Yu Kunwu, Yu Zhao, Yudong Peng, Yueh-Hung Lin, Yulan Zhao, Yumei Dong, Yunhai Zhao, Yutthaphan Wannasopha, Yvonne Taul, Zakir Sahul, Zalina Kudzoeva, Zbigniew Kalarus, Zeljko Z Markovic, Zhen Huang, Zheng Ji, Zhenyu Liu, Zhou Yue, Zhulin Zhang, Zhuxi Li, Zile Singh Meharwal, Ziliang Bai, Zixiang Yu, Zohra Huda, Zoltan Davidovits, Maron D.J., Hochman J.S., Reynolds H.R., Bangalore S., O'Brien S.M., Boden W.E., Chaitman B.R., Senior R., Lopez-Sendon J., Alexander K.P., Lopes R.D., Shaw L.J., Berger J.S., Newman J.D., Sidhu M.S., Goodman S.G., Ruzyllo W., Gosselin G., Maggioni A.P., White H.D., Bhargava B., Min J.K., John Mancini G.B., Berman D.S., Picard M.H., Kwong R.Y., Ali Z.A., Mark D.B., Spertus J.A., Krishnan M.N., Elghamaz A., Moorthy N., Hueb W.A., Demkow M., Mavromatis K., Bockeria O., Peteiro J., Miller T.D., Szwed H., Doerr R., Keltai M., Selvanayagam J.B., Gabriel Steg P., Held C., Kohsaka S., Mavromichalis S., Kirby R., Jeffries N.O., Harrell F.E., Rockhold F.W., Broderick S., Bruce Ferguson T., Williams D.O., Harrington R.A., Stone G.W., Rosenberg Y, and ISCHEMIA Research Group: Joseph Ricci, A Tello Montoliu, A I Robero Aniorte, Abbey Mulder, Abhay A Laddu, Abhinav Goyal, Abhishek Dubey, Abhishek Goyal, Abigail Knighton, Abraham Oomman, Adam J Jaskowiak, Adam Kolodziej, Adam Witkowski, Adnan Hameed, Adriana Anesini, Afshan Hussain, Agne Juceviciene, Agne Urboniene, Agnes Jakal, Agnieszka Szramowska, Ahmad Khairuddin, Ahmed Abdel-Latif, Ahmed Adel, Ahmed Aljzeeri, Ahmed Kamal, Ahmed Talaat, Aimee Mann, Aira Contreras, Ajit Kumar, V K Kumar, Akemi Furukawa, Akshay Bagai, Akvile Smigelskaite, Alain Furber, Alain Rheault, Alaine Melanie Loehr, Alan Rosen, Albert Varga, Albertina Qelaj, Alberto Barioli, Aldo Russo, Alec Moorman, Alejandro Gisbert, Aleksandra Fratczak, Aleksandras Laucevicius, Alena Kuleshova, Alessandro Sionis, Alexander A Sirker, Alexander M Chernyavskiy, Alexandra Craft, Alexandra Vazquez, Alexandre Ciappina Hueb, Alexandre S Colafranseschi, Alexandre Schaan de Quadros, Alexandre Tognon, Ali Alghamdi, Alice Manica Muller, Aline Nogueira Rabaça, Aline Peixoto Deiro, Alison Hallam, Allegra Stone, Allison Schley, Almudena Castro, Alvaro Rabelo Ales, Amanda Germann, Amanda O'Malley, Amar Uxa, Amarachi Ojajuni, Amarino C Oliveira Jr, Amber B Hull, Ambuj Roy, Amer Zarka, Amir Janmohamed, Ammani Brown, Ammy Malinay, Amparo Martinez Monzonis, Amy J Richards, Amy Iskandrian, Amy Ollinger, Ana D Djordjevic-Dikic, Ana Fernández Martínez, Ana Gomes Almeida, Ana Paula Batista, Ana Rita Francisco, Ana S Mladenovic, Ana Santana, Anam Siddiqui, Anastasia M Kuzmina-Krutetskaya, Andras Vertes, Andre S Sousa, Andre Gabriel, André Schmidt, Andrea M Lundeen, Andrea Bartykowszki, Andrea Lorimer, Andrea Mortara, Andrea Pascual, Andreia Coelho, Andreia Rocha, Andrés García-Rincón, Andrew G Howarth, Andrew J Moriarty, Andrew Docherty, Andrew Starovoytov, Andrew Zurick, Andrzej Łabyk, Andrzej Swiatkowski, Andy Lam, Anelise Kawakami, Angela Hoye, Angela Kim, Angelique Smit, Angelo Nobre, Anil V Shah, Anja Ljubez, Anjali Anand, Ankush Sachdeva, Ann Greenberg, Ann Luyten, Ann Ostrander, Anna Di Donato, Anna Cichocka-Radwan, Anna Fojt, Anna Plachcinska, Anna Proietti, Anna Teresinska, Anne Marie Webb, Anne Cartwright, Anne Heath, Anne Mackin, Anong Amaritakomol, Anong Chaiyasri, Anoop Chauhan, Anoop Mathew, Anthony Gemignani, Anto Luigi Andres, Antonia Vega, Antonietta Hansen, Antonino Ginel Iglesias, Antonio Carlos Carvalho, Antonio Di Chiara, Antonio Serra Peñaranda, Antonio Carvalho, Antonio Colombo, Antonio Fiarresga, Anupama Rao, Aquiles Valdespino-Estrada, Araceli Boan, Areef Ishani, Ariel Diaz, Arijit Ghosh, Arintaya Prommintikul, Arline Roberts, Arnold H Seto, Arnold P Good, Arshed Quyyumi, Arthur J Labovitz, Arthur Kerner, Arturo S Campos-Santaolalla, Arunima Misra, Ashok Mukherjee, Ashok Seth, Ashraf Seedhom, Asim N Cheema, Asker Ahmed, Atul Mathur, Atul Verma, Audrey W Leong, Axel Åkerblom, Axelle Fuentes, Aynun Naher, Badhma Valaiyapathi, Baljeet Kaur, Bandula Guruge, Barbara Brzezińska, Barbara Nardi, Bartosz Czarniak, Bebek Singh, Begoña Igual, Bela Merkely, Belen Cid Alvarez, Benjamin J Spooner, Benjamin J W Chow, Benjamin Cheong, Benoy N Shah, Bernard de Bruyne, Bernardas Valecka, Bernhard Jäger, Beth A Archer, Beth Abramson, Beth Jorgenson, Bethany Harvey, Betsy O'Neal, Bev Atkinson, Bev Bozek, Bevin Lang, Bijulal Sasidharan, Bin Yang, Bin Zhang, Binoy Mannekkattukudy Kurian, Bjoern Goebel, Bob Hu, Bogdan A Popescu, Bogdan Crnokrak, Bolin Zhu, Bonnie J Kirby, Brandi D Zimbelman, Brandy Starks, Branko D Beleslin, Brenda Hart, Brian P Shapiro, Brian McCandless, Brianna Wisniewski, Brigham R Smith, Brooks Mirrer, Bruce McManus, Bruce Rutkin, Bruna Edilena Paulino, Bruna Maria Ascoli, Bryn Smith, Byron J Allen, C Michael Gibson, C Noel Bairey Merz, Calin Pop, Cameron Hague, Camila Thais de Ormundo, Candace Gopaul, Candice P Edillo, Carísi A Polanczyk, Carita Krannila, Carla Vicente, Carl-Éric Gagné, Carlo Briguori, Carlos Peña Gil, Carlos Alvarez, Carly Ohmart, Carmen C Beladan, Carmen Ginghina, Carol M Kartje, Caroline Alsweiler, Caroline Brown, Caroline Callison, Caroline Pinheiro, Caroline Rodgers, Caroline Spindler, Carolyn Corbett, Carrie Drum, Casey Riedberger, Catherine Bone, Catherine Fleming, Catherine Gordon, Catherine Jahrsdorfer, Catherine Lemay, Catherine Weick, Cathrine Patten, Cecilia Goletto, Cezary Kepka, Chandini Suvarna, Chang Xu, Chantale Mercure, Charle A Viljoen, Charlene Wiyarand, Charles Jia-Yin Hou, Charles Y Lui, Charles Cannan, Charles Cornet, Charlotte Pirro, Chataroon Rimsukcharoenchai, Chen Wang, Cheng-Ting Tsai, Chen-Yen Chien, Cheryl A Allardyce, Chester M Hedgepeth, Chetan Patel, Chiara Attanasio, Chih-Hsuan Yen, Chi-Ming Chow, Ching Min Er, Ching-Ching Ong, Cholenahally Nanjappa Manjunath, Chris Beck, Chris Buller, Christel Vassaliere, Christian Hamm, Christiano Caldeira, Christie Ballantyne, Christina Björklund, Christine R Hinton, Christine Bergeron, Christine Masson, Christine Roraff, Christine Shelley, Christophe Laure, Christophe Thuaire, Christopher Kinsey, Christopher McFarren, Christopher Spizzieri, Christopher Travill, Chun-Chieh Liu, Chung-Lieh Hung, Chunguang Li, Chun-Ho Yun, Chunli Xia, Ciarra Heard, Cidney Schultz, Clare Venn-Edmonds, Claudia P Hochberg, Claudia Wegmayr, Claudia Cortés, Claudia Escobar, Cláudia Freixo, Claudio T Mesquita, Clemens T Kadalie, Colin Berry, Constance Philander, Corine Thobois, Costantino Costantini, Courtney Page, Craig Atkinson, Craig Barr, Craig Paterson, Cristina Bare, Cynthia Baumann, Cynthia Burman, Dalisa Espinosa, Damien Collison, Dan Deleanu, Dan Elian, Dan Gao, Dana Oliver, Daniel P Vezina, Daniel O'Rourke, Daniele Komar, Danielle Schade, Darrel P Francis, Dastan Malaev, David A Bull, David E Winchester, David P Faxon, David Booth, David Cohen, David DeMets, David Foo, David Schlichting, David Taggart, David Waters, David Wohns, Davis Vo, Dawid Teodorczyk, Dawn Shelstad, Dawn Turnbull, Dayuan Li, Dean Kereiakes, Deborah O'Neill, Deborah Yip, Debra K Johnson, Debra Dees, Deepak L Bhatt, Deepika Gopal, Deepti Kumar, Deirdre Mattina, Deirdre Murphy, Delano R Small, Delsa K Rose, Dengke Jiang, Denis Carl Phaneuf, Denise Braganza, Denise Fine, Derek Cyr, Desiree Tobin, Diana Cukali, Diana Parra, Diane Camara, Diane Minshall Liu, Diego Adrián Vences, Diego Franca de Cunha, Dimitrios Stournaras, Dipti Patel, Dongze Li, Donna Exley, Dorit Grahl, Dragana Stanojevic, Duarte Cacela, Dwayne S G Conway, E Pinar Bermudez, Eapen Punnoose, Edgar L Tay, Edgar Karanjah, Edoardo Verna, Eduardo Hernandez-Rangel, Edward D Nicol, Edward O McFalls, Edward T Martin, Edyta Kaczmarska, Ekaterina I Lubinskaya, Elena A Demchenko, Elena Refoyo Salicio, Eli Feen, Elihú Durán-Cortés, Elisabeth M Janzen, Elise L Hannemann, Elise van Dongen, Elissa Restelli Piloto, Eliza Kaplan, Elizabeta Srbinovska Kostovska, Elizabeth Capasso-Gulve, Elizabeth Congdon, Elizabeth Ferguson, Elizaveta V Zbyshevskaya, Ellen Magedanz, Ellie Fridell, Ellis W Lader, Elvin Kedhi, Emanuela Racca, Emilie Tachot, Emily DeRosa, Encarnación Alonso-Álvarez, Eric Nicollet, Eric Peterson, Erick Alexánderson Rosas, Erick Donato Morales, Erin Orvis, Ermina Moga, Estelle Montpetit, Estevao Figueiredo, Eugene Passamani, Eugenia Nikolsky, Eunice Yeoh, Evgeniy I Kretov, Ewa Szczerba, Ewelina Wojtala, Expedito Eustáquio Ribeiro Silva, F Marin Ortuño, Fabio R Farias, Fabio Fimiani, Fabrizio Rolfo, Fa-Chang Yu, Fadi Hage, Fadi Matar, Fahim Haider Jafary, Fang Feng, Fang Liu, Fatima Ranjbaran, Fatima Rodriguez, Fausto J Pinto, Fauzia Rashid, Federica Ramani, Fei Wang, Fernanda Igansi, Filipa Silva, Filippo Ottani, Fiona Haines, Firas Al Solaiman, Flávia Egydio, Flavio Lyra, Florian Egger, Fran Farquharson, Frances Laube, Francesc Carreras Costa, Francesca de Micco, Francesca Bianchini, Francesca Pezzetta, Francesca Pietrucci, Francesco Orso, Francesco Pisano, Francis Burt, Francisca Patuleia Figueiras, Francisco Fernandez-Aviles, Francois Pierre Mongeon, Frans Van de Werf, Franziska Guenther, Fraser N Witherow, Fred Mohr, Frederico Dall'Orto, Fumiyuki Otsuka, G De La Morena, G Karthikeyan, Gabor Dekany, Gabor Kerecsen, Gabriel Galeote, Gabriel Grossmann, Gabriel Vorobiof, Gabriela Sanchez de Souza, Gabriela Guzman, Gabriela Zeballos, Gabriele Gabrielli, Gabriele Jakl-Kotauschek, Gail A Shammas, Gail Brandt, Gang Chen, Gary E Lane, Gary J Luckasen, Gautam Sharma, Gelmina Mikolaitiene, Gennie Yee, Georg Nickenig, George E Revtyak, George J Juang, Gerald Fletcher, Gerald Leonard, Gerard Patrick Devlin, Gerard Esposito, Gergely Ágoston, Gervasio Lamas, Geza Fontos, Ghada Mikhail, Gia Cobb, Gian Piero Perna, Gianpiero Leone, Giles Roditi, Gilles Barone-Rochette, Girish Mishra, Giuseppe Tarantini, Glenda Wong, Glenn S Hamroff, Glenn Rayos, Gong Cheng, Gonzalo Barge-Caballero, Goran Davidović, Goran Stankovic, Gordana Stevanovic, Grace Jingyan Wang, Grace M Young, Graceanne Wayser, Graciela Scaro, Graham S Hillis, Graham Wong, Grazyna Anna Szulczyk, Gregor Simonis, Gregory Kumkumian, Gretchen Ann Peichel, Grzegorz Gajos, Gudrun Steinmaurer, Guilherme G Rucatti, Guilherme Portugal, Guilhermina Cantinho Lopes, Guillem Pons Lladó, Gunnar Frostfelt, Gurpreet S Wander, Gurpreet Gulati, Gustavo Pucci, Hafidz Abd Hadi, Haibo Zhang, Haitao Wang, Halina Marciniak, Han Chen, Hanan Kerr, Hani Najm, Hanna Douglas, Hannah Phillips, Hao Dai, Haojian Dong, Haqeel Jamil, Harikrishnan Sivadasanpillai, Harry Suryapranata, Hassan Reda, Hayley Pomeroy, Heather Barrentine, Heather Golden, Heather Hurlburt, Heidi Wilson, Helen C Tucker, Helene Abergel, Hemalata Siddaram, Hermine Osseni, Herwig Schuchlenz, Hesong Zeng, Hicham Skali, Hilda Solomon, Hollie Horton, Holly Hetrick, Holly Little, Holly Park, Hongjie Chi, Hossam Mahrous, Howard A Levite, Hristo Pejkov, Huajun Li, Hugo Bloise-Adames, Hugo Marques, Hui Zhong, Hui-Min Zhang, Humayrah Hashim, Hung-I Yeh, Hussien El Fishawy, Ian Webb, Iftikhar Kullo, Igor O Grazhdankin, Ihab Hamzeh, Ikraam Hassan, Ikuko Ueda, Ileana L Pina, Ilona Tamasauskiene, Ilse Bouwhuis, Imran Arif, Ina Wenzelburger, Inês Zimbarra Cabrita, Ines Rodrigues, Inga H Robbins, Inga Soveri, Ingela Schnittger, Iqbal Karimullah, Ira M Dauber, Iram Rehman, Irena Peovska Mitevska, Irene Marthe Lang, Irina Subbotina, Irma Kalibataite-Rutkauskiene, Irni Yusnida, Isabel Estela Carvajal, Isabella C Palazzo, Isabelle Hogan, Isabelle Roy, Ishba Syed, Ishita Tejani, Ivan A Naryshkin, Ivana Jankovic, Iwona Niedzwiecka, J David Knight, Jacek Kusmierek, Jackie M White, Jackie Chow, Jacob Udell, Jacqueline E Tamis-Holland, Jacqueline Fannon, Jacquelyn A Quin, Jacquelyn Do, Jaekyeong Heo, Jakub Maksym, James E Davies, James H O'Keefe Jr, James J Jang, James Cha, James Harrison, James Hirsch, James Stafford, James Tatoulis, Jamie Rankin, Jan Henzel, Jan Orga, Jana Tancredi, Janaina Oliveira, Jane Burton, Jane Eckstein, Jane Marucci, Janet P Knight, Janet Blount, Janet Halliday, Janetta Kourzenkova, Janitha Raj, Jan-Malte Sinning, Jaqueline Pozzibon, Jaroslaw Drozdz, Jaroslaw Karwowski, Jason D Glover, Jason Loh Kwok, Jason T Call, Jason Linefsky, Jassira Gomes, Jati Anumpa, Javier J Garcia, Javier Courtis, Jay Meisner, K Jayakumar, Jayne Scales, Jean E Denaro, Jean Michel Juliard, Jean Ho, Jeanette K Stansborough, Jean-Michel Juliard, Jeanne Russo, Jeannette J M Schoep, Jeet Thambyrajah, Jeff Leimberger, Jeffery A Breall, Jeffrey A Kohn, Jeffrey C Milliken, Jeffrey Anderson, Jeffrey Blume, Jeffrey Kanters, Jeffrey Lorin, Jeffrey Moses, Jelena J Stepanovic, Jelena Celutkiene, Jelena Djokic, Jelena Stojkovic, Jenne M Jose, Jenne Manchery, Jennifer A Mull, Jennifer H Czerniak, Jennifer L Stanford, Jennifer Gillis, Jennifer Horst, Jennifer Isaacs, Jennifer Langdon, Jennifer Thomson, Jennifer Tomfohr, Jennifer White, Jen-Yuan Kuo, Jeremy Rautureau, Jerome Fleg, Jessica Berg, Jessica Rodriguez, Jessica Waldron, Jhina Patro, Jia Li, Jiajia Mao, Jiamin Liu, Jian'an Wang, Jianhua Li, Jianxin Zhang, Jie Qi, Jihyun Lyo, Jill Marcus, Jim Blankenship, Jing Zhang, Jingjing Liu, Jing-Yao Fan, Jiun-Yi Li, Jiwan Pradhan, Jiyan Chen, J M Rivera Caravaca, Jo Evans, Joan Garcia Picart, Joan Hecht, Joanna Jaroch, Joanna Zalewska, Joanne Kelly, Joanne Taaffe, João Reynaldo Abbud, João V Vitola, Joaquín V Peñafiel, Jocelyne Benatar, Jody Bindeman, Joe Sabik, Joel Klitch, Johann Christopher, Johannes Aspberg, John D Friedman, John F Beltrame, John F Heitner, John Joseph Graham, John R Davies, John Doan, John Kotter, John Kurian, John Mukai, John Pownall, Jolanta Sobolewska, Jon Kobashigawa, Jonathan L Goldberg, Jonathan W Bazeley, Jonathan Byrne, Jonathan Himmelfarb, Jonathan Leipsic, Jonean Thorsen, Jorge F Trejo Gutierrez, Jorge Escobedo, Jorik Timmer, José A Ortega-Ramírez, José Antonio Marin-Neto, Jose D Salas, Jose Enrique Castillo, Jose Francisco Saraiva, José J Cuenca-Castillo, Jose L Diez, José Luis Narro Villanueva, José Luiz da Vieira, José M Flores-Palacios, Jose Ramon Gonzalez, Jose Seijas Amigo, Jose Fragata, Josep Maria Padró, Josheph F X McGarvey Jr, Joseph Hannan, Joseph Sacco, Joseph Sweeny, Joseph Wiesel, Josephine D Abraham, Joshua P Loh, Joy Burkhardt, Joyce R White, Joyce Riestenberg-Smith, Judit Sebo, Judith L Meadows, Judith Wright, Judy Mae Foltz, Judy Hung, Judy Otis, Juergen Stumpf, Jui-Peng Tsai, Julia S Dionne, Julia de Aveiro Morata, Julie Bunke, Julie Morrow, Julio César Figal, Jun Fujita, Jun Jiang, Junhua Li, Junqing Yang, Juntima Euathrongchit, Jyotsna Garg, K Manjula Rani, K Preethi, Kaatje Goetschalckx, Kai Eggers, Kamalakar Surineni, Kanae Hirase, T R Kapilamoorthy, Karen Calfas, Karen Gratrix, Karen Hallett, Karen Hultberg, Karen Nugent, Karen Petrosyan, Karen Swan, Karolina Kryczka, Karolina Wojtczak-Soska, Karolina Wojtera, Karsten Lenk, Karthik Ramasamy, Katarzyna Łuczak, Katarzyna Malinowska, Kate Pointon, Kate Robb, Katherine Martin, Kathleen Claes, Kathryn Carruthers, Kathy E Siegel, Katia Drouin, Katie Fowler-Lehman, Kavita Rawat, Kay Rowe, Keiichi Fukuda, Keith A A Fox, Ken Mahaffey, Kendra Unterbrink, Kenneth Giedd, Kerrie Van Loo, Kerry Lee, Kerstin Bonin, Kevin R Bainey, Kevin T Harley, Kevin Anstrom, Kevin Chan, Kevin Croce, Kevin Landolfo, Kevin Marzo, Keyur Patel, Khaled Abdul-Nour, Khaled Alfakih, Khaled Dajani, Khaled Ziada, Khaula Baloch, Khrystyna Kushniriuk, Kian-Keong Poh, Kim F Ireland, Kim Holland, Kimberly Ann Byrne, Kimberly E Halverson, Kimberly Elmore, Kimberly Miller-Cox, Kiran Reddy, Kirsten J Quiles, Kirsty Abercrombie, Klaus Matschke, Konrad Szymczyk, Koo Hui Chan, Kotiboinna Preethi, Kozhaya Sokhon, Krissada Meemuk, Kristian Thygesen, Kristin M Salmi, Kristin Newby, Kristina Wippler, Kristine Arges, Kristine Teoh, Krystal Etherington, Krystyna Łoboz-Grudzień, Krzysztof W Reczuch, Krzysztof Bury, Krzysztof Drzymalski, Krzysztof Kukuła, Kuo-Tzu Sung, Kurt Huber, Ladda Douangvila, Lance Sullenberger, Larissa Miranda Trama, Laszlone Matics, Laura Drew, Laura Flint, Laura Keinaite, Laura Sarti, Laurel Kolakaluri, Lawrence M Phillips, Lawrence Friedman, Lawrence Phillips, Lazar Velicki, Leah Howell, Leandro C Maranan, Leanne Cox, Ledjalem Daba, Lei Zhang, Lekshmi Dharmarajan, Leo Bockeria, Leonardo Pizzol Caetano, Leonardo Bridi, Leonid L Bershtein, Leszek Sokalski, Li Hai Yan, Li Li, Lia Nijmeijer, Lidia Sousa, Lihong Xu, Lihua Zhang, Lili Zhang, Lilia Schiavi, Lilian Mazza Barbosa, Lillian L Khor, Lina Felix-Stern, Linda L Hall, Linda M Hollenweger, Linda Arcand, Linda Davidson-Ray, Linda Schwarz, Lindsey N Sikora, Lingping Chi, Lino Patricio, Liping Zhang, Lisa Chaytor, Lisa Hatch, Lisa McCloy, Lisa Wong, Liselotte Persson, Lixin Jiang, Liz Low, Ljiljana Pupic, Loïc Bière, Lorenzo Monti, Lori Christensen, Lori Pritchard, Loriane Black, Lori-Ann Desimone, Lori-Ann Larmand, Lorraine McGregor, Louise Morby, Louise Thomson, Luc Harvey, Luciana de Pádua Baptista, Lucilla Garcia, Ludivine Eliahou, Ludmila Helmer, Luis F Smidt, Luis Bernanrdes, Luis Guzman, Luiz A Carvalho, Luyang Xiong, Lynette L Teo, Lynn M Neeson, Lynne Winstanley, M Barbara Srichai-Parsia, M Quintana Giner, M Sowjanya Reddy, M Valdés Chávarri, M Grazia Rossi, Maarten Simoons, Maayan Konigstein, Maciej Lesiak, Maciej Olsowka, Mafalda Selas, Magalie Corfias, Magdalena Madero Rovalo, Magdalena Łanocha, Magdalena Miller, Magdalena Misztal-Teodorczyk, Magdalena Rantinella, Magdy Abdelhamid, Magnolia Jimenez, Mahboob Alam, Mahevamma Mylarappa, Mahfouz El Shahawy, Mahmoud Mohamed, Mahmud Al-Bustami, Majo X Joseph, Malgorzata Frach, Małgorzta Celińska-Spodar, Malte Helm, Manas Chacko, Mandy Murphy, Manitha Vinod, Manjula Rani, Manu Dhawan, Manuela Mombelli, Marcel Weber, Marcello Galvani, Marcelo Jamus Rodrigues, Marcia F Dubin, Marcia F Werner Bayer, Marcin Szkopiak, Marco Antonio Monsalve, Marco Bizzaro Santos, Marco Magnoni, Marco Marini, Marco Sicuro, Marco Zenati, Marcos Valério Coimbra Resende, Marek Roik, Margalit Bentzvi, Margaret Gilsenan, Margaret Iraola, Margot C Quinn, Maria A Alfonso, Maria Antonieta Pereira Moraes, María Dolores Martínez-Ruíz, María Fernanda Canales, Maria Inês Caetano, Maria P Corral, Maria Pérez García, Maria Victoria Actis, Maria Aguirre, Maria Andreasson, Maria Aprile, Maria Colton, Maria Eugenia Martin, Maria Lasala, Maria Lorenzo, Maria Posada, Maria Shier, Maria Thottam, Mariana V Furtado, Mariana Yumi Okada, Marianna D A Dracoulakis, Marianne De Andrade, Mariano Rubio, Marie Essermark, Marielle Scherrer-Crosbie, Marija T Petrovic, Marija Zdravkovic, Marilyn Black, Marina Garcia, Mario J Garcia, Mariola Szulik, Marisa Orgera, Mark A de Belder, Mark Harbinson, Mark Hyun, Mark Peterson, Mark Xavier, Marlowe Mosley, Marta Capinha, Marta Marcinkiewicz-Siemion, Marta Swiderek, Martha Meyer, Martina Ceseri, Martina Tricoli, Marvin Kronenberg, Mary Williams, Mary Ann Champagne, Mary Colleen Rogge, Mary R Soltau, Mary Streif, Massimo Villella, Massoud Leesar, Matei Claudia, Mateusz Solecki, Matías Nicolás Mungo, Matthew Wall Jr, Matthew Budoff, Matthew Jezior, Matthew Luckie, Matthias Friedrich, Mauren P Haeffner, Maximilian Tscharre, Max-Paul Winter, Mayana Almeida, Mayil S Krishnam, Mayuri Patel, Meenakshi Mishra, Megan Manocchia, Meghana Kakade, Melanie J Munro, Melissa D Chaplin, Melissa LeFevre, Mervyn Andiapen, Michael A Gibson, Michael B Rubens, Michael C Turner, Michael D Shapiro, Michael W Lee, Michael Berlowitz, Michael Davidson, Michael Mack, Michael McDaniel, Michael Mumma, Michal Wlodarczyk, Michel G Khouri, Michel S Slama, Michele Rawlins, Michelle M Bonner, Michelle M Seib, Michelle Chang, Michelle Crowder, Michelle Dixon, Michelle Mayon, Michelle McEvoy, Michelle Yee, Miguel M Fernandes, Miguel Nobre Menezes, Miguel Souto Bayarri, Miguel Barrero, Mikhail T Torosoff, Milan R Dobric, Milan Dobric, Milica Nikola Dekleva, Milind Avdhoot Gadkari, Millie Gomez, Min Tun Kyaw, Miriam Brooks, Miroslav Stevo Martinovic, Mitchel B Lustre, Mohammad Tariq Vakani, Mohammad El-Hajjar, Mohammed Al-Amoodi, Mohammed Hussain, Mohammed Saleem, Moisés Blanco-Calvo, Moisés Jiménez-Santos, Mona Bhatia, Monica Rosca, Monika Laukyte, Montserrat Gracida Blanca, Montserrat Vila Perales, Mouaz H Al-Mallah, Moysés de Oliveira Filho, Mpiko Ntsekhe, Muhamed Saric, Mulei Chen, Myriam Brousseau, Myrthes Emy Takiuti, Nada Cemerlic-Adjic, Nadia Asif, Nadia Gakou, Nafisa Hussain, Nana O Katamadze, Nancy L Clapp, Nancy Aedy, Nandita Nataraj, Nanette K Wenger, Naomi Uchida, Nasrul Ismail, Natalia S Oliveira, Natalia de Carvalho Maffei, Natalie Spitzer, Natasha C Putnam, Naved Aslam, Neamat Mowafy, Neeraj Pandit, Neeraj Parakh, Nevena Garcevic, Ngaire Meadows, Nhi N Tran, Nicholas Danchin, Nicki Lakeman, Nicola Johnston, Nicolas W Shammas, Nicole Saint Vrestil, Nicole Deming, Nier Zhong, Niket Patel, Nikola N Boskovic, Nikolaos Karogiannis, Nikos Werner, Nina Johnston, Ning Zhang, Ning Zhou, Niree Hindoyan, Nirmal Kumar, Nitika Chadha, Nitish Naik, Nodira Aripova, Noloyiso Mtana, Nona A Eskelson, Noor Syamira Mokhtar, Noppon Taksaudom, Nor Asiah Basri, Nora Marchelletta, Norma Hogg, Nungshi Jungla, Nuno Ferreira, Oksana A Lubyanaya, Olga B Nikolaeva, Olga Cañavate, Olga Sobrino, Olga Walesiak, Olga Walter, Olga Zdończyk, Olivia J Lim, Olivia Anaya, Olivia Mancilla, Olivier Dubourg, Olugbenga Bello, Omar Almousalli, Omar Thompson, Oni Olurinde, Or Harel, Osama Raheem, Oscar Méndiz, Óscar Prada-Delgado, Oz Shapira, P Christian Schulze, Pachara Panpunuan, Pal Maurovich-Horvat, Pallav Garg, Paloma Moraga, Pam Singh, Pamela Julian, Pamela Ouyang, Pamela Sigel, Pamela Woodard, Panpan Zhou, Paola Emanuela Poggio, Paola Smanio, Paolo Calabro, Paramjit Jeetley, Pascal Goube, Patricia K Nguyen, Patricia Alarie, Patricia Arakelian, Patricia Arsenault, Patricia Blaise, Patricia Brito, Patricia Cowper, Patricia Endsley, Patricia Mieses, Patrick B Alexander, Patrick Donnelly, Patrick Wilmot, Patrycja Lebioda, Paul C Gordon, Paul Der Mesropian, Paul Galiwango, Paul Hauptman, Paul Kennedy, Paula Beardsley, Paula García-González, Paulo Cury Rezende, Paulo Ricardo Caramori, Pavel S Kozlov, Pedro Canas Silva, Pedro Gabriel Melo Barros E Silva, Pedro Píccaro de Oliveira, Pedro Carvalho, Pedro Modas, Pedro Rio, Peeyush Jain, Peiyu He, Peter A McCullough, Peter H Stone, Peter M Pollak, Peter Douglass, Peter Henriksen, Peter OKane, Peter Ong, Philip Jones, Philip Rogal, Philippe Généreux, Philippe Menasche, Philippe Rheault, Phoebe Goold, Pierre Gervais, Pierre Michaud, Pilar Calvillo, Ping Chai, Piotr Jakubowski, Piotr Pruszczyk, Piotr Slomka, Piyamitr Sritara, Poay-Huan Loh, Poonam Sonawane, Pouneh Samadi, Pragnesh P Parikh, Prakash Deedwania, Pranav M Patel, Praneeth Polamuri, Pratiksha Sharma, Precilia Vasquez, Preeti Kamath, Prince Thomas, Priyadarshani Arambam, Puja K Mehta, Purvez Grant, Pushpa Naik, Qi Zhong, Qian Zhao, Qiang Zhou, Qianqian Yuan, Qin Yu, Qingxian Li, Qiulan Xie, Qiutang Zeng, R J Vindhya, R James Gerlach, Rachel King, Rada Vučić, Radmila Lyubarova, Radoslaw Pracon, Raewyn Fisher, Rafael Beyar, Rafael Diaz, Rafael Selgas, Raffaele Bugiardini, Raffaele Fanelli, Raisa Kavalakkat, V S Rajalekshmi, Rajat S Barua, Rajeev Menon, Rajesh Gopalan Nair, Rajesh Francis, Rajiv Narang, Rakesh Yadav, Ralph Alan Huston, T Ramakrishnan, Ramesh de Silva, Rami El Mahmoud, Ramiro Carvalho, Ramon de Jesús-Pérez, Ramona Stevens, Ran Leng, Ranjan Kachru, Ranjit Kumar Nath, Raquel Sanchez, Raven R Dwyer, Raven Lee, Ray Wyman, Raymond C Wong, Raymond W Little, Raymundo Ocaranza Sanchez, Rebecca J Wimmer, Rebecca Bariciano, Rebecca Otis, Rebekah R Herrmann, Reem Yunis, Reinette Hampson, Renato Abdala Karam, Renee C Hessian, Renee Kaneshiro, Reshma Ravindran, Reto Andreas Gamma, Reyna Bhandari, Reza Arsanjani, Ricardo L Lopes, Ricardo Mendes Oliveira, Ricardo Costa, Richa Bhatt, Richard F Davies, Richard H J Trimlett, Richard Goldweit, Rik Hermanides, Rine Nakanishi, Rinu R Sidh, Risha Patel, Rita Coram, Rizwan A Siddiqui, Rob S Beanlands, Robert J Hamburger, Robert K Riezebos, Robert M Donnino, Robert Bojar, Robert Chilton, Robert Guyton, Robert Henderson, Robert Kornberg, Robert Leber, Robert Mao, Robert Stenberg, Roberta P Santos, Roberto René Favaloro, Roberto Amati, Rodolfo G S D Lima, Rodrigo J Cerci, Rogerio Tumelero, Rohit Tandon, Roma Tewari, Romalisa Miranda-Peats, Ron Wald, Ronald A Mastouri, Ronald G Morford, Ronald G Schwartz, Ronald P Pedalino, Rongrong Hu, Ronnell A Hansen, Ronny A Cohen, Rory Hachamovitch, Rosa Homem, Rosa Sandonato, Rosane Laimer, Rosann Gans, Roxanne Yost, Roy Mathew, Rubén Baleón-Espinosa, Ruben Ramos, Rubine Gevorgyan, Rui Ferreira, Rui Jing, Ruth Pérez-Fernández, S K Dwivedi, S Ramakrishnan, Saadat Khan, Sabahat Bokhari, Sabu Thomas, Sadath Lubna, Sajeeda Parveen Khan, Sajeev Chakanalil Govindan, Saket Girotra, Saleem Kassam, Sallie Canada, Salvador Cruz-Flores, Samaa Mohamed, Samantha Ly, Sameh El Kaffas, Samia Massalha, Sampoornima Setty, Samuel Nwosu, Sandeep Seth, Sandeep Singh, Sander R Niehe, Sandra M Rivest, Sandra S Zier, Sandra Ahoud, Sandy Carr, Sanjay Ganapathi, Sanjay Shetty, Sanjeev Sharma, Santa Jimenez, Santhosh Satheesh, Santiago A Garcia, Sara Fernandez, Sara Karlsson, Sara Salkind, Sara Temiyasathit, Sarah Medina Rodriguez, Sarah Beaudry, Sarah Hadjih, Sarah Williams, Sarah Zahrani, Sarju Ralhan, Sasa Hinic, Sasko Kedev, Satinder Singh, Satoshi Yasuda, Satvic Cholenahally Manjunath, Sau Lee, Scott M Kaczkowski, Scott Kinlay, Sean W Hayes, Sebastian Sobczak, Senait Asier, Sergey A Sayganov, Seth I Sokol, Shaheen Pandie, Shaiful Azmi Yahaya, Shamir Mehta, Shao-Ping Nie, Sharad Chandra, Sharder Islam, Sharon Tai, Sheetal Rupesh Karwa, Sheri Ussery, Sheromani Bajaj, Sherron C Crook, Shigeyuki Nishimura, Shintaro Nakano, Shirin Heydari, Shiv Kumar Choudhary, Shivali Patel, Shobana Ganesan, Shruti Pandey, Shuyang Zhang, Shweta Hande, Siddharth Gadage, Sik-Yin V Tan, Silvia Zottis Poletti, Silvia Riera, Silvia Valbuena, Simon Walsh, Simona Maspoli, Simone Savaris, Si-Ting Feng, So Yang Cho, Solomon Yakubov, Songlin Zhu, Songtao Wang, Sonia Guerrero, Sonika Gupta, Sonja Salinger Martinovic, Sonya Brons, Sorin Brener, Sothinathan Gurunathan, Souheil Saba, Soundarya Nayak, Sowjanya Reddy, Srinivasa Potluri, Sriram Sudarshan, Srun Kuanprasert, Stacie Van Oosterhout, Stamatios Lerakis, Stanley E Cobos, Stefan C Bertog, Stefan M Simović, Stefan Weikl, Stefano Di Marco, Stefano Provasoli, Stephanie A Tirado, Stephanie C Boer, Stephanie M Lane, Stephanie Ferket, Stephanie Kelly, Stephanie Wasmiller, Stephen H McKellar, Stephen P Hoole, Stephen Fremes, Stephen Preston, Steve Leung, Steven A Fein, Steven J Lindsay, Steven P Sedlis, Steven Giovannone, Steven Michael, Steven Weitz, Stijn van Vugt, Subhash Banerjee, Sudhir Naik, Suellen Hosino, Sukie Desire, Sukit Yamwong, Suku T Thambar, Sulagna Mookherjee, Suman Singh, Sundeep Mishra, Sunil Kumar Verma, Supap Kulthawong, Supatchara Khwakhong, Surendra Naik, Suresh Babu, Surin Woragidpoonpol, Suryaprakash Narayanappa, Susan Derbyshire, Susan Gent, Susan Mathus, Susan Milbrandt, Susan Moore, Susan Regan, Susan Stinson, Susan Webber, Susana Silva, Susanna Stevens, Susanne Gruensfelder, Suthara Aramcharoen, Suvarna Kolhe, Suzana Tavares, Suzanne Arnold, Suzanne Welsh, Svetlana Apostolovic, Swapna Kunhunny, Ta-Chuan Hung, Taissa Zappernick, Tali Sharir, Talita Silva, Tamara Colaiácovo Soares, Tapan Umesh Pillay, Tarun K Mittal, Tatiana Trifonova, Tauane Bello Duarte, Tauqir Huk, Téodora Dutoiu, Terrance Chua, Terry Weyand, Thabitha Charles, Theodoros Kofidis, Theresa McCreary, Thierry Lefevre, Thippeekaa Arumairajah, Thitipong Tepsuwan, Thomas J Mulhearn, Thomas M Meyer, Thomas P Rocco, Thomas R Downes, Thomas Crain, Thomas Haldis, Thomas Mathew, Thomas Redick, Thounaojam Indira Devi, Thuraia Nageh, Tia Cauthren, Tiago Silva, Tiffany Little, Tijana Andric, Tina Harding, Titus Lau, Tiziana Formisano, Tiziano Moccetti, Tomasz Ciurus, Tomasz Mazurek, Tomasz Tarchalski, Toshiyuki Nagai, Tri Tran, Tricia Youn, Trish Tucker, Trudie Milner, Tuhina Bose, Tushar Kotecha, Udo Sechtem, Uma S Valeti, Umberto Cucchini, Umesh Badami, Upendra Kaul, V K Bahl, V S Narain, Valentina Casali, Valeria Godoy, Valerie Robesyn, Vamshi P Priya, Vandana Yadav, Vera McKinney, Veronica De Lenges, Veronica Tinnirello, Vicente Miro, Victor Navarro, Victoria Gumerova, Victoria Hernandez, Vidya Seeratan, Vijay Kumar, Vikentiy Y Kozulin, Viktoria Bulkley, Vilmar Veiga Jr, Vincent Setang, C P Vineeth, Virginai Pubull Nuñez, Virginia Fernández-Figares, Vitor Gomes, Viviana Gabriel, Viviane Dos Santos, Viviane Almeida, Vlad A Iliescu, Vladan Mudrenovic, Vladimir Dzavik, Vojislav L Giga, Walter Enrique Mogrovejo, Wan Xian Chan, Wanda C Marfori, Wanda Parker, Warangkana Mekara, Wassim Nona, Wayne Old, Wayne Pennachi, Weerachai Nawarawong, Wei Chen, Wei Su, Weibing Xing, Wei-Ren Lan, Wenda Crawford, Wendy L Stewart, Wendy Drewes, Wenhua Lin, William B Abernethy, William D Salerno, William F Fearon, William Vergoni, William Weintraub, Winnie C Sia, Wlodzimierz J Musial, Xacobe Flores-Ríos, Xavier Garcia-Moll Marimon, Xi Su, Xiang Ma, Xiangqiong Gu, Xiao Wang, Xiaomei Li, Xiaowei Yao, Xin Fu, Xin Su, Xin Zeng, Xinchun Yang, Xiuhong Li, Xuehua Fang, Xutong Wang, Yaming Geng, Yan Yan, Yanek Pépin-Dubois, Yanfu Wang, Yang Wang, Yanmeng Tian, Yaping Huang, Yechen Han, Yesenia Zambrano, Yi-Hsuan Yang, Ying Tung Sia, Yining Yang, Yitong Ma, Yolayfi Peralta, Yongjian Wu, Yu Kunwu, Yu Zhao, Yudong Peng, Yueh-Hung Lin, Yulan Zhao, Yumei Dong, Yunhai Zhao, Yutthaphan Wannasopha, Yvonne Taul, Zakir Sahul, Zalina Kudzoeva, Zbigniew Kalarus, Zeljko Z Markovic, Zhen Huang, Zheng Ji, Zhenyu Liu, Zhou Yue, Zhulin Zhang, Zhuxi Li, Zile Singh Meharwal, Ziliang Bai, Zixiang Yu, Zohra Huda, Zoltan Davidovits

Subjects
Male, Cardiac Catheterization, Computed Tomography Angiography, medicine.medical_treatment, Myocardial Ischemia, Coronary Disease, Coronary Artery Disease, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Coronary Angiography, ISCHEMIA Research Group, law.invention, Angina, Coronary artery disease, 0302 clinical medicine, Randomized controlled trial, law, Cardiovascular Disease, Myocardial Revascularization, 030212 general & internal medicine, Coronary Artery Bypass, 11 Medical and Health Sciences, Cardiac catheterization, General Medicine, Middle Aged, humanities, Cardiovascular Diseases, Cardiology, Female, Human, medicine.medical_specialty, Ischemia, Article, 03 medical and health sciences, Geriatric cardiology, Percutaneous Coronary Intervention, General & Internal Medicine, Internal medicine, medicine, Humans, Angina, Unstable, Aged, business.industry, Coronary Artery Bypa, Percutaneous coronary intervention, Bayes Theorem, medicine.disease, Heart failure, Quality of Life, business
Abstract

BACKGROUND: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS: We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS: Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, -1.8 percentage points; 95% CI, -4.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS: Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used. (Funded by the National Heart, Lung, and Blood Institute and others; ISCHEMIA ClinicalTrials.gov number, NCT01471522.).

Published
2020

4. Both 'Vitamin L for Life' and 'One Milligram of Satan': A Multi-Perspective Qualitative Exploration of Adjuvant Endocrine Therapy Use after Breast Cancer

Author

Tavis S. Campbell, Kirsti I Toivonen, Devesh Oberoi, Linda E. Carlson, Joshua A. Rash, Kathryn King-Shier, and Katherine-Ann Piedalue

Subjects
medicine.medical_specialty, media_common.quotation_subject, education, Psychological intervention, Information needs, Breast Neoplasms, Article, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, breast cancer, medicine, Humans, 030212 general & internal medicine, RC254-282, media_common, Research ethics, business.industry, Endocrine therapy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, adjuvant endocrine therapy, persistence, Vitamins, medicine.disease, Combined Modality Therapy, Discontinuation, Feeling, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Family medicine, qualitative, Female, Thematic analysis, Neoplasm Recurrence, Local, business
Abstract

Adjuvant endocrine therapy (AET) is recommended after hormone receptor-positive breast cancer to reduce risk of recurrence, but adherence is sub-optimal in many women. Behavioral interventions have been ineffective in improving adherence rates to AET. This qualitative descriptive study investigates factors that support women in AET use and suggestions for interventions to improve AET use and management. Interviews with women who persisted with AET (n = 23), women who discontinued AET (n = 15), and healthcare providers (HCPs, oncologists, oncology residents, and pharmacists, n = 9) were conducted, transcribed, and described using thematic analysis. Data collection stopped once saturation occurred (i.e., no new codes or themes emerged during interviews). Two researchers created codes and developed themes in an iterative process, a third researcher verified the representativeness of final themes. This study was approved by the Health Research Ethics Board of Alberta (ID: HREBA.CC-17-0513). Women who persisted described being prepared for side effects and having self-management strategies, strong rationale for AET use, supportive HCPs, and available resources as relevant factors. Women who discontinued described feeling overwhelmed by side effects, information needs, drawbacks of AET, helpful/unhelpful experiences with HCPs, and contextual factors as relevant to their discontinuation. HCPs described health system-related and patient-related barriers, side effect management, and patient-provider interactions as relevant to supporting AET use. The considerable overlap in themes among the three groups suggests broad recognition of salient factors relevant to AET use and that associated strategies to improve use may be acceptable to patients and providers alike. Factors supporting AET use could include the following: education (which may be necessary but insufficient), developing a strong personal rationale for use, being prepared for side effects, having side effect management strategies, reciprocal communication between patients and HCPs, and accessible resources.

Published
2021

5. 'In the tube' following sternotomy: A quasi-experimental study

Author

L. Park, C. Coltman, Kathryn King-Shier, S. Colwell, and H. Agren

Subjects
Male, Sternum, medicine.medical_specialty, Functional impairment, 030204 cardiovascular system & hematology, 03 medical and health sciences, Coronary artery bypass surgery, 0302 clinical medicine, Quasi experimental study, medicine, Humans, Surgical Wound Infection, Tube (fluid conveyance), Postoperative Period, 030212 general & internal medicine, Cardiac Surgical Procedures, Coronary Artery Bypass, Advanced and Specialized Nursing, business.industry, Sternotomy, Cardiac surgery, Surgery, Medical–Surgical Nursing, Cardiac Surgery procedures, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Background Traditionally, physical movement has been limited for cardiac surgery patients, up to 12-weeks post-operatively. Patients are asked to use “standard sternal precautions,” restricting their arm movement, and thereby limiting stress on the healing sternum. Aim To compare return to function, pain/discomfort, wound healing, use of pain medication and antibiotics, and post-operative length of hospital stay in cardiac surgery patients having median sternotomy who used standard sternal precautions or Keep Your Move in the Tube movement protocols post-operatively. Methods A quasi-experimental design was used (100 standard sternal precautions and 100 Keep Your Move in the Tube patients). Patients were followed in person or by telephone over a period of 12-weeks postoperatively. Outcomes were measured at day 7, as well as weeks 4, 8, and 12 weeks. Results The majority of participants (77% in each group) were male and had coronary artery bypass graft surgery (66% standard sternal precautions and 72% Keep Your Move in the Tube). Univariate analysis revealed the standard sternal precautions group had lesser ability to return to functional activities than the Keep Your Move in the Tube group (p Conclusions Keep Your Move in the Tube, a novel patient-oriented movement protocol, has potential for cardiac surgery patients to be more confident and comfortable in their recovery.

Published
2020

6. Importance of the hematology laboratory in infectious disease diagnosis by morphology: Four educational case studies

Author

Harold L. Atkins, Hakan Buyukdere, Aleksandra Paliga, Luke R. Shier, Ruth Padmore, Gonzalo G. Alvarez, and Chelsey Ellis

Subjects
Adult, Male, medicine.medical_specialty, Pathology, bone marrow, International Society for Laboratory Hematology 2020 Education Issue, Clinical Biochemistry, Morphology (biology), Infections, Infectious disease diagnosis, Internal medicine, morphology, medicine, Humans, Letters, Letter to the Editor, Hematology, Education, Medical, Clinical Laboratory Techniques, business.industry, Biochemistry (medical), General Medicine, Middle Aged, infection, medicine.anatomical_structure, Female, Bone marrow, business
Published
2020

7. South Asian patients’ perceptions and experiences of compassion in healthcare

Author

Shane Sinclair, Kathryn King-Shier, and Pavneet Singh

Subjects
Male, Cultural Studies, Canada, Asia, animal structures, Health Personnel, media_common.quotation_subject, Ethnic group, Compassion, Grounded theory, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, Asian People, Arts and Humanities (miscellaneous), Nursing, Cultural diversity, Health care, Humans, 030212 general & internal medicine, Qualitative Research, Quality of Health Care, media_common, Hindi, Receipt, 030505 public health, business.industry, Cultural group selection, Public Health, Environmental and Occupational Health, Middle Aged, Culturally Competent Care, language.human_language, Grounded Theory, language, Female, Perception, Empathy, 0305 other medical science, Psychology, business
Abstract

Background: South Asians are one of the fastest growing ethnic populations in Western countries. Accordingly, providing culturally sensitive healthcare to South Asians is becoming increasingly important. Compassion is a key component of quality healthcare and is central to bridging ethnic and cultural differences between patients and their healthcare providers (HCP).Objective: We aimed to identify and describe the perspectives, experiences, importance, and impact of compassion among South Asian patients.Methods: Straussian grounded theory was used to examine the perspectives of South Asians patients who had recent experience(s) with the Canadian healthcare system. A convenience sample of 19 South Asian participants underwent semi-structured audio-recorded interviews in either English, Hindi, or Punjabi. Transcribed interview data were analyzed using constant comparison.Results: Three categories were generated from the data: (1) South Asians' understandings of compassion, (2) HCPs' cultural sensitivity as an indicator of compassion, and (3) enhancing compassion: importance and patient recommendations for overcoming barriers to compassion. The first category included themes exploring South Asian patients' perspectives of compassion. The second category was divided into themes which examined how delivery and receipt of compassion can be influenced by ethnic and cultural differences between patients and HCPs. The third category consisted of themes highlighting participants' views on the importance of compassion, recommendations for overcoming language and cultural barriers to providing compassion, and the role of compassion in bridging language, culture and ethnic differences between patients and HCPs.Conclusion: Compassion was described as a universal concept that is interpreted through the cultural and ethnic background of the recipient and provider in the way it is perceived, enacted, and received. This information can aid HCP to modulate compassion to South Asian patients and may provide a foundation for future studies on compassion within other cultural groups.

Published
2020

8. Predictive Utility of Alternate Measures of Physical Activity and Diet for Overweight and Obesity in Low-Income Minority Women

Author

Ying Liu, Victoria Shier, Sara King, and Ashlesha Datar

Subjects
Adult, Cohort Studies, Health (social science), Cross-Sectional Studies, Public Health, Environmental and Occupational Health, Humans, Female, Obesity, Overweight, Exercise, Article, Body Mass Index, Diet
Abstract

Purpose The purpose is to compare the predictive utility of alternate measures of diet and physical activity for overweight and obesity among low-income minority women. Design Cross-sectional analysis of baseline data from a cohort study. Setting Three public housing developments in South Los Angeles. Subjects: Adult women (N = 425). Measures Primary outcome—weight status (normal BMI, overweight, or obese). Primary predictors— diet: 24-hour dietary recalls (Healthy Eating Index), dietary screener (intake of specific food groups), and single-item survey question (diet quality); physical activity: accelerometry (minutes/day of moderate-to-vigorous activity), short recall questionnaire (minutes/week of moderate and vigorous activity), and single-item questions (days per week did exercise; self-assessment of overall activity level). Analysis Multinomial logistic regression models, controlling for socio-demographic covariates. Models are built up starting with least resource-intensive measures of diet and physical activity (single items) and sequentially adding more resource-intensive measures. Model performance is assessed via information-based model selection indices. Results Adjusted relative risk for obesity for single-item measures ranged from .61 to .64 for diet ( P < .01) and from .80 to .81 for physical activity (P Conclusion Single-item questions for diet and physical activity can provide valuable information about risk for overweight and obesity in low-income minority women when more resource-intensive assessments are infeasible.

Published
2022

9. Predicting the difficult laparoscopic cholecystectomy: development and validation of a pre-operative risk score using an objective operative difficulty grading system

Author

Nassar, A. H. M., Hodson, J., H. J., Ng, Vohra, R. S., Katbeh, T., Zino, S., Griffiths, E. A., Kirkham, A. J., Pasquali, S., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Fenwick, S., Elmasry, M., Nunes, Q. M., Kennedy, D., Khan, R. B., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Haque, S. U., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P. B., Lee, K., Joji, N., Lambert, J., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., Mcnair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C. -B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., W. -M., Ho, Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al-Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., Mccallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D. M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Mockford, J. D. K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Rodriguez, D. U., Sen, G., Robinson, S., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Shah, R., Hornby, S. T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Bajwa, D. S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Giwa, L., Iqbal, N., Watson, N. F., Aggarwal, S. K., Orchard, P., Villatoro, E., Willson, P. D., Mok, K. W. J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., O'Shea, K. M., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O'Reilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Guy Finch, J., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al-Khyatt, W., Taylor, C., Bhandari, S., Subramanium, D., Toh, S. K. C., Carter, N. C., Tate, S., Pearce, B., Wainwright, D., Mercer, S. J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A. K., Basu, S., Chhabra, A., Harilingam, M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho-Gomes, A. C., Kausar, A., Obeidallah, M. R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Goh, Y. L., Turner, P., Shetty, V., Riera, M., Macano, C. A. W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., Mcglone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B. S., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A. Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P. A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R. C., Hebbar, M., Farag, S. F., Spearman, J., Hamdan, M. F., D'Costa, C., Blane, C., Giles, M., Peter, M. B., Hirst, N. A., Hossain, T., Pannu, A., El-Dhuwaib, Y., Morrison, T. E. M., Taylor, G. W., Thompson, R. L. E., Mccune, K., Loughlin, P., Lawther, R., Byrnes, C. K., Simpson, D. J., Mawhinney, A., Warren, C., Mckay, D., Mcilmunn, C., Martin, S., Macartney, M., Diamond, T., Davey, P., Jones, C., Clements, J. M., Digney, R., Chan, W. M., Mccain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., Mcaree, B., Ghareeb, E., Thomas, G., Connelly, M., Mckenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A. D. K., Cassidy, J. T., Boland, M., Burke, P., Nally, D. M., Khogali, E., Shabo, W., Iskandar, E., Mcentee, G. P., O'Neill, M. A., Peirce, C., Lyons, E. M., O'Sullivan, A. W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D. C., Kelly, M. E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J. G., Mcdermott, F., Martin, S. T., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Ullah, M. F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A. M., Vaughan, E. M., Ramage, M. I., Aldridge, R. C., Gibson, S., Nicholson, G. A., Vass, D. G., Grant, A. J., Holroyd, D. J., Jones, M. A., Sutton, C. M. L. R., O'Dwyer, P., Nilsson, F., Weber, B., Williamson, T. K., Lalla, K., Bryant, A., Carter, C. R., Forrest, C. R., Hunter, D. I., Nassar, A. H., Orizu, M. N., Knight, K., Qandeel, H., Suttie, S., Belding, R., Mcclarey, A., Boyd, A. T., Guthrie, G. J. K., Lim, P. J., Luhmann, A., Watson, A. J. M., Richards, C. H., Nicol, L., Madurska, M., Harrison, E., Boyce, K. M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M. S. J., Dalgaty, F., Fothergill, L., Driscoll, P. J., Mozolowski, K. L., Banwell, V., Bennett, S. P., Rogers, P. N., Skelly, B. L., Rutherford, C. L., Mirza, A. K., Lazim, T., Lim, H. C. C., Duke, D., Ahmed, T., Beasley, W. D., Wilkinson, M. D., Maharaj, G., Malcolm, C., Brown, T. H., Al-Sarireh, B., Shingler, G. M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D. J., Baker, A. L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J. A., Singh-Ranger, D., Hisham, E., Ainley, P., O'Neill, S., Terrace, J., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., Mcguigan, A., Shahin, Y., Aymon, Luther, A. A., Nicholson, J. A., Rajendran, I., Boal, M., and Ritchie, J.

Subjects
Adult, Male, operative difficulty, medicine.medical_specialty, medicine.medical_treatment, Difficulty grading, difficult cholecystectomy, predictive score, surgery, laparoscopic, cholecystectomy, Surgical planning, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Preoperative Care, Humans, Medicine, Laparoscopic cholecystectomy, Framingham Risk Score, business.industry, General surgery, Reproducibility of Results, Middle Aged, medicine.disease, Pre operative, Single surgeon, Cholecystectomy, Laparoscopic, ROC Curve, 030220 oncology & carcinogenesis, Multivariate Analysis, Cholecystitis, Female, 030211 gastroenterology & hepatology, Surgery, Cholecystectomy, business, Abdominal surgery
Abstract

The prediction of a difficult cholecystectomy has traditionally been based on certain pre-operative clinical and imaging factors. Most of the previous literature reported small patient cohorts and have not used an objective measure of operative difficulty. The aim of this study was to develop a pre-operative score to predict difficult cholecystectomy, as defined by a validated intra-operative difficulty grading scale. Two cohorts from prospectively maintained databases of patients who underwent laparoscopic cholecystectomy were analysed: the CholeS Study (8755 patients) and a single surgeon series (4089 patients). Factors potentially predictive of difficulty were correlated to the Nassar intra-operative difficulty scale. A multivariable binary logistic regression analysis was then used to identify factors that were independently associated with difficult laparoscopic cholecystectomy, defined as operative difficulty grades 3 to 5. The resulting model was then converted to a risk score, and validated on both internal and external datasets. Increasing age and ASA classification, male gender, diagnosis of CBD stone or cholecystitis, thick-walled gallbladders, CBD dilation, use of pre-operative ERCP and non-elective operations were found to be significant independent predictors of difficult cases. A risk score based on these factors returned an area under the ROC curve of 0.789 (95% CI 0.773–0.806, p

Published
2019

10. Interpreting the role of nuchal fold for fetal growth restriction prediction using machine learning

Author

Lung Yun Teng, Citra Nurfarah Zaini Mattar, Arijit Biswas, Wai Lam Hoo, and Shier Nee Saw

Subjects
Machine Learning, Multidisciplinary, Fetal Growth Retardation, Pregnancy, Pregnancy Trimester, Second, Humans, Female, Nuchal Translucency Measurement, Ultrasonography, Prenatal
Abstract

The objective of the study is to investigate the effect of Nuchal Fold (NF) in predicting Fetal Growth Restriction (FGR) using machine learning (ML), to explain the model's results using model-agnostic interpretable techniques, and to compare the results with clinical guidelines. This study used second-trimester ultrasound biometry and Doppler velocimetry were used to construct six FGR (birthweight

Published
2021

11. The effects of vertically integrated care on health care use and outcomes in inpatient rehabilitation facilities

Author

Victoria Shier, José J. Escarce, Neeraj Sood, Lianna Weissblum, and Peter J. Huckfeldt

Subjects
Male, medicine.medical_specialty, Patient assessment, Medicare Advantage, Health outcomes, Postacute Care, Medicare, Patient Readmission, Rehabilitation Centers, 03 medical and health sciences, Insurance Claim Review, 0302 clinical medicine, Health care, Outcome Assessment, Health Care, Medicine, Humans, 030212 general & internal medicine, Health Care Integration, Aged, Aged, 80 and over, Inpatients, business.industry, Delivery of Health Care, Integrated, 030503 health policy & services, Health Policy, Medicare beneficiary, Fee-for-Service Plans, Health Services, Length of Stay, Patient Acceptance of Health Care, United States, Emergency medicine, Functional status, Female, 0305 other medical science, business, Inpatient rehabilitation
Abstract

Objective To understand the effects of receiving vertically integrated care in inpatient rehabilitation facilities (IRFs) on health care use and outcomes. Data sources Medicare enrollment, claims, and IRF patient assessment data from 2012 to 2014. Study design We estimated within-IRF differences in health care use and outcomes between IRF patients admitted from hospitals vertically integrated with the IRF (parent hospital) vs patients admitted from other hospitals. For hospital-based IRFs, the parent hospital was defined as the hospital that owned the IRF and co-located with the IRF. For freestanding IRFs, the parent hospital(s) was defined as the hospital(s) that was in the same health system. We estimated models for freestanding and hospital-based IRFs and for fee-for-service (FFS) and Medicare Advantage (MA) patients. Dependent variables included hospital and IRF length of stay, functional status, discharged to home, and hospital readmissions. Data extraction methods We identified Medicare beneficiaries discharged from a hospital to IRF. Principal findings In adjusted models with hospital fixed effects, our results indicate that FFS patients in hospital-based IRFs discharged from the parent hospital had shorter hospital (-0.7 days, 95% CI: -0.9 to -0.6) and IRF (-0.7 days, 95% CI: -0.9 to -0.6) length of stay were less likely to be readmitted (-1.6%, 95% CI: -2.7% to -0.5%) and more likely to be discharged to home care (1.4%, 95% CI: 0.7% to 2.0%), without worse patient clinical outcomes, compared to patients discharged from other hospitals and treated in the same IRFs. We found similar results for MA patients. However, for patients in freestanding IRFs, we found little differences in health care use or patient outcomes between patients discharged from a parent hospital compared to patients from other hospitals. Conclusions Our results indicate that receiving vertically integrated care in hospital-based IRFs shortens institutional length of stay while maintaining or improving health outcomes.

Published
2021

12. Inpatient Rehabilitation Care in Alberta: How Much Does Stroke Severity and Timing Matter?

Author

Cydnee Seneviratne, Sean P. Dukelow, Eric Tanlaka, Theresa Green, and Kathryn King-Shier

Subjects
Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Stroke severity, Mild stroke, Severe stroke, Severity of Illness Index, Time-to-Treatment, Disability Evaluation, medicine, Humans, Stroke, Aged, Retrospective Studies, Aged, 80 and over, Inpatients, Rehabilitation, business.industry, Stroke Rehabilitation, Recovery of Function, General Medicine, Middle Aged, medicine.disease, Functional Independence Measure, Hospitalization, Neurology, Physical therapy, Female, Neurology (clinical), business, Inpatient rehabilitation
Abstract

We examined the impact of stroke severity and timing to inpatient rehabilitation admission on length of stay (LOS), functional gains, and discharge destination.Alberta inpatient stroke rehabilitation data between April 2013 and March 2017 were analyzed. We evaluated the impact of stroke severity, as measured by the Functional Independence Measure (FIM), on timing to inpatient rehabilitation, functional gains, LOS, and discharge destination. Further, we examined whether timing to inpatient rehabilitation impacted the latter three factors.The 2404 adults were subcategorized as mild (1237), moderate (1031), or severe (136) based on FIM at inpatient rehabilitation admission. Length of time to rehabilitation admission was not significantly (p = 0.232) different between stroke severities. Mean length of time (days) to rehabilitation admission was 19.79 (20.3 SD) for mild, 27.7 (35.7 SD) for moderate, and 37.70 (56.8 SD) for severe stroke. Mean FIM change for mild (M = 16.3, 9.9 SD) differed significantly (p = 5.1 × 10-9) from moderate (M = 30.4, 16.4 SD) and severe (M = 31.0, 25.7 SD) stroke. The mean LOS for mild stroke (M = 41.3, 31.9 SD) was significantly (p = 5.1 × 10-9) different from moderate stroke (M = 86.8, 76.4 SD) and severe stroke (M = 126.1, 104.2 SD). Time to inpatient rehabilitation admission showed a small, significant impact on FIM change (p = 1.4 × 10-9, partial η2 0.022) and LOS (p = 1.1 × 10-19, partial η2 0.042). Shorter times to rehabilitation admission and mild stroke were associated with discharging home without needing homecare.Stroke severity has a significant impact on the conduct of inpatient rehabilitation. Yet, despite suggestions shortening timing to rehabilitation should improve outcomes, the impact on functional gains and rehabilitation LOS was small.Les soins de réadaptation prodigués à des patients albertains hospitalisés: quelle est l’importance de la gravité des AVC et des délais d’admission en matière de réadaptation? Contexte: Nous nous sommes penchés sur l’impact que la gravité des AVC et les délais d’admission à des soins de réadaptation peuvent avoir sur la durée de séjour de patients hospitalisés, sur leurs gains fonctionnels et sur leur lieu de destination à la suite de leur congé. Méthodes: Nous avons analysé les données portant sur la réadaptation de patients albertains hospitalisés à la suite d’un AVC. Ces données couvraient la période allant d’avril 2013 à mars 2017. À l’aide de la mesure de l’indépendance fonctionnelle (MIF), nous avons ainsi évalué l’impact de la gravité des AVC sur les délais d’admission de patients hospitalisés à des soins de réadaptation, sur leurs gains fonctionnels, sur la durée de leur séjour et sur leur lieu de destination à la suite de leur congé. De plus, nous avons examiné dans quelle mesure les délais d’admission à des soins de réadaptation avaient un impact sur ces trois dernières variables. Résultats: Au total, 2 404 adultes ont été répartis en trois catégories en fonction de leur résultat à la MIF: AVC légers (1237), modérés (1031) ou graves (136). Mentionnons que les délais avant d’être admis à des soins de réadaptation ne se sont pas révélés notablement différents (p = 0,232) selon les niveaux de gravité des AVC. Les délais moyens (en jours) avant d’être admis à des soins de réadaptation ont été de 19,79 (σ 20,3) pour les AVC légers; de 27,7 (σ 35,7) pour les AVC modérés; et de 37,70 (σ 56,8) pour les AVC graves. En se basant sur la MIF, les changements moyens pour les AVC légers (M = 16,3; σ 9,9) ont différé de façon notable (p = 5,1 x 10-9) par rapport à ceux des AVC modérés (M = 30,4; σ 16,4) et des AVC graves (M = 31,0; σ 25,7). La durée moyenne de séjour dans le cas des AVC légers (M = 41,3; σ 31,9) s’est par ailleurs révélée significativement (p = 5,1 x 10-9) différente si on la compare aux autres catégories (AVC modérés M = 86,8; σ 76,4 ou AVC graves M = 126,1; σ 104,2). Les délais d’admission à des soins de réadaptation ont donné à voir un faible, quoique notable, impact sur les changements révélés par la MIF (p = 1,4 x 10-9, eta-carré partiel 0,022) et sur la durée des séjours (p = 1,1 x 10-19, eta-carré partiel 0,042). Enfin, des délais d’admission plus courts à des soins de réadaptation et des AVC légers ont été associés, à la suite d’un congé, à un retour à la maison sans devoir recourir à des soins à domicile. Conclusion: La gravité des AVC a un impact considérable sur la réadaptation de patients ayant été hospitalisés. Bien qu’il ait été suggéré que la réduction des délais d’admission à des soins de réadaptation devrait améliorer l’évolution de leur état de santé, l’impact quant à leurs gains fonctionnels et leur durée de séjour en réadaptation a toutefois été mineur.

Published
2019

13. Guided Growth Improves Coxa Valga and Hip Subluxation in Children with Cerebral Palsy

Author

Ting-Ming Wang, Hsiang-Chieh Hsieh, Kuan-Wen Wu, Shier-Chieg Huang, and Ken N. Kuo

Subjects
Male, medicine.medical_specialty, Bone Screws, Treatment outcome, Cerebral palsy, 03 medical and health sciences, 0302 clinical medicine, Clinical Research, Guided growth, Coxa Valga, medicine, Hip Dislocation, Humans, Orthopedics and Sports Medicine, Coxa valga deformity, Femur, 030212 general & internal medicine, Child, Retrospective Studies, 030222 orthopedics, business.industry, Coxa valga, Cerebral Palsy, Follow up studies, General Medicine, medicine.disease, Surgery, Bone screws, Treatment Outcome, Hip subluxation, Child, Preschool, Female, medicine.symptom, business, Epiphyses, Follow-Up Studies
Abstract

Spastic hip subluxation or dislocation that is associated with an excessive coxa valga deformity is a common pathologic condition in children with cerebral palsy (CP) that is often treated with large bone reconstructive procedures. Guided growth techniques (such as stapling, plate, or transphyseal screw) have been widely used to alter the growth axis in patients with a lower-limb deformity but only a few reports have described their use in patients with coxa valga deformities.(1) Does guided growth surgery using a transphyseal screw combined with adductor tenotomy prevent progressive coxa valga deformity and lateral hip subluxation in children with CP? (2) What factors influence the correction of coxa valga deformity and the success of hip stabilization? (3) What complications were associated with this operation and how often did children treated with it undergo reoperation?From 2012 to 2016, at our institution, three authors (H-CH, KNK, K-WW) retrospectively studied data on children with CP who underwent guided growth of the hip for progressive bilateral hip subluxation associated with coxa valga deformities. A single percutaneous screw was inserted across the inferomedial portion of proximal femoral physis in an AP view and centered along femoral neck in lateral view under fluoroscopy guidance. During the period, we treated 25 consecutive children with CP who had progressive hip subluxation with coxa valga deformities. The indications for surgery were migration percentage30% and head-shaft angle155° with at least 2 years growth remaining. Of those, 13 patients underwent guided growth alone, and 48% (12) underwent a combination of guided growth and adductor tenotomy. Of the 25 patients treated with this approach, 96% (24) were available for follow-up with complete data at a minimum of 2 years follow-up (mean 50 months; range 25 to 72). All children (17 boys and seven girls; 48 hips) underwent surgery at a mean age of 8 years (range 5 to 12). With regard to the gross motor function classification system, three patients were Level 1, four patients were Level II, seven patients were Level III, seven were Level IV, and three were Level V. Radiographic parameters including the head-shaft angle, Hilgenreiner's epiphyseal angle, acetabular index, and Reimer's migration percentage were assessed before surgery and at the latest follow-up examination by one author (H-CH). Complications and reoperations were assessed by chart review. During the period in question, we generally offered secondary reconstructive surgery to patients who underwent a guided growth procedure once their subluxation progressed.With the data available, the coxa valga and lateral hip subluxation improved in terms of the reduction of head-shaft angle by a mean of 13° ± 7° (95% CI 11 to 15; p0.001) and the reduction of the migration percentage by 10% ± 11% (95% CI 7 to 13; p0.001). After controlling for potentially confounding variables like gender, gross motor function classification system, Hilgenreiner's epiphyseal angle and acetabular index, we found that longer follow-up duration (r = 0.234; p0.001) and a smaller preoperative migration percentage (r = -0.258; p = 0.004) were associated with larger changes in the head-shaft angle. In terms of complications, we found that the proximal femoral physis grew off the screw tip in 44% (21 of 48 hips) at a mean of 28 months. Among these, 31% of hips (15 of 48) in 33% of patients (eight of 24) underwent replacement with a longer screw. Among the 17% of hips (eight of 48) in 21% of patients (five of 24) who had progressive lateral subluxation and underwent secondary reconstructive surgery, we found that their preoperative acetabular index was higher (mean 29° versus 21°; p0.001), as was their head-shaft angle (mean 166° versus 162°; p = 0.045), and migration percentage (mean 54% versus 36 %; p0.001).Although guided growth with single transphyseal screw did not create as large a degree of varus as proximal femoral osteotomy, it did stabilize the hip in children with cerebral palsy with migration percentage less than 50% in our series. It is a simple procedure that can be of benefit to children with cerebral palsy with unstable hip. Reoperation in patients where the physis has grown off the screw tip can be a problem; fortunately, it is a rather minor procedure to replace with a longer screw.Level III, therapeutic study.

Published
2019

14. Comparison of two methods for idiopathic clubfoot treatment: A case-controlled study in Taiwan

Author

Ken N. Kuo, Kuan-Wen Wu, Ting-Ming Wang, Shier-Chieg Huang, and Chunho Chen

Subjects
Male, Comparative Effectiveness Research, medicine.medical_specialty, Clubfoot, Percutaneous, Taiwan, Achilles Tendon, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Humans, Medicine, Range of Motion, Articular, lcsh:R5-920, business.industry, Idiopathic clubfoot, Significant difference, Infant, Newborn, Case-control study, Infant, General Medicine, medicine.disease, Ponseti method, Surgery, Treatment Outcome, Case-Control Studies, 030220 oncology & carcinogenesis, Orthopedic surgery, Manipulation, Orthopedic, Female, 030211 gastroenterology & hepatology, Achilles tenotomy, lcsh:Medicine (General), business, Follow-Up Studies
Abstract

Background/Purpose: In last century, two distinctive methods of manipulation and casting were developed, Kite method and Ponseti method. The purpose of this study is to compare the outcomes of parallel series between two methods in one institution. Methods: From 2003 to 2008, two pediatric orthopedic services in one institution treated 57 patients with 88 idiopathic clubfeet. One service continued using Kite casting method consisted of 58 feet, and other service employed Ponseti casting method consisted of 30 feet. There was a minimum of 4 years follow-up. Results: Both groups had similar Dimeglio severity scores before treatment. Initial correction was achieved in 40 feet (69%) in the Kite group compared with 27 feet (90%) in the Ponseti group, while 19 feet (63.3%) had percutaneous Achilles tenotomy. The Ponseti method was found to have a significantly higher correction rate (p = 0.028). After a mean follow-up of 72 months, there were 29 relapses (50%) in the Kite group and 8 relapses (26.7%) in the Ponseti group with significant difference (p = 0.036). At the latest follow-up, the outcome measures were 24 feet (41.4%) good, 18 feet (31%) fair and 16 (27.6%) poor in the Kite group and 25 feet (83.3%) good, 3 feet (10%) fair and 2 feet (6.7%) poor in the Ponseti group with significant difference between two groups (p

Published
2019

15. The evaluation of a brief motivational intervention to promote intention to participate in cardiac rehabilitation: A randomized controlled trial

Author

Codie R. Rouleau, Lianne Tomfohr-Madsen, Ross Arena, Kathryn King-Shier, Tavis S. Campbell, Sandeep Aggarwal, and Simon L. Bacon

Subjects
Male, Health Knowledge, Attitudes, Practice, Acute coronary syndrome, medicine.medical_specialty, Referral, medicine.medical_treatment, Motivational interviewing, Context (language use), Intention, Motivational Interviewing, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, Social support, 0302 clinical medicine, Randomized controlled trial, law, Intervention (counseling), medicine, Humans, 030212 general & internal medicine, Acute Coronary Syndrome, Exercise, Aged, Aged, 80 and over, Cardiac Rehabilitation, Rehabilitation, business.industry, General Medicine, Middle Aged, medicine.disease, Self Efficacy, Treatment Outcome, Physical therapy, Female, business
Abstract

Objectives Cardiac rehabilitation (CR) is an effective treatment for cardiovascular disease, yet many referred patients do not participate. Motivational interviewing could be beneficial in this context, but efficacy with prospective CR patients has not been examined. This study investigated the impact of motivational interviewing on intention to participate in CR. Methods Individuals recovering from acute coronary syndrome ( n = 96) were randomized to motivational interviewing or usual care, following CR referral but before CR enrollment. The primary outcome was intention to attend CR. Secondary outcomes included CR beliefs, barriers, self-efficacy, illness perception, social support, intervention acceptability, and CR participation. Results Compared to those in usual care, patients who received the motivational intervention reported higher intention to attend CR ( p = .001), viewed CR as more necessary ( p = .036), had fewer concerns about exercise ( p = .011), and attended more exercise sessions ( p = .008). There was an indirect effect of the intervention on CR enrollment ( b = 0.45, 95% CI 0.04–1.18) and CR adherence ( b = 2.59, 95% CI 0.95–5.03) via higher levels of intention. Overall, patients reported high intention to attend CR ( M = 6.20/7.00, SD = 1.67), most (85%) enrolled, and they attended an average of 65% of scheduled CR sessions. Conclusion A single collaborative conversation about CR can increase both intention to attend CR and actual program adherence. Practice Implications The findings will inform future efforts to optimize behavioral interventions to enhance CR participation.

Published
2018

16. Clinical Characteristics of Patients Undergoing Needle Thoracostomy in a Canadian Helicopter Emergency Medical Service

Author

Catherine M. Laing, Gudrun Reay, Graham Newton, and Kathryn King-Shier

Subjects
Male, medicine.medical_specialty, Canada, Emergency Medical Services, Aircraft, 030204 cardiovascular system & hematology, Emergency Nursing, Thoracostomy, Wounds, Nonpenetrating, Needle Thoracostomy, 03 medical and health sciences, 0302 clinical medicine, Helicopter emergency medical service, Medicine, Humans, Retrospective Studies, business.industry, General surgery, Needle decompression, Pneumothorax, 030208 emergency & critical care medicine, Air Ambulances, medicine.disease, Tension pneumothorax, Emergency Medicine, Female, business
Abstract

Objective: Needle thoracostomy (NT) can be a life-saving procedure when used to treat tension pneumothorax. However, there is some question regarding the efficacy of NT in the prehospital setting. ...

Published
2021

17. Machine learning improves early prediction of small-for-gestational-age births and reveals nuchal fold thickness as unexpected predictor

Author

Choon Hwai Yap, Hwee Kuan Lee, Citra Nurfarah Zaini Mattar, Arijit Biswas, and Shier Nee Saw

Subjects
Male, Demographics, Birth weight, Gestational Age, Machine learning, computer.software_genre, Logistic regression, Retrospective data, Machine Learning, Predictive Value of Tests, Gestational Weeks, Early prediction, Medicine, Humans, Nuchal fold, reproductive and urinary physiology, Genetics (clinical), Retrospective Studies, Singapore, business.industry, Infant, Newborn, Obstetrics and Gynecology, medicine.disease, female genital diseases and pregnancy complications, Logistic Models, Infant, Small for Gestational Age, Small for gestational age, Female, Artificial intelligence, business, Nuchal Translucency Measurement, computer
Abstract

Objective To investigate the performance of the machine learning (ML) model in predicting small-for-gestational-age (SGA) at birth, using second-trimester data. Methods Retrospective data of 347 patients, consisting of maternal demographics and ultrasound parameters collected between the 20th and 25th gestational weeks, were studied. ML models were applied to different combinations of the parameters to predict SGA and severe SGA at birth (defined as 10th and third centile birth weight). Results Using second-trimester measurements, ML models achieved an accuracy of 70% and 73% in predicting SGA and severe SGA whereas clinical guidelines had accuracies of 64% and 48%. Uterine PI (Ut PI) was found to be an important predictor, corroborating with existing literature, but surprisingly, so was nuchal fold thickness (NF). Logistic regression showed that Ut PI and NF were significant predictors and statistical comparisons showed that these parameters were significantly different in disease. Further, including NF was found to improve ML model performance, and vice versa. Conclusion ML could potentially improve the prediction of SGA at birth from second-trimester measurements, and demonstrated reduced NF to be an important predictor. Early prediction of SGA allows closer clinical monitoring, which provides an opportunity to discover any underlying diseases associated with SGA.

Published
2021

18. Women are dying unnecessarily from cardiovascular disease

Author

David R. Thompson, Chantal F. Ski, and Kathryn King-Shier

Subjects
medicine.medical_specialty, Treatment outcome, MEDLINE, Myocardial Infarction, Disease, Symptom assessment, Diagnostic Self Evaluation, Text mining, Sex Factors, SDG 3 - Good Health and Well-being, Sex factors, Medicine, Humans, Healthcare Disparities, Gender identity, business.industry, Gender Identity, Treatment Outcome, Cardiovascular Diseases, Family medicine, Female, Symptom Assessment, Cardiology and Cardiovascular Medicine, business
Published
2020

19. Cytology-based screening for anal intraepithelial neoplasia in women with a history of cervical intraepithelial neoplasia or cancer

Author

Michael Shier, Liying Zhang, Zeina Ghorab, Christoph Wohlmuth, Allan Covens, Danielle Vicus, Jill Tinmouth, and Irving E. Salit

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Uterine Cervical Neoplasms, 030209 endocrinology & metabolism, Cervical intraepithelial neoplasia, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Cytology, medicine, Anal cancer, Humans, Prospective Studies, Prospective cohort study, Gynecology, Cervical cancer, medicine.diagnostic_test, business.industry, Anoscopy, Cancer, medicine.disease, Anus Neoplasms, Uterine Cervical Dysplasia, Oncology, 030220 oncology & carcinogenesis, Cohort, Female, business, Precancerous Conditions
Abstract

Background High-risk human papillomavirus (HPV) has been identified in the pathogenesis of anal cancer. The purpose of this study was to assess the prevalence of abnormal anal cytology and HPV in women aged ≥40 years who have a history of high-grade cervical squamous intraepithelial lesion (SIL) or cancer and to estimate the prevalence of anal intraepithelial neoplasia (AIN) using cytology as the primary screening modality. Methods Women who had a history of high-grade cervical SIL or cancer and were ≥40 years of age were included in this prospective study. Anal cytology with HPV-DNA testing was performed. All patients with abnormal anal cytology were referred for high-resolution anoscopy (HRA), and abnormal lesions were biopsied and treated if pathologically confirmed. Abnormal anal cytology correlated with HPV status, HRA findings, and clinical and demographic characteristics. Results A total of 317 women completed the study. Of these, 96 (30.3%) had abnormal anal cytology (high-grade SIL, 12.5%; low-grade SIL, 19.8%; atypical squamous cells, cannot exclude high-grade SIL, 6.3%; atypical squamous cells of undetermined significance, 61.5%) and 101 (31.9%) were HPV-DNA-positive. There was a significant association between abnormal cytology results and the presence of high-risk HPV. Of the 96 patients with abnormal cytology, 30 (31.3%) had biopsy-proven AIN on HRA, representing 9.5% of the total patient cohort; of these, 10 (33.3%) had low-grade AIN and 20 (66.7%) had high-grade AIN. Older age and smoking were significant risk factors for abnormal anal cytology. Conclusion Women aged ≥40 years with a history of high-grade cervical SIL or cancer have a high rate of AIN. Screening for anal cancer may therefore be considered in this patient population. The optimal screening approach should be addressed in future studies.

Published
2020

20. Sex Differences in Stroke Rehabilitation Care in Alberta

Author

Eric Tanlaka, Kathryn King-Shier, Sean P. Dukelow, Cydnee Seneviratne, and Theresa Green

Subjects
Male, Patient Transfer, medicine.medical_specialty, medicine.medical_treatment, Stroke severity, Severe stroke, 030204 cardiovascular system & hematology, Alberta, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Acute care, medicine, Humans, Stroke, Aged, Aged, 80 and over, Sex Characteristics, Rehabilitation, business.industry, Age Factors, Stroke Rehabilitation, General Medicine, Length of Stay, Middle Aged, medicine.disease, Rehabilitation care, Functional Independence Measure, Patient need, Neurology, Physical therapy, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Background:Female stroke patients may experience poorer functional outcomes than males following inpatient rehabilitation.Methods:Data from Alberta inpatient stroke rehabilitation units were examined to determine: (1) the impact of sex on time to inpatient rehabilitation, functional gains (using the Functional Independence Measure (FIM)), length of stay (LOS), and discharge destination; (2) if sex was related to age at the time of stroke, stroke severity, and living arrangement at discharge from rehabilitation; and (3) whether patients’ age and preadmission living arrangement had an influence on LOS in rehabilitation or discharge destination.Results:Two thousand two hundred sixty-six adult stroke patients (1283 males and 983 females) were subcategorized as mild (FIM >80; n = 1155), moderate (FIM 40–80; n = 994), or severe (FIM n = 117). Fifty-five percent of males (45.7% females) had mild stroke; 39.5% of males (49.5% females) had moderate stroke; and 5.5% of males (4.8% females) had severe stroke. Females were significantly older than males (p = 2.4 × 10−4). No sex difference existed in time from acute care to rehabilitation admission (p = 0.73) or in mean FIM change (p = 0.294). Mean LOS was longer for females than males (p=0.018). Males were more likely than females to be discharged home (p = 1.8 × 10−13). Further, male patients (p = 6.4 × 10−7) and those < 65 years (p = 1.4 × 10−23) were more likely to be discharged home without homecare.Conclusion:There are significant sex and age differences in LOS in rehabilitation and discharge destination of stroke patients. These differences may suggest that sex and age of the patient need to be considered in care planning.

Published
2020

21. Natural environments in the urban context and gut microbiota in infants

Author

Charlene C. Nielsen, Mireia Gascon, Diana L. Lefebvre, Stuart E. Turvey, Catherine Shier, Jeffrey R. Brook, Hein M. Tun, Allan B. Becker, Piush J. Mandhane, Meghan B. Azad, Malcolm R. Sears, Tim K. Takaro, Theo J. Moraes, David S. Guttman, James A. Scott, Anita L. Kozyrskyj, Padmaja Subbarao, and Alvaro Osornio-Vargas

Subjects
Enterobacteriales, 010504 meteorology & atmospheric sciences, Natural environments, Biodiversity, Context (language use), Gut microbiota, 010501 environmental sciences, Biology, Gut flora, 01 natural sciences, Cohort Studies, Feces, Diversity index, Environmental health, Humans, Urban, Child, lcsh:Environmental sciences, 0105 earth and related environmental sciences, General Environmental Science, lcsh:GE1-350, 2. Zero hunger, Diversity, Microbiota, Infant, Infant exposure, biology.organism_classification, Gastrointestinal Microbiome, Breast Feeding, Population study, Female, Infants, Cohort study
Abstract

The biodiversity hypothesis that contact with natural environments (e.g. native vegetation) and biodiversity, through the influence of environmental microbes, may be beneficial for human commensal microbiota has been insufficiently tested. We aimed to study the association between living near natural environments in the urban context, and gut microbiota diversity and composition in young infants. Based on data linkage between the unique Urban Primary Land and Vegetation Inventory (uPLVI) for the city of Edmonton and 355 infants in the CHILD Cohort Study, infant exposure to natural environments (any and specific types, yes/no) was determined within 500 m and 1000 m of their home residence. Gut microbiota composition and diversity at age 4 months was assessed in infant fecal samples. Adjusted for covariates, we observed a reduced odds of high microbial alpha-diversity in the gut of infants exposed to any natural environment within 500 m [Shannon index aOR (95%CI) = 0.63 (0.40, 0.98) and Simpson index = 0.63 (0.41, 0.98)]. In stratified analyses, these associations remained only among infants not breastfed or living with household pets. When doubly stratifying by these variables, the reduced likelihood of high alpha-diversity was present only among infants who were not breastfed and lived with household pets [9% of the study population, Shannon index = 0.07 (0.01, 0.49) and Simpson index = 0.11 (0.02, 0.66)]. Differences in beta-diversity was also seen (p = 0.04) with proximity to a nature space in not breastfed and pets-exposed infants. No associations were observed among infants who were fully formula-fed but without pets at home. When families and their pets had close access to a natural environment, Verrucomicrobiales colonization was reduced in the gut microbiota of formula-fed infants, the abundance of Clostridiales was depleted, whereas the abundance of Enterobacteriales was enriched. Our double-stratified results indicate that proximity to a natural environment plus pet ownership has the capacity to alter the gut microbiota of formula-fed infants. Further research is needed to replicate and better interpret these results, as well as to understand their health consequences.

Published
2020

22. Survival among older adults with kidney failure is better in the first three years with chronic dialysis treatment than not

Author

Braden J. Manns, Robert G. Weaver, Ping Liu, Kathryn King-Shier, Fliss E M Murtagh, Pietro Ravani, Helen Tam-Tham, Jianguo Zhang, Brenda R. Hemmelgarn, Matthew T. James, Chandra Thomas, Robert R. Quinn, Marcello Tonelli, and Karen Fruetel

Subjects
Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, 030232 urology & nephrology, Renal function, Lower risk, Alberta, 03 medical and health sciences, 0302 clinical medicine, Renal Dialysis, Internal medicine, medicine, Humans, 030212 general & internal medicine, Dialysis, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Proportional hazards model, Geriatric nephrology, Hazard ratio, Age Factors, Retrospective cohort study, Survival Analysis, Confidence interval, Hospitalization, Treatment Outcome, Nephrology, Kidney Failure, Chronic, Female, business, Follow-Up Studies, Glomerular Filtration Rate
Abstract

Comparisons of survival between dialysis and nondialysis care for older adults with kidney failure have been limited to those managed by nephrologists, and are vulnerable to lead and immortal time biases. So we compared time to all-cause mortality among older adults with kidney failure treated vs. not treated with chronic dialysis. Our retrospective cohort study used linked administrative and laboratory data to identify adults aged 65 or more years of age in Alberta, Canada, with kidney failure (2002-2012), defined by two or more consecutive outpatient estimated glomerular filtration rates less than 10 mL/min/1.73m2, spanning 90 or more days. We used marginal structural Cox models to assess the association between receipt of dialysis and all-cause mortality by allowing control for both time-varying and baseline confounders. Overall, 838 patients met inclusion criteria (mean age 79.1; 48.6% male; mean estimated glomerular filtration rate 7.8 mL/min/1.73m2). Dialysis treatment (vs. no dialysis) was associated with a significantly lower risk of death for the first three years of follow-up (hazard ratio 0.59 [95% confidence interval 0.46-0.77]), but not thereafter (1.22 [0.69-2.17]). However, dialysis was associated with a significantly higher risk of hospitalization (1.40 [1.16-1.69]). Thus, among older adults with kidney failure, treatment with dialysis was associated with longer survival up to three years after reaching kidney failure, though with a higher risk of hospital admissions. These findings may assist shared decision-making about treatment of kidney failure.

Published
2018

23. The use and abuse of credentials: More is not better…

Author

Roger Watson, David R. Thompson, and Kathryn King-Shier

Subjects
Adult, Male, Licensure, Nursing, Educational Status, Humans, Female, Nursing Staff, Credentialing, Middle Aged, General Nursing
Published
2019

24. Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Author

Griffiths, Ewen A, Hodson, James, Vohra, Ravi S, Marriott, Paul, Katbeh, Tarek, Zino, Samer, Nassar, Ahmad HM, Vohra, Ravinder S, Kirkham, Amanda J, Pasquali, Sandro, Johnstone, Marianne, Spreadborough, Philip, Alderson, Derek, Fenwick, Stephen, Elmasry, Mohamed, Nunes, Quentin M, Kennedy, David, Khan, Raja Basit, Khan, Muhammad AS, Magee, Conor J, Jones, Steven M, Mason, Denise, Parappally, Ciny P, Mathur, Pawan, Saunders, Michael, Jamel, Sara, Haque, Samer Ul, Zafar, Sara, Shiwani, Muhammad Hanif, Samuel, Nehemiah, Dar, Farooq, Jackson, Andrew, Lovett, Bryony, Dindyal, Shiva, Winter, Hannah, Fletcher, Ted, Rahman, Saquib, Wheatley, Kevin, Nieto, Tom, Ayaani, Soofiyah, Youssef, Haney, Nijjar, Rajwinder S, Watkin, Helen, Naumann, David, Emesih, Sophie, Sarmah, Piyush B, Lee, Kathryn, Joji, Nikita, Lambert, Joel, Heath, Jonathan, Teasdale, Rebecca L, Weerasinghe, Chamindri, Needham, Paul J, Welbourn, Hannah, Forster, Luke, Finch, David, Blazeby, Jane M, Robb, William, McNair, Angus GK, Hrycaiczuk, Alex, Charalabopoulos, Alexandros, Kadirkamanathan, Sritharan, Tang, Cheuk-Bong, Jayanthi, Naga VG, Noor, Nigel, Dobbins, Brian, Cockbain, Andrew J, Nilsen-Nunn, April, de Siqueira, Jonathan, Pellen, Mike, Cowley, Jonathan B, Ho, Wei-Min, Miu, Victor, White, Timothy J, Hodgkins, Kathryn A, Kinghorn, Alison, Tutton, Matthew G, Al-Abed, Yahya A, Menzies, Donald, Ahmad, Anwar, Reed, Joanna, Khan, Shabuddin, Monk, David, Vitone, Louis J, Murtaza, Ghulam, Joel, Abraham, Brennan, Stephen, Shier, David, Zhang, Catherine, Yoganathan, Thusidaran, Robinson, Steven J, McCallum, Iain JD, Jones, Michael J, Elsayed, Mohammed, Tuck, Liz, Wayman, John, Carney, Kate, Aroori, Somaiah, Hosie, Kenneth B, Kimble, Adam, Bunting, David M, Fawole, Adeshina S, Basheer, Mohammed, Dave, Rajiv V, Sarveswaran, Janahan, Jones, Elinor, Kendal, Chris, Tilston, Michael P, Gough, Martin, Wallace, Tom, Singh, Shailendra, Downing, Justine, Mockford, Katherine A, Issa, Eyad, Shah, Nayab, Chauhan, Neal, Wilson, Timothy R, Forouzanfar, Amir, Wild, Jonathan RL, Nofal, Emma, Bunnell, Catherine, Madbak, Khaliel, Rao, Sudhindra TV, Devoto, Laurence, Siddiqi, Najaf, Khawaja, Zechan, Hewes, James C, Gould, Laura, Chambers, Alice, Rodriguez, Daniel Urriza, Sen, Gourab, Robinson, Stuart, Bartlett, Francis, Rae, David M, Stevenson, Thomas EJ, Sarvananthan, Kas, Dwerryhouse, Simon J, Higgs, Simon M, Old, Oliver J, Hardy, Thomas J, Shah, Reena, Hornby, Steve T, Keogh, Ken, Frank, Lucinda, Al-Akash, Musallam, Upchurch, Emma A, Frame, Richard J, Hughes, Michael, Jelley, Clare, Weaver, Simon, Roy, Sudipta, Sillo, Toritseju O, Galanopoulos, Giorgios, Cuming, Tamzin, Cunha, Pedro, Tayeh, Salim, Kaptanis, Sarantos, Heshaishi, Mohamed, Eisawi, Abdalla, Abayomi, Michael, Ngu, Wee Sing, Fleming, Katie, Bajwa, Dalvi S, Chitre, Vivek, Aryal, Kamal, Ferris, Paul, Silva, Michael, Lammy, Simon, Mohamed, Sarah, Khawaja, Amir, Hussain, Adnan, Ghazanfar, Mudassar A, Bellini, Maria Irene, Ebdewi, Hamdi, Elshaer, Mohamed, Gravante, Gianpiero, Drake, Benjamin, Ogedegbe, Arikoge, Mukherjee, Dipankar, Arhi, Chanpreet, Giwa, Lola, Iqbal, Nusrat, Watson, Nicholas F, Aggarwal, Smeer Kumar, Orchard, Philippa, Villatoro, Eduardo, Willson, Peter D, Mok, Kam Wa Jessica, Woodman, Thomas, Deguara, Jean, Garcea, Giuseppe, Babu, Benoy I, Dennison, AR, Malde, Deep, Lloyd, David, Satheesan, Steve, Al-Taan, Omer, Boddy, Alexander, Slavin, John P, Jones, Robert P, Ballance, Laura, Gerakopoulos, Stratos, Jambulingam, Periyathambi, Mansour, Sami, Sakai, Naomi, Acharya, Vikas, Sadat, Mohammed M, Karim, Lawen, Larkin, David, Amin, Khalid, Khan, Amarah, Law, Jennifer, Jamdar, Saurabh, Smith, Stella R, Sampat, Keerthika, O'shea, Kathryn M, Manu, Mangta, Asprou, Fotini M, Malik, Nabeela S, Chang, Jessica, Lewis, Michael, Roberts, Geoffrey P, Karavadra, Babu, Photi, Evangelos, Hewes, James, Rodriguez, Dan, O'Reilly, Derek A, Rate, Anthony J, Sekhar, Hema, Henderson, Lucy T, Starmer, Benjamin Z, Coe, Peter O, Tolofari, Sotonye, Barrie, Jenifer, Bashir, Gareth, Sloane, Jake, Madanipour, Suroosh, Halkias, Constantine, Trevatt, Alexander EJ, Borowski, David W, Hornsby, Jane, Courtney, Michael J, Virupaksha, Suvi, Seymour, Keith, Robinson, Sarah, Hawkins, Helen, Bawa, Sadiq, Gallagher, Paul V, Reid, Alistair, Wood, Peter, Finch, JG, Finch, J Guy, Parmar, J, Stirland, E, Gardner-Thorpe, James, Al-Muhktar, Ahmed, Peterson, Mark, Majeed, Ali, Bajwa, Farrukh M, Martin, Jack, Choy, Alfred, Tsang, Andrew, Pore, Naresh, Andrew, David R, Al-Khyatt, Waleed, Bhandari, Christopher Taylor Santosh, Chambers, Adam, Subramanium, Dhivya, Toh, Simon KC, Carter, Nicholas C, Tate, Sophie, Pearce, Belinda, Wainwright, Denise, Mercer, Stuart J, Knight, Benjamin, Vijay, Vardhini, Alagaratnam, Swethan, Sinha, Sidhartha, Khan, Shahab, El-Hasani, Shamsi S, Hussain, Abdulzahra A, Bhattacharya, Vish, Kansal, Nisheeth, Fasih, Tani, Jackson, Claire, Siddiqui, Midhat N, Chishti, Imran A, Fordham, Imogen J, Siddiqui, Zohaib, Bausbacher, Harald, Geogloma, Ileana, Gurung, Kabita, Tsavellas, George, Basynat, Pradeep, Shrestha, Ashish Kiran, Basu, Sanjoy, Harilingam, Alok Chhabra Mohan, Rabie, Mohamed, Akhtar, Mansoor, Kumar, Pradeep, Jafferbhoy, Sadaf F, Hussain, Najam, Raza, Soulat, Haque, Manzarul, Alam, Imran, Aseem, Rabiya, Patel, Shakira, Asad, Mehek, Booth, Michael I, Ball, William R, Wood, Christopher PJ, Pinho-Gomes, Ana C, Kausar, Ambareen, Obeidallah, Moh'd Rami, Varghase, Joseph, Lodhia, Joshil, Bradley, Donal, Rengifo, Carla, Lindsay, David, Gopalswamy, Sivakumar, Finlay, Ian, Wardle, Stacy, Bullen, Naomi, Iftikhar, Syed Yusuf, Awan, Altaf, Ahmed, Javed, Leeder, Paul, Fusai, Guiseppe, Bond-Smith, Giles, Psica, Alicja, Puri, Yogesh, Hou, David, Noble, Fergus, Szentpali, Karoly, Broadhurst, Jack, Date, Ravindra, Hossack, Martin R, Goh, Yan Li, Turner, Paul, Shetty, Vinutha, Riera, Manel, Macano, Christina AW, Sukha, Anisha, Preston, Shaun R, Hoban, Jennifer R, Puntis, Daniel J, Williams, Sophie V, Krysztopik, Richard, Kynaston, James, Batt, Jeremy, Doe, Matthew, Goscimski, Andrzej, Jones, Gareth H, Hall, Claire, Carty, Nick, Ahmed, Jamil, Panteleimonitis, Sofoklis, Gunasekera, Rohan T, Sheel, Andrea RG, Lennon, Hannah, Hindley, Caroline, Reddy, Marcus, Kenny, Ross, Elkheir, Natalie, McGlone, Emma R, Rajaganeshan, Rajasundaram, Hancorn, Kate, Hargreaves, Anita, Prasad, Raj, Longbotham, David A, Vijayanand, Dhakshinamoorthy, Wijetunga, Imeshi, Ziprin, Paul, Nicolay, Christopher R, Yeldham, Geoffrey, Read, Edward, Gossage, James A, Rolph, Rachel C, Ebied, Husam, Phull, Manraj, Khan, Mohammad A, Popplewell, Matthew, Kyriakidis, Dimitrios, Hussain, Anwar, Henley, Natasha, Packer, Jessica R, Derbyshire, Laura, Porter, Jonathan, Appleton, Shaun, Farouk, Marwan, Basra, Melvinder, Jennings, Neil A, Ali, Shahda, Kanakala, Venkatesh, Ali, Haythem, Lane, Risha, Dickson-Lowe, Richard, Zarsadias, Prizzi, Mirza, Darius, Puig, Sonia, Al Amari, Khalid, Vijayan, Deepak, Sutcliffe, Robert, Marudanayagam, Ravi, Hamady, Zayed, Prasad, Abheesh R, Patel, Abhilasha, Durkin, Damien, Kaur, Parminder, Bowen, Laura, Byrne, James P, Pearson, Katherine L, Delisle, Theo G, Davies, James, Tomlinson, Mark A, Johnpulle, Michelle A, Slawinski, Corinna, Macdonald, Andrew, Nicholson, James, Newton, Katy, Mbuvi, James, Farooq, Ansar, Mothe, Bhavani Sidhartha, Zafrani, Zakhi, Brett, Daniel, Francombe, James, Barnes, James, Cheung, Melanie, Al-Bahrani, Ahmed Z, Preziosi, Giuseppe, Urbonas, Tomas, Alberts, Justin, Mallik, Mekhlola, Patel, Krashna, Segaran, Ashvina, Doulias, Triantafyllos, Sufi, Pratik A, Yao, Caroline, Pollock, Sarah, Manzelli, Antonio, Wajed, Saj, Kourkulos, Michail, Pezzuto, Roberto, Wadley, Martin, Hamilton, Emma, Jaunoo, Shameen, Padwick, Robert, Sayegh, Mazin, Newton, Richard C, Hebbar, Madhusoodhana, Farag, Sameh F, Spearman, John, Hamdan, Mohammed F, D'Costa, Conrad, Blane, Christine, Giles, Mathew, Peter, Mark B, Hirst, Natalie A, Hossain, Tanvir, El-Dhuwaib, Arslan Pannu Yesar, Morrison, Tamsin EM, Taylor, Greg W, Thompson, Ronald LE, McCune, Ken, Loughlin, Paula, Lawther, Roger, Byrnes, Colman K, Simpson, Duncan J, Mawhinney, Abi, Warren, Conor, McKay, Damian, McIlmunn, Colin, Martin, Serena, MacArtney, Matthew, Diamond, Tom, Davey, Phil, Jones, Claire, Clements, Joshua M, Digney, Ruairi, Chan, Wei Ming, McCain, Stephen, Gull, Sadaf, Janeczko, Adam, Dorrian, Emmet, Harris, Andrew, Dawson, Suzanne, Johnston, Dorothy, McAree, Barry, Ghareeb, Essam, Thomas, George, Connelly, Martin, McKenzie, Stephen, Cieplucha, Krzysztos, Spence, Gary, Campbell, William, Hooks, Gareth, Bradley, Neil, Hill, Arnold DK, Cassidy, John T, Boland, Michael, Burke, Paul, Nally, Deirdre M, Khogali, Elmoataz, Shabo, Wael, Iskandar, Edrin, McEntee, Gerry P, O'Neill, Maeve A, Peirce, Colin, Lyons, Emma M, O'Sullivan, Adrian W, Thakkar, Rohan, Carroll, Paul, Ivanovski, Ivan, Balfe, Paul, Lee, Matthew, Winter, Des C, Kelly, Michael E, Hoti, Emir, Maguire, Donal, Karunakaran, Priyadarssini, Geoghegan, Justin G, McDermott, Frank, Martin, Sean T, Cross, Keith S, Cooke, Fiachra, Zeeshan, Saquib, Murphy, James O, Mealy, Ken, Mohan, Helen M, Nedujchelyn, Yuwaraja, Ullah, Muhammad Fahad, Ahmed, Irfan, Giovinazzo, Francesco, Milburn, James, Prince, Sarah, Brooke, Eleanor, Buchan, Joanna, Khalil, Ahmed M, Vaughan, Elizabeth M, Ramage, Michael I, Aldridge, Roland C, Gibson, Simon, Nicholson, Gary A, Vass, David G, Grant, Alan J, Holroyd, David J, Jones, M Angharad, Sutton, Cherith MLR, O'Dwyer, Patrick, Nilsson, Frida, Weber, Beatrix, Williamson, Tracey K, Lalla, Kushik, Bryant, Alice, Carter, C Ross, Forrest, Craig R, Hunter, David I, Nassar, Ahmad H, Orizu, Mavis N, Knight, Katrina, Qandeel, Haitham, Suttie, Stuart, Belding, Rowena, McClarey, Andrew, Boyd, Alan T, Guthrie, Graeme JK, Lim, Pei J, Luhmann, Andreas, Watson, Angus JM, Richards, Colin H, Nicol, Laura, Madurska, Marta, Harrison, Ewen, Boyce, Kathryn M, Roebuck, Amanda, Ferguson, Graeme, Pati, Pradeep, Wilson, Michael SJ, Dalgaty, Faith, Fothergill, Laura, Driscoll, Peter J, Mozolowski, Kirsty L, Banwell, Victoria, Bennett, Stephen P, Rogers, Paul N, Skelly, Brendan L, Rutherford, Claire L, Mirza, Ahmed K, Lazim, Taha, Lim, Henry CC, Duke, Diana, Ahmed, Talat, Beasley, William D, Wilkinson, Marc D, Maharaj, Geta, Malcolm, Cathy, Brown, Timothy H, Al-Sarireh, Bilal, Shingler, Guy M, Mowbray, Nicholas, Radwan, Rami, Morcous, Paul, Wood, Simon, Kadhim, Abbas, Stewart, Duncan J, Baker, Andrew L, Tanner, Nicola, Shenoy, Hrishikesh, Hafiz, Shazia, De Marchi, Joshua A, Singh-Ranger, Deepak, Hisham, Elzanati, Ainley, Paul, O'Neill, Stephen, Terrace, John, Napetti, Sara, Hopwood, Benjamin, Rhys, Thomas, Kanavati, Osama, Coats, Maria, Aleksandrov, Danail, Kallaway, Charlotte, Yahya, Salama, Templeton, Alexa, Trotter, Martin, Lo, Christina, Dhillon, Ajit, Heywood, Nick, Aawsaj, Yousif, Hamdan, Alhafidz, Reece-Bolton, Obuobi, McGuigan, Andrew, Shahin, Yousef, Aymon, Luther, Ali Alison, Nicholson, James A, Rajendran, Ilayaraja, Boal, Matthew, Ritchie, Judith, Grp, CholeS Study, Collaborative, West Midlands Res, Segaran, A, and Collaborative, West Midlands Research

Subjects
medicine.medical_specialty, medicine.medical_treatment, 030230 surgery, Article, 03 medical and health sciences, 0302 clinical medicine, Case mix index, Laparoscopic, length of stay, male, middle aged, postoperative complications, Medicine, Cholecystectomy, Prospective cohort study, Grading (education), humans, Laparoscopic cholecystectomy, business.industry, General surgery, adult, cholecystectomy, difficulty grading, laparoscopic, operative difficulty, surgery, aged, cholecystectomy, laparoscopic, conversion to open surgery, female, multivariate analysis, prospective studies, ROC curve, Difficulty grading, Cohort, 030211 gastroenterology & hepatology, Surgery, business, Operative difficulty, Grading scale, Abdominal surgery
Abstract

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p p Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty.

Published
2018

25. The treatment of chronic radial head dislocation in Monteggia fracture without annular ligament reconstruction

Author

Ken N. Kuo, Ting-Ming Wang, Zheng-Ren Dong, Hsuan-Yu Chen, Kuan-Wen Wu, and Shier-Chieg Huang

Subjects
Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Radiography, Elbow, Ulna, Monteggia fracture, Elbow pain, Monteggia's Fracture, 03 medical and health sciences, 0302 clinical medicine, Elbow Joint, Humans, Medicine, Orthopedics and Sports Medicine, 030212 general & internal medicine, Range of Motion, Articular, Child, Reduction (orthopedic surgery), Retrospective Studies, Orthodontics, 030222 orthopedics, Ligaments, business.industry, Radial head dislocation, medicine.disease, Osteotomy, body regions, Open Fracture Reduction, Radius, Treatment Outcome, medicine.anatomical_structure, Orthopedic surgery, Ligament, Female, Surgery, business, Bone Wires
Abstract

The treatment of neglected radial head dislocation after missed Monteggia fracture dislocation in children is a controversial issue. The purpose of this study is to report our clinical experience in the treatment of the condition without annular ligament reconstruction. This is a retrospective review of 20 patients between 2008 and 2014. Procedures included open reduction of the radial head and ulnar lengthening angulation osteotomy. In cases of unstable radial head reduction, a trans-capitellar K wire was applied. The pre- and post-operative radiographs were available for evaluation as well as the Mayo Elbow Performance Index (MEPI). The average pre-operative elbow extension-flexion arc was 99.5° and pronation-supination arc was 151°. At last follow-up, the flexion of elbow had significant improvement (from 110° to 124°), while the average pronation and supination arc decreased, most in pronation (from 75° to 65°). Post-operatively, MEPI scored higher, especially in elbow pain and stability. Patients underwent surgery within one year of injury had better functional outcome than those injured over one year. The patients required trans-capitellar K wire for unstable radial head reduction and were in the older age group. At final follow-up, the reduction of radial head was maintained in all cases except two with mild subluxations of the radial head in radiographs. Two cases required radial shaft shortening to facilitate the reduction because of proximal migration of the radius. For neglected radial head dislocation following Monteggia fracture dislocation, we presented our surgical strategy to reduce the radial head without annual ligament reconstruction. Our patients functionally benefited from the procedure with significant improvement in elbow pain and stability, as well as improved flexion of the elbow with stable radial head reduction. IV

Published
2018

26. Characterization of the hemodynamic wall shear stresses in human umbilical vessels from normal and intrauterine growth restricted pregnancies

Author

Yu Wei Poh, Citra Nurfarah Zaini Mattar, Choon Hwai Yap, Arijit Biswas, Shier Nee Saw, and D. Chia

Subjects
0301 basic medicine, Umbilical Veins, medicine.medical_specialty, Intrauterine growth restriction, Hemodynamics, Placental insufficiency, Umbilical vein, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Internal medicine, medicine.artery, Pressure, medicine, Humans, Computer Simulation, reproductive and urinary physiology, Fetus, Fetal Growth Retardation, 030219 obstetrics & reproductive medicine, business.industry, Mechanical Engineering, Gestational age, Umbilical artery, Blood flow, medicine.disease, 030104 developmental biology, Modeling and Simulation, Hydrodynamics, cardiovascular system, Cardiology, Regression Analysis, Female, Stress, Mechanical, Shear Strength, business, circulatory and respiratory physiology, Biotechnology
Abstract

Significant reductions in blood flow and umbilical diameters were reported in pregnancies affected by intrauterine growth restriction (IUGR) from placental insufficiency. However, it is not known if IUGR umbilical blood vessels experience different hemodynamic wall shear stresses (WSS) compared to normal umbilical vessels. As WSS is known to influence vasoactivity and vascular growth and remodeling, which can regulate flow rates, it is important to study this parameter. In this study, we aim to characterize umbilical vascular WSS environment in normal and IUGR pregnancies, and evaluate correlation between WSS and vascular diameter, and gestational age. Twenty-two normal and 21 IUGR pregnancies were assessed via ultrasound between the 27th and 39th gestational week. IUGR was defined as estimated fetal weight and/or abdominal circumference below the 10th centile, with no improvement during the remainder of the pregnancy. Vascular diameter was determined by 3D ultrasound scans and image segmentation. Umbilical artery (UA) WSS was computed via computational flow simulations, while umbilical vein (UV) WSS was computed via the Poiseuille equation. Univariate multiple regression analysis was used to test for the differences between normal and IUGR cohort. UV volumetric flow rate, UA and UV diameters were significantly lower in IUGR fetuses, but flow velocities and WSS trends in UA and UV were very similar between normal and IUGR groups. In both groups, UV WSS showed a significant negative correlation with diameter, but UA WSS had no correlation with diameter, suggesting a constancy of WSS environment and the existence of WSS homeostasis in UA, but not in UV. Despite having reduced flow rate and vascular sizes, IUGR UAs had hemodynamic mechanical stress environments and trends that were similar to those in normal pregnancies. This suggested that endothelial dysfunction or abnormal mechanosensing was unlikely to be the cause of small vessels in IUGR umbilical cords.

Published
2018

27. The Effects of Exercise on Physical and Psychological Outcomes in Cancer Caregivers: Results From the RECHARGE Randomized Controlled Trial

Author

Colleen A Cuthbert, Dianne M. Tapp, J. Dean Ruether, S. Nicole Culos-Reed, Kathryn King-Shier, Tak Fung, and Kathryn Wytsma-Fisher

Subjects
Male, medicine.medical_specialty, Physical fitness, law.invention, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Randomized controlled trial, law, Neoplasms, Intervention (counseling), medicine, Humans, 030212 general & internal medicine, Exercise, General Psychology, Family caregivers, business.industry, Middle Aged, Mental health, Exercise Therapy, Clinical trial, Psychiatry and Mental health, Caregivers, Physical Fitness, 030220 oncology & carcinogenesis, Quality of Life, Physical therapy, Anxiety, Female, medicine.symptom, business
Abstract

Background Family caregivers to cancer patients are at risk for physical and psychological morbidity as a direct result of being in the caregiver role. Exercise as an intervention to support caregiver health and well-being has been tested in other caregiver populations; however, no randomized controlled trials testing the effects of an aerobic and resistance training program have been conducted where cancer caregivers only have participated. Purpose To examine the effects of a 12-week exercise program on quality of life (Short Form 36 v2), psychological outcomes, physical activity levels, and physical fitness in caregivers to cancer patients. Methods Seventy-seven caregivers were randomized to either an exercise intervention or wait-list control. Two participants in the exercise arm dropped out immediately after their baseline assessment. Outcome data for n = 77 participants were analyzed using intention-to-treat analysis with linear mixed models. Results Significant group by time interaction effects were detected for exercise on the mental health component score of quality of life, self-reported weekly exercise levels, and the six-minute walk test. Small to medium effect sizes were detected on several outcomes including physical health component of quality of life (d = 0.36), mental health component of quality of life (d = 0.74), depression (d = 0.41), anxiety (d = 0.35), physical activity levels (d = 0.80), and the six-minute walk test (d = 0.21). Conclusions The findings suggest that exercise may improve health and well-being and could be considered as an additional type of support offered to cancer caregivers. Clinical trial registration no NCT02580461.

Published
2018

28. Exploring Gender Differences in Self-Reported Physical Activity and Health Among Older Caregivers

Author

Dean Ruether, S. Nicole Culos-Reed, Dianne M. Tapp, Colleen A. Cuthbert, and Kathryn King-Shier

Subjects
Male, Gerontology, Health Status, Population, Physical activity, Alberta, 03 medical and health sciences, Social support, Sex Factors, 0302 clinical medicine, Surveys and Questionnaires, Humans, Medicine, 030212 general & internal medicine, education, Exercise, Depression (differential diagnoses), Aged, Aged, 80 and over, education.field_of_study, Descriptive statistics, business.industry, Family caregivers, Middle Aged, Mental health, Cross-Sectional Studies, Caregivers, 030220 oncology & carcinogenesis, Quality of Life, Anxiety, Female, Self Report, medicine.symptom, business
Abstract

Purpose/objectives To document self-reported physical health and activity levels of older caregivers. Gender differences in physical health, physical activity levels, and predictors of physical activity were also examined. . Design A cross-sectional study. . Setting Tom Baker Cancer Centre in Calgary, Alberta, Canada. . Sample 130 caregivers aged 60 years or older caring for individuals with breast, prostate, or colorectal cancer. . Methods Self-report survey including validated questionnaires on physical and mental health and physical activity levels. Convenience sampling was used. Data were analyzed using descriptive statistics, correlations, and multiple regression. . Main research variables The physical component score of the SF-36v2® was the main research variable. Other variables included the mental component score of the SF-36v2, sleep quality, depression, social support, physical activity levels, and anxiety. . Findings The mean age of caregivers was 70 years. Physical health and physical activity levels were higher than population norms. A significant difference in physical health (p = 0.015) existed between men and women but not in physical activity levels (p = 0.079). Predictors of physical activity levels were age (β = -0.291), physical health (β = 0.307), and caregiving hours per week (β = -0.221). . Conclusions The findings suggest that gender had a minimal effect on physical health and no effect on physical activity levels in older caregivers. Depression and poor sleep quality were high in some caregivers but did not predict physical activity levels. . Implications for nursing The negative effects of caregiving on physical health and physical activity levels in older caregivers are not universal. Nurses should be aware of the caregiving situation and promote health based on the individual.

Published
2017

29. Supporting Intrapersonal Development in Substance Use Disorder Programs: A Conceptual Framework for Client Assessment

Author

Micheal L. Shier and Aaron Turpin

Subjects
Male, Coping (psychology), Health (social science), Sociology and Political Science, Social Psychology, Substance-Related Disorders, media_common.quotation_subject, Emotions, Applied psychology, 030508 substance abuse, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, Adaptation, Psychological, Substance misuse, medicine, Humans, 030212 general & internal medicine, media_common, Addiction, General Medicine, medicine.disease, Self Concept, Substance abuse, Conceptual framework, Personal Autonomy, Female, Substance Abuse Treatment Centers, 0305 other medical science, Psychology, Clinical psychology, Intrapersonal communication, Qualitative research
Abstract

Improvements to intrapersonal development of clients involved with substance use disorder treatment programs has widely been recognized as contributing to the intended goal of reducing substance misuse behaviors. This study sought to identify a broad framework of primary outcomes related to the intrapersonal development of clients in treatment for substance misuse.Using qualitative research methods, individual interviews were conducted with program participants (n = 41) at three treatment programs to identify the ways in which respondents experienced intrapersonal development through participation in treatment.The findings support the development of a conceptual model that captures the importance and manifestation of achieving improvements in the following outcomes: self-awareness, coping ability, self-worth, outlook, and self-determination.The findings provide a conceptual framework for client assessment that captures a broad range of the important intrapersonal development factors utilized as indicators for client development and recovery that should be measured in tandem during assessment.

Published
2017

30. A qualitative study exploring factors that influence enrollment in outpatient cardiac rehabilitation

Author

Kathryn King-Shier, Tavis S. Campbell, Codie R. Rouleau, Lianne Tomfohr-Madsen, Ross Arena, and Sandeep Aggarwal

Subjects
Adult, Male, Canada, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Decision Making, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Ambulatory Care, medicine, Humans, 030212 general & internal medicine, Acute Coronary Syndrome, Aged, Aged, 80 and over, Cardiac Rehabilitation, Rehabilitation, business.industry, Middle Aged, medicine.disease, Physical therapy, Female, Patient Participation, business, Qualitative research
Abstract

This study explored patients' decision-making about whether or not to enroll in cardiac rehabilitation (CR), an underutilized program that is associated with significantly improved health outcomes.Face-to-face interviews were conducted with acute coronary syndrome patients (n = 14) after referral to a local CR center, but prior to program enrollment. Thematic analysis was used to derive themes from interview transcripts.Three themes emerged including anticipated benefit, perceived ability, and contextual influences. Participants believed key benefits of CR would be access to specialist health care providers, improved longevity, reduced cardiovascular risk, as well as improved motivation, accountability, learning opportunities, and general fitness. Participants were concerned about their ability to engage in and travel to exercise sessions, pay the program fee, and manage scheduling conflicts. Contextual influences on decision-making included health care provider recommendation, first impressions of the CR center, knowledge gaps about what CR entails, input from family and peers, and psychological distress.The period following CR referral but prior to enrollment represents an optimal opportunity to promote in-the-moment decisions in favor of CR. Patients report both positive and negative aspects of CR, suggesting individualized efforts to resolve ambivalence may increase program participation. Implications for Rehabilitation Cardiovascular disease is a leading cause of mortality worldwide. Cardiac rehabilitation (CR) is an effective secondary prevention strategy to improve cardiovascular morbidity and mortality, but only a subset of eligible patients enroll. After referral but prior to enrollment, patients anticipate both positive and negative aspects of CR participation. Individualized efforts to resolve ambivalence, address knowledge gaps, and problem-solve barriers may increase uptake into CR programs.

Published
2016

31. Management of Juvenile Hallux Valgus Deformity: the role of combined Hemiepiphysiodesis

Author

Ting-Ming Wang, Ming-Hung Chiang, Ken N. Kuo, Shier-Chieg Huang, and Kuan-Wen Wu

Subjects
Male, Metatarsophalangeal Joint, medicine.medical_specialty, Percutaneous, lcsh:Diseases of the musculoskeletal system, Adolescent, medicine.medical_treatment, Radiography, Bone Screws, Arthrodesis, Osteotomy, Bunion, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Hemiepiphysiodesis, medicine, Deformity, Juvenile hallux valgus, Humans, Orthopedics and Sports Medicine, 030212 general & internal medicine, Hallux Valgus, Range of Motion, Articular, Hallux valgus angle, Intermetatarsal angle, Child, Reduction (orthopedic surgery), Valgus deformity, Retrospective Studies, 030222 orthopedics, Bone Development, biology, business.industry, Age Factors, biology.organism_classification, medicine.disease, Surgery, Valgus, Treatment Outcome, Orthopedic surgery, Female, medicine.symptom, lcsh:RC925-935, business, Epiphyses, Research Article, Follow-Up Studies
Abstract

BackgroundThis study aimed to investigate the efficacy of percutaneous hemiepiphysiodesis for gradual correction of symptomatic juvenile hallux valgus (HV) deformity.MethodsBetween 2012 to 2014, 24 patients with symptomatic juvenile HV were treated by combined percutaneous medial drilling hemiepiphysiodesis of the first proximal phalanx and lateral transphyseal screw hemiepiphysiodesis of the first metatarsal at our institution. Twenty-one of 24 patients fulfilled inclusion criteria had a complete radiological and clinical follow-up of at least 2 years. Preoperative and postoperative radiographs of the feet were reviewed for measurements of hallux valgus angle (HVA), intermetatarsal angle (IMA), proximal metatarsal articular angle (PMAA), proximal phalangeal articular angle (PPAA), and metatarsal length ratio (MTLR). Clinical outcomes were assessed using the AOFAS hallux metatarsophalangeal-interphalangeal score.ResultsThe study included 21 consecutive patients (37 ft) for analysis. The mean age at surgery was 12.0 years (SD = 1.3) and mean follow-up after surgery was 35.1 months (SD = 6.0). With the data available, the HV deformity improved in terms of the reduction of HVA by a mean of 4.7 degrees (P P P = .216) which was indicative of no length discrepancy between first and second metatarsals. The AOFAS score increased from 68.7 to 85.2 (P P = .003).ConclusionAlthough combined hemiepiphysiodesis does not create a large degree of correction as osteotomy, yet it did improve HV deformity with adequate growth remaining in our series. It is a procedure that can be of benefit to patients with symptomatic juvenile HV from this minimal operative approach before skeletal maturity.Level of evidenceLevel IV, retrospective case series.

Published
2019

32. Differences in placental capillary shear stress in fetal growth restriction may affect endothelial cell function and vascular network formation

Author

Shier Nee Saw, Win Min Tun, Choon Hwai Yap, Joanna L. James, and Alys R. Clark

Subjects
0301 basic medicine, Cell biology, Angiogenesis, Science, Placenta, Cell, Neovascularization, Physiologic, Biology, Article, Neovascularization, Andrology, 03 medical and health sciences, Fetus, 0302 clinical medicine, Pregnancy, Fetal growth, medicine, Shear stress, Humans, Fetal Growth Retardation, Multidisciplinary, Endothelial Cells, Computational biology and bioinformatics, Capillaries, Endothelial stem cell, 030104 developmental biology, medicine.anatomical_structure, Medicine, Gestation, Female, medicine.symptom, Structural biology, Shear Strength, 030217 neurology & neurosurgery
Abstract

Fetal growth restriction (FGR) affects 5–10% of pregnancies, leading to clinically significant fetal morbidity and mortality. FGR placentae frequently exhibit poor vascular branching, but the mechanisms driving this are poorly understood. We hypothesize that vascular structural malformation at the organ level alters microvascular shear stress, impairing angiogenesis. A computational model of placental vasculature predicted elevated placental micro-vascular shear stress in FGR placentae (0.2 Pa in severe FGR vs 0.05 Pa in normal placentae). Endothelial cells cultured under predicted FGR shear stresses migrated significantly slower and with greater persistence than in shear stresses predicted in normal placentae. These cell behaviors suggest a dominance of vessel elongation over branching. Taken together, these results suggest (1) poor vascular development increases vessel shear stress, (2) increased shear stress induces cell behaviors that impair capillary branching angiogenesis, and (3) impaired branching angiogenesis continues to drive elevated shear stress, jeopardizing further vascular formation. Inadequate vascular branching early in gestation could kick off this cyclic loop and continue to negatively impact placental angiogenesis throughout gestation.

Published
2019

33. Nonsymptomatic Factors More Strongly Associated with High-Quality End-of-Life Care than Symptomatic Factors for Community-Dwelling Older Adults with Multiple Chronic Conditions

Author

Gayle Shier Kricke, Donna M. Woods, Alicia Arbaje, and Neil Jordan

Subjects
Male, Gerontology, media_common.quotation_subject, Population, Logistic regression, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, 030502 gerontology, Odds Ratio, Humans, Medicine, Quality (business), Multiple Chronic Conditions, education, General Nursing, Aged, Quality of Health Care, Retrospective Studies, media_common, Aged, 80 and over, Terminal Care, education.field_of_study, business.industry, Palliative Care, Original Articles, General Medicine, Odds ratio, Confidence interval, Cross-Sectional Studies, Logistic Models, Anesthesiology and Pain Medicine, Patient Satisfaction, 030220 oncology & carcinogenesis, Quality of Life, Female, Independent Living, 0305 other medical science, business, End-of-life care, Cohort study
Abstract

Background: Information about end-of-life goals and preferences of older adults with multiple chronic conditions (MCCs) is scarce, but necessary for prioritizing resources to care for this population. Objective: The aim of this study was to determine which end-of-life quality domains are associated with excellent overall end-of-life care quality for older adults with MCCs. Design: This study involved retrospective cross-sectional cohort analysis of secondary data derived from the National Health and Aging Trends Study (NHATS), Last Month of Life Interview. Measurements: Weighted bivariable analyses determined unadjusted relationships between overall care quality and end-of-life care quality. Weighted unadjusted and adjusted multiple logistic regression tested the association of ratings of overall care quality with the perception of quality. Results: The final analytic sample included 477 NHATS participants (weighted: 1,123,887 participants). For older adults with MCC, the rating of overall care quality was positively associated with coordination (adjusted odds ratio [aOR] 4.49; 95% confidence interval [CI]: 1.85–10.86), shared decision making (aOR 1.97; 95% CI: 1.12–3.47), respect (aOR 6.36; 95% CI: 3.23–12.52), and spiritual and emotional support (aOR 2.02; 95% CI: 1.23–3.30). We found no significant association between the rating of overall care quality and symptom management (aOR 1.49; 95% CI: 0.81–2.71). Conclusion: Given that nonsymptomatic domains (coordination, shared decision making, respect, and spiritual and emotional support) were most associated with high-quality end-of-life care for older adults with MCC as rated by their proxies, increased attention is needed to strengthen these aspects of care. Symptom management was unrelated to the overall quality rating, and further research is needed to illuminate the meaning of this finding.

Published
2019

34. Protective behaviours of near work and time outdoors in myopia prevalence and progression in myopic children: a 2-year prospective population study

Author

Yiing Mei Liou, Pin Chen Huang, Ya Chuan Hsiao, Shier Chieg Huang, Chi Wen Chen, Chih Chien Hsu, Der Chong Tsai, Ching Yao Tsai, and Meng Hui Lin

Subjects
Male, medicine.medical_specialty, Work, Population, Taiwan, Child Behavior, Spherical equivalent, Refraction, Ocular, Cellular and Molecular Neuroscience, Leisure Activities, Risk Factors, Surveys and Questionnaires, Epidemiology, Activities of Daily Living, Myopia, Prevalence, Medicine, Near work, Humans, Prospective Studies, education, Child, Dioptre, education.field_of_study, business.industry, Vision Tests, Sensory Systems, Ophthalmology, Reading, Relative risk, Lower prevalence, Disease Progression, Population study, Female, business, Demography
Abstract

AimTo investigate the protective behaviours of longer near work distance, discontinuing near work and more time outdoors in recess from parent self-report in the myopia prevalence and progression among myopic children aged 9–11 years.MethodsMyopia Investigation study in Taipei is a longitudinal population-based study that enrolled elementary school students in Taipei. We provided vision and refraction examination every 6 months. Spherical equivalent (SE) of cycloplegic refraction ≤−0.50 Diopter (D) is defined as myopia. Total 10 743 (70.4%) students completed 2-year refraction data and questionnaire. The myopia prevalence and progression (difference of SE) in baseline, 6, 12, 18 and 24 months were compared by generalised estimating equations.ResultsChildren with persistent protective behaviour had significant lower prevalence of myopia. The protective impact was statistically significant from 6 to 24 months. In 2 years follow-up, risk ratio after adjusting the background variables and the other two behaviours in near work distance, near work time and outdoor time were 0.71, 0.89 and 0.77. In SE analysis, after adjusting the other two behaviours, near work distance >30 cm (−0.7 vs −1.04 D; p<0.001), discontinuing near work every 30 min (−0.77 vs −0.96 D, p=0.005) and more time outdoors in recess from parent self-report (−0.75 vs −0.98 D; p=0.012) revealed protective impacts on diminishing myopia progression from 6 to 24 months.ConclusionIn myopic children aged around 10 years in Taipei, longer distance in near work, discontinuing near work every 30 min and more outdoor time from parent self-report are protective behaviours in myopia prevalence and progression in 6–24 months.

Published
2019

35. Altered Placental Chorionic Arterial Biomechanical Properties During Intrauterine Growth Restriction

Author

Yu Wei Poh, Liying Yang, Arijit Biswas, Choon Hwai Yap, Citra Nurfarah Zaini Mattar, Alys R. Clark, Shier Nee Saw, Jess Jia Hwee Tay, Wei Ching Tan, and Lay Kok Tan

Subjects
medicine.medical_specialty, lcsh:Medicine, Intrauterine growth restriction, Pulse Wave Analysis, 030204 cardiovascular system & hematology, Models, Biological, Article, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Internal medicine, Placenta, Prevalence, medicine, Humans, Placental Circulation, lcsh:Science, reproductive and urinary physiology, Fetus, Fetal Growth Retardation, 030219 obstetrics & reproductive medicine, Multidisciplinary, biology, business.industry, lcsh:R, Hemodynamics, Arteries, Blood flow, medicine.disease, Biomechanical Phenomena, medicine.anatomical_structure, embryonic structures, Cardiology, Vascular resistance, biology.protein, lcsh:Q, Female, Chorionic Villi, business, Elastin
Abstract

Intrauterine growth restriction (IUGR) is a pregnancy complication due to placental dysfunction that prevents the fetus from obtaining enough oxygen and nutrients, leading to serious mortality and morbidity risks. There is no treatment for IUGR despite having a prevalence of 3% in developed countries, giving rise to an urgency to improve our understanding of the disease. Applying biomechanics investigation on IUGR placental tissues can give important new insights. We performed pressure-diameter mechanical testing of placental chorionic arteries and found that in severe IUGR cases (RI > 90th centile) but not in IUGR cases (RI < 90th centile), vascular distensibility was significantly increased from normal. Constitutive modeling demonstrated that a simplified Fung-type hyperelastic model was able to describe the mechanical properties well, and histology showed that severe IUGR had the lowest collagen to elastin ratio. To demonstrate that the increased distensibility in the severe IUGR group was related to their elevated umbilical resistance and pulsatility indices, we modelled the placental circulation using a Windkessel model, and demonstrated that vascular compliance (and not just vascular resistance) directly affected blood flow pulsatility, suggesting that it is an important parameter for the disease. Our study showed that biomechanics study on placenta could extend our understanding on placenta physiology.

Published
2018

36. Prevalence of Barriers and Facilitators to Enhancing Conservative Kidney Management for Older Adults in the Primary Care Setting

Author

Brenda R. Hemmelgarn, Robert R. Quinn, Karen Fruetel, Kathryn King-Shier, Chandra Thomas, Sara N. Davison, and Helen Tam-Tham

Subjects
Adult, Male, medicine.medical_specialty, Epidemiology, Cross-sectional study, Health Personnel, medicine.medical_treatment, Population, 030232 urology & nephrology, Conservative Treatment, Critical Care and Intensive Care Medicine, Health Services Accessibility, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, 030212 general & internal medicine, education, Dialysis, Aged, Response rate (survey), Geriatrics, Transplantation, education.field_of_study, Primary Health Care, business.industry, Geriatric nephrology, Behavior change, Original Articles, Middle Aged, Home Care Services, Confidence interval, Cross-Sectional Studies, Nephrology, Health Care Surveys, Family medicine, Physical therapy, Kidney Failure, Chronic, Female, Interdisciplinary Communication, Clinical Competence, Family Practice, business
Abstract

Background and objectives Conservative management of adults with stage 5 CKD (eGFR Design, setting, participants, & measurements In 2015, we conducted a cross–sectional, population–based survey of all primary care physicians in Alberta, Canada. Eligible participants had experience caring for adults ages ≥75 years old with stage 5 CKD not planning on initiating dialysis. Questionnaire items were on the basis of a qualitative descriptive study informed by the Behavior Change Wheel and tested for face and content validity. Physicians were contacted via postal mail and/or fax on the basis of a modified Dillman method. Results Four hundred nine eligible primary care physicians completed the questionnaire (9.6% response rate). The majority of respondents were men (61.6%), were ages 40–60 years old (62.6%), and practiced in a large/medium population center (68.0%). The most common barrier to providing conservative care in the primary care setting was the inability to access support to maintain patients in the home setting (39.1% of respondents; 95% confidence interval, 34.6% to 43.6%). The second most common barrier was working with nonphysician providers with limited kidney–specific clinical expertise (32.3%; 95% confidence interval, 28.0% to 36.7%). Primary care physicians indicated that the two most common strategies that would enhance their ability to provide conservative management would be the ability to use the telephone to contact a nephrologist or clinical staff from the conservative care clinic (86.9%; 95% confidence interval, 83.7% to 90.0% and 85.6%; 95% confidence interval, 82.4% to 88.9%, respectively). Conclusions We identified important areas to inform clinical programs to reduce barriers and enhance facilitators to improve primary care physicians’ provision of conservative kidney care. In particular, primary care physicians require additional resources for maintaining patients in their home and telephone access to nephrologists and conservative care specialists.

Published
2016

37. The comparative, long-term effect of the Salter osteotomy and Pemberton acetabuloplasty on pelvic height, scoliosis and functional outcome

Author

Ting-Ming Wang, Ken N. Kuo, Kuan-Wen Wu, Shier-Chieg Huang, and Cheng-Yi Wang

Subjects
Male, Pelvic tilt, medicine.medical_specialty, medicine.medical_treatment, Scoliosis, Osteotomy, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Lumbar, medicine, Humans, Orthopedics and Sports Medicine, Child, Pelvic Bones, Hip Dislocation, Congenital, 030222 orthopedics, Cobb angle, business.industry, Acetabulum, Lumbar Curve, medicine.disease, Body Height, Leg Length Inequality, Surgery, Harris Hip Score, Female, Acetabuloplasty, business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

Aims This study compared the long-term results following Salter osteotomy and Pemberton acetabuloplasty in children with developmental dysplasia of the hip (DDH). We assessed if there was a greater increase in pelvic height following the Salter osteotomy, and if this had a continued effect on pelvic tilt, lumbar curvature or functional outcomes. Patients and Methods We reviewed 42 children at more than ten years post-operatively following a unilateral Salter osteotomy or Pemberton acetabuloplasty. We measured the increase in pelvic height and the iliac crest tilt and sacral tilt at the most recent review and at an earlier review point in the first decade of follow-up. We measured the lumbar Cobb angle and the Short Form-36 (SF-36) and Harris hip scores were collected at the most recent review. Results During the first decade of follow-up, there was a greater increase in pelvic height in the children who had a Salter osteotomy (Salter, 10.1%; Pemberton, 4.3%, p < 0.001). The difference in the increase in pelvic height was insignificant at the most recent review (Salter, 4.4%; Pemberton, 3.1%, p = 0.249). There was no significant difference between the two groups for the lumbar Cobb angle, (Salter, 3.1°; Pemberton, 3.3°, p = 0.906). A coronal lumbar curve was seen in 41 children (97%), 30 of these had a compensatory curve. Sacral tilt was the radiographic parameter for pelvic imbalance that correlated most with the lumbar Cobb angle (Pearson correlation co-efficient 0.59). The Harris hip score and SF-36 were good and showed no differences between the two groups. Conclusion In the long-term, we found no difference in the functional results or pelvic imbalance between Salter osteotomy and Pemberton acetabuloplasty in the management of children with DDH. Cite this article: Bone Joint J 2016;98-B:1145–50.

Published
2016

38. The Ambulatory Integration of the Medical and Social (AIMS) model: A retrospective evaluation

Author

Victoria M. Rizzo, Jeannine M. Rowe, Grisel Rodriguez-Morales, Gayle Shier Kricke, Robyn Golden, Kate Krajci, and Michelle Newman

Subjects
Male, Social Work, Patient Readmission, 03 medical and health sciences, 0302 clinical medicine, Ambulatory care, Health care, medicine, Humans, 030212 general & internal medicine, Referral and Consultation, Aged, Retrospective Studies, Aged, 80 and over, Community and Home Care, 030505 public health, Social work, Population statistics, business.industry, Retrospective cohort study, Emergency department, Continuity of Patient Care, Health Services, Middle Aged, medicine.disease, Ambulatory care nursing, Psychiatry and Mental health, Socioeconomic Factors, Ambulatory, Female, Medical emergency, Health Expenditures, Emergency Service, Hospital, 0305 other medical science, business
Abstract

An exploratory, retrospective evaluation of Ambulatory Integration of the Medical and Social (AIMS), a care coordination model designed to integrate medical and non-medical needs of patients and delivered exclusively by social workers was conducted to examine mean utilization of costly health care services for older adult patients. Results reveal mean utilization of 30-day hospital readmissions, emergency department (ED) visits, and hospital admissions are significantly lower for the study sample compared to the larger patient population. Comparisons with national population statistics reveal significantly lower mean utilization of 30-day admissions and ED visits for the study sample. The findings offer preliminary support regarding the value of AIMS.

Published
2016

39. Loading rates during walking in adolescents with type II osteonecrosis secondary to pelvic osteotomy

Author

Ken N. Kuo, Tung-Wu Lu, Ching‐Ru Chen, Shier-Chieg Huang, Shih-Wun Hong, Kuan-Wen Wu, and Ting-Ming Wang

Subjects
Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Walking, medicine.disease_cause, Osteotomy, Weight-bearing, Weight-Bearing, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, medicine, Humans, Orthopedics and Sports Medicine, In patient, Ground reaction force, Child, Hip Dislocation, Congenital, Retrospective Studies, Valgus deformity, 030222 orthopedics, business.industry, Osteonecrosis, Infant, Retrospective cohort study, medicine.disease, Gait, Surgery, Female, Joints, business, Pelvic osteotomy, 030217 neurology & neurosurgery
Abstract

Although Pemberton osteotomy has shown a high success rate even in older children, the occurrence of osteonecrosis (ON) remains one of the most severe complications, leading to premature osteoarthritis. Patients with type II ON are characterized by a valgus deformity of the proximal femur with altered musculoskeletal conditions, affecting the ability to attenuate or sustain the impulsive loading from the ground reaction force. It remains unclear whether these conditions also predispose these patients to harmful impulsive loadings. This study aimed to bridge the gap by measuring the loading rates in the lower limbs during level walking in adolescents who were treated during their infancy for unilateral developmental dysplasia of the hip by a pelvic osteotomy, with or without having developed type II ON. Patients with type II ON were found to display increased loading rates, not only at both the affected and unaffected hip, but also at other joints of the affected limb during level walking when compared to patients without ON changes (p

Published
2016

40. Low-Dose Ketamine Infusions for Highly Opioid-Tolerant Adults Following Spinal Surgery: A Retrospective Before-and-after Study

Author

Patrycja R. Vaid, Theresa Green, Kathryn King-Shier, and Kelly Shinkaruk

Subjects
Adult, Male, medicine.medical_treatment, Population, Drug Administration Schedule, law.invention, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, 030202 anesthesiology, law, medicine, Humans, Ketamine, Young adult, Infusions, Intravenous, Adverse effect, education, Aged, Pain Measurement, Retrospective Studies, Aged, 80 and over, Advanced and Specialized Nursing, Analgesics, Pain, Postoperative, education.field_of_study, business.industry, Trauma center, Retrospective cohort study, Middle Aged, Analgesics, Opioid, Spinal Fusion, Treatment Outcome, Anesthesia, Spinal fusion, Female, business, 030217 neurology & neurosurgery, medicine.drug
Abstract

Managing acute-on-chronic pain in opioid-tolerant individuals is complex and challenging; exploring new analgesia regimens for this population is essential. Ketamine is an N-methyl D-aspartate antagonist that blocks transmission of painful stimuli and could be a useful medication for this patient population. A new low-dose ketamine protocol as an adjunct to conventional pain therapy was implemented in a major urban Level 1 trauma center in Canada. A retrospective before-and-after chart review was conducted to explore the research question, "What is the effect of low-dose ketamine continuous intravenous infusions on pain of highly opioid-tolerant adults following spinal surgery?". All patients had spine surgery, used a minimum of 100 mg daily oral morphine equivalent preoperatively and were followed postoperatively by the hospital's Acute Pain Service. Data from individuals treated with conventional therapy during the year prior to protocol implementation were compared with data from patients who received conventional therapy plus ketamine post implementation. Outcome measures included pain scores and daily opioid consumption on postoperative days 0 through 5, time to ambulation, time to discharge, and adverse effects. There were no statistically significant differences between conventional therapy and conventional therapy plus ketamine. Ketamine may still be of benefit to patients with acute-on-chronic pain, although this was not evident in this study. Future research using more robust assessment tools to determine effectiveness of ketamine is required.

Published
2016

41. Primary care physicians’ perceived barriers, facilitators and strategies to enhance conservative care for older adults with chronic kidney disease: a qualitative descriptive study

Author

Karen Fruetel, Kathryn King-Shier, Chandra Thomas, Brenda R. Hemmelgarn, David J.T. Campbell, Helen Tam-Tham, and Robert R. Quinn

Subjects
Adult, Male, medicine.medical_specialty, Attitude of Health Personnel, 030232 urology & nephrology, Alternative medicine, Primary care, Conservative Treatment, Physicians, Primary Care, Alberta, 03 medical and health sciences, 0302 clinical medicine, Clinical pathway, Acquired immunodeficiency syndrome (AIDS), medicine, Humans, 030212 general & internal medicine, Renal Insufficiency, Chronic, Qualitative Research, Aged, Transplantation, Primary Health Care, business.industry, Qualitative descriptive, Middle Aged, medicine.disease, Snowball sampling, Nephrology, Health Care Surveys, Family medicine, Female, Clinical Competence, Guideline Adherence, business, Kidney disease, Qualitative research
Abstract

Background Although primary care physicians (PCPs) are often responsible for the routine care of older adults with chronic kidney disease (CKD), there is a paucity of evidence regarding their perspectives and practice of conservative (non-dialysis) care. We undertook a qualitative study to describe barriers, facilitators and strategies to enhance conservative, non-dialysis, CKD care by PCPs in the community. Methods Semi-structured telephone and face-to-face interviews were conducted with PCPs from Alberta, Canada. Participants were identified using a snowball sampling strategy and purposively sampled based on sex, age and rural/urban location of clinical practice. Eligible participants had managed at least one patient ≥75 years with Stage 5 CKD (estimated glomerular filtration rate Results In total, 27 PCPs were interviewed. The majority were male (15/27), were aged 40-60 years (15/27) and had practiced in primary care for >20 years (14/27). Perceived barriers to conservative CKD care included: managing expectations of kidney failure for patients and their families; dealing with the complexity of medical management of patients requiring conservative care; and challenges associated with managing patients jointly with specialists. Factors that facilitated conservative CKD care included: establishing patient/family expectations early; preserving continuity of care; and utilizing a multidisciplinary team approach. Suggested strategies for improving conservative care included having: direct telephone access to clinicians familiar with conservative care; treatment decision aids for patients and their families; and a conservative care clinical pathway to guide management. Conclusions PCPs identified important barriers and facilitators to conservative care for their older patients with Stage 5 CKD. Further investigation of potential strategies that address barriers and enable facilitators is required to improve the quality of conservative care for older adults in the community.

Published
2015

42. Successful Management of Papular Acantholytic Dyskeratosis Using Carbon Dioxide Laser: A Case Report and Literature Review

Author

Adrienne L.K. Li, Matthew Cesari, and R. Michael Shier

Subjects
Adult, medicine.medical_specialty, business.industry, medicine.medical_treatment, Treatment outcome, Obstetrics and Gynecology, General Medicine, Carbon Dioxide, Carbon dioxide laser, Perineum, Skin Diseases, Dermatology, 030207 dermatology & venereal diseases, 03 medical and health sciences, Treatment Outcome, 0302 clinical medicine, 030220 oncology & carcinogenesis, Humans, Medicine, Female, Laser Therapy, Acantholytic dyskeratosis, business
Published
2017

43. Correction to: Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Author

Griffiths, E. A., Hodson, J., Vohra, R. S., Marriott, P., Katbeh, T., Zino, S., Nassar, A. H. M., Kirkham, A. J., Pasquali, S., Johnstone, M., Spreadborough, P., Alderson, D., Fenwick, S., Elmasry, M., Nunes, Q. M., Kennedy, D., Khan, R. B., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Haque, S. U., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P. B., Lee, K., Joji, N., Lambert, J., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., Mcnair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C. -B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., W. -M., Ho, Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al-Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., Mccallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D. M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Mockford, J. D. K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Rodriguez, D. U., Sen, G., Robinson, S., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Hornby, R. S. S. T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Bajwa, D. S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Mohamed, S. L. S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Iqbal, L. G. N., Watson, N. F., Aggarwal, S. K., Orchard, P., Villatoro, E., Willson, P. D., Mok, K. W. J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., O'Shea, K. M., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O'Reilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Guy Finch, J., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al-Khyatt, W., Bhandari, C. T. S., Subramanium, D., Toh, S. K. C., Carter, N. C., Tate, S., Pearce, B., Wainwright, D., Mercer, S. J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A. K., Basu, S., Harilingam, A. C. M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho-Gomes, A. C., Kausar, A., Obeidallah, M. R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Goh, Y. L., Turner, P., Shetty, V., Riera, M., Macano, C. A. W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., Mcglone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Amari, K. A., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B. S., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A. Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P. A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R. C., Hebbar, M., Farag, S. F., Spearman, J., Hamdan, M. F., D'Costa, C., Blane, C., Giles, M., Peter, M. B., Hirst, N. A., Hossain, T., El-Dhuwaib, A. P. Y., Morrison, T. E. M., Taylor, G. W., Thompson, R. L. E., Mccune, K., Loughlin, P., Lawther, R., Byrnes, C. K., Simpson, D. J., Mawhinney, A., Warren, C., Mckay, D., Mcilmunn, C., Martin, S., Macartney, M., Diamond, T., Davey, P., Jones, C., Clements, J. M., Digney, R., Chan, W. M., Mccain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., Mcaree, B., Ghareeb, E., Thomas, G., Connelly, M., Mckenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A. D. K., Cassidy, J. T., Boland, M., Burke, P., Nally, D. M., Khogali, E., Shabo, W., Iskandar, E., Mcentee, G. P., O'Neill, M. A., Peirce, C., Lyons, E. M., O'Sullivan, A. W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D. C., Kelly, M. E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J. G., Mcdermott, F., Martin, S. T., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Ullah, M. F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A. M., Vaughan, E. M., Ramage, M. I., Aldridge, R. C., Gibson, S., Nicholson, G. A., Vass, D. G., Grant, A. J., Holroyd, D. J., Angharad Jones, M., Sutton, C. M. L. R., O'Dwyer, P., Nilsson, F., Weber, B., Williamson, T. K., Lalla, K., Bryant, A., Ross Carter, C., Forrest, C. R., Hunter, D. I., Nassar, A. H., Orizu, M. N., Knight, K., Qandeel, H., Suttie, S., Belding, R., Mcclarey, A., Boyd, A. T., Guthrie, G. J. K., Lim, P. J., Luhmann, A., Watson, A. J. M., Richards, C. H., Nicol, L., Madurska, M., Harrison, E., Boyce, K. M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M. S. J., Dalgaty, F., Fothergill, L., Driscoll, P. J., Mozolowski, K. L., Banwell, V., Bennett, S. P., Rogers, P. N., Skelly, B. L., Rutherford, C. L., Mirza, A. K., Lazim, T., Lim, H. C. C., Duke, D., Ahmed, T., Beasley, W. D., Wilkinson, M. D., Maharaj, G., Malcolm, C., Brown, T. H., Al-Sarireh, B., Shingler, G. M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D. J., Baker, A. L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J. A., Singh-Ranger, D., Hisham, E., Ainley, P., John Terrace, S. O. N., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., Mcguigan, A., Shahin, Y., Aymon, Luther, A. A., Nicholson, J. A., Rajendran, I., Boal, M., and Ritchie, J.

Subjects
Adult, Male, operative difficulty, medicine.medical_specialty, MEDLINE, cholecystectomy, difficulty grading, laparoscopic, Surgery, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Internal medicine, medicine, Humans, Prospective Studies, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Laparoscopic cholecystectomy, Aged, business.industry, General surgery, Correction, Hepatology, Length of Stay, Middle Aged, Conversion to Open Surgery, Cholecystectomy, Laparoscopic, ROC Curve, 030220 oncology & carcinogenesis, Multivariate Analysis, 030211 gastroenterology & hepatology, Female, business, Grading scale, Abdominal surgery
Abstract

A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets.Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall's tau for dichotomous variables, or Jonckheere-Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis.A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p 0.001).We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty.

Published
2018

44. Ethnocultural influences in how people prefer to obtain and receive health information

Author

Simran Johal, Alyssa Lau, Kathryn King-Shier, Pamela LeBlanc, and Sunny Fung

Subjects
Adult, Male, Canada, media_common.quotation_subject, Population, Ethnic group, Emigrants and Immigrants, White People, Access to Information, 03 medical and health sciences, 0302 clinical medicine, Asian People, Ethnicity, Humans, Relevance (information retrieval), 030212 general & internal medicine, education, Health communication, General Nursing, Minority Groups, media_common, Aged, Aged, 80 and over, Medical education, education.field_of_study, Cultural Characteristics, 030504 nursing, Information Dissemination, Specific-information, General Medicine, Focus Groups, Middle Aged, Focus group, Jargon, Female, 0305 other medical science, Psychology, Diversity (politics)
Abstract

Aims and objectives To develop an understanding of south Asian and Chinese people's preferences about where to find health information and how best to receive health information, relative to their white counterparts. Background South Asian and Chinese ethnic groups represent the largest proportion of Canada's growing visible minorities. There may be challenges to ensuring that south Asian and Chinese people have access to health information in the same way that others do. Design Qualitative descriptive. Methods Fifty-two participants (12 white, 16 south Asian and 24 Chinese) engaged in six focus groups (two for each ethnocultural group). Focus groups were conducted in English, Punjabi and Cantonese, with the assistance of Punjabi and Cantonese interpreters. Questions were focused on how participants have preferred or would prefer to receive health information (e.g., when, where, what format, from whom), as well as the facilitators and barriers to understanding the health information. Results Participants agreed that although physicians were their primary source for health information, they also used written materials, media and the Internet to glean information. Participants identified concerns regarding the use of technical jargon by healthcare providers. South Asians and Chinese referred to their English language fluency and the lack of ethnoculturally specific information as additional challenges to understanding information they were offered. Whether and how family members were included in the communication process, also varied by ethnocultural group. Conclusions As Canada welcomes immigrants from other countries, and its population becomes more diverse, healthcare providers need to have an understanding of the potential diversity in how to approach offering health information. Relevance to clinical practice Healthcare providers need to consider what people of different ethnocultural backgrounds need when developing effective health communication strategies.

Published
2018

45. The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Author

Bharamgoudar, R., Sonsale, A., Hodson, J., Griffiths, E., Vohra, R.S., Kirkham, A.J., Pasquali, S., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Griffiths, E.A., Fenwick, S., Elmasry, M., Nunes, Q.M., Kennedy, D., Khan, R.B., Khan, M.A.S., Magee, C.J., Jones, S.M., Mason, D., Parappally, C.P., Mathur, P., Saunders, M., Jamel, S., Haque, S.U., Zafar, S., Shiwani, M.H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R.S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P.B., Lee, K., Joji, N., Lambert, J., Heath, J., Teasdale, R.L., Weerasinghe, C., Needham, P.J., Welbourn, H., Forster, L., Finch, D., Blazeby, J.M., Robb, W., McNair, A.G.K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C.-B., Jayanthi, N.V.G., Noor, N., Dobbins, B., Cockbain, A.J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J.B., Ho, W.-M., Miu, V., White, T.J., Hodgkins, K.A., Kinghorn, A., Tutton, M.G., Al-Abed, Y.A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L.J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S.J., McCallum, I.J.D., Jones, M.J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K.B., Kimble, A., Bunting, D.M., Fawole, A.S., Basheer, M., Dave, R.V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M.P., Gough, M., Wallace, T., Singh, S., Mockford, J.D.K.A., Issa, E., Shah, N., Chauhan, N., Wilson, T.R., Forouzanfar, A., Wild, J.R.L., Nofal, E., Bunnell, C., Madbak, K., Rao, S.T.V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J.C., Gould, L., Chambers, A., Rodriguez, D.U., Sen, G., Robinson, S., Bartlett, F., Rae, D.M., Stevenson, T.E.J., Sarvananthan, K., Dwerryhouse, S.J., Higgs, S.M., Old, O.J., Hardy, T.J., Shah, R., Hornby, S.T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E.A., Frame, R.J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T.O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W.S., Fleming, K., Bajwa, D.S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M.A., Bellini, M.I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Giwa, L., Iqbal, N., Watson, N.F., Aggarwal, S.K., Orchard, P., Villatoro, E., Willson, P.D., Mok, K.W.J., Woodman, T., Deguara, J., Garcea, G., Babu, B.I., Dennison, A.R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J.P., Jones, R.P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M.M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S.R., Sampat, K., O?shea, K.M., Manu, M., Asprou, F.M., Malik, N.S., Chang, J., Lewis, M., Roberts, G.P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O?Reilly, D.A., Rate, A.J., Sekhar, H., Henderson, L.T., Starmer, B.Z., Coe, P.O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A.E.J., Borowski, D.W., Hornsby, J., Courtney, M.J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P.V., Reid, A., Wood, P., Finch, J.G., Guy Finch, J., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F.M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D.R., Al-Khyatt, W., Taylor, C., Bhandari, S., Subramanium, D., Toh, S.K.C., Carter, N.C., Tate, S., Pearce, B., Wainwright, D., Mercer, S.J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S.S., Hussain, A.A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M.N., Chishti, I.A., Fordham, I.J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A.K., Basu, S., Chhabra, A., Harilingam, M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S.F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M.I., Ball, W.R., Wood, C.P.J., Pinho-Gomes, A.C., Kausar, A., Obeidallah, M.R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S.Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M.R., Goh, Y.L., Turner, P., Shetty, V., Riera, M., Macano, C.A.W., Sukha, A., Preston, S.R., Hoban, J.R., Puntis, D.J., Williams, S.V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G.H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R.T., Sheel, A.R.G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., McGlone, E.R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D.A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C.R., Yeldham, G., Read, E., Gossage, J.A., Rolph, R.C., Ebied, H., Phull, M., Khan, M.A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J.R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N.A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A.R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J.P., Pearson, K.L., Delisle, T.G., Davies, J., Tomlinson, M.A., Johnpulle, M.A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B.S., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A.Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P.A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R.C., Hebbar, M., Farag, S.F., Spearman, J., Hamdan, M.F., D?Costa, C., Blane, C., Giles, M., Peter, M.B., Hirst, N.A., Hossain, T., Pannu, A., El-Dhuwaib, Y., Morrison, T.E.M., Taylor, G.W., Thompson, R.L.E., McCune, K., Loughlin, P., Lawther, R., Byrnes, C.K., Simpson, D.J., Mawhinney, A., Warren, C., McKay, D., McIlmunn, C., Martin, S., MacArtney, M., Diamond, T., Davey, P., Jones, C., Clements, J.M., Digney, R., Chan, W.M., McCain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., McAree, B., Ghareeb, E., Thomas, G., Connelly, M., McKenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A.D.K., Cassidy, J.T., Boland, M., Burke, P., Nally, D.M., Khogali, E., Shabo, W., Iskandar, E., McEntee, G.P., O?Neill, M.A., Peirce, C., Lyons, E.M., O?Sullivan, A.W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D.C., Kelly, M.E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J.G., McDermott, F., Martin, S.T., Cross, K.S., Cooke, F., Zeeshan, S., Murphy, J.O., Mealy, K., Mohan, H.M., Nedujchelyn, Y., Ullah, M.F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A.M., Vaughan, E.M., Ramage, M.I., Aldridge, R.C., Gibson, S., Nicholson, G.A., Vass, D.G., Grant, A.J., Holroyd, D.J., Jones, M.A., Sutton, C.M.L.R., O?Dwyer, P., Nilsson, F., Weber, B., Williamson, T.K., Lalla, K., Bryant, A., Carter, C.R., Forrest, C.R., Hunter, D.I., Nassar, A.H., Orizu, M.N., Knight, K., Qandeel, H., Suttie, S., Belding, R., McClarey, A., Boyd, A.T., Guthrie, G.J.K., Lim, P.J., Luhmann, A., Watson, A.J.M., Richards, C.H., Nicol, L., Madurska, M., Harrison, E., Boyce, K.M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M.S.J., Dalgaty, F., Fothergill, L., Driscoll, P.J., Mozolowski, K.L., Banwell, V., Bennett, S.P., Rogers, P.N., Skelly, B.L., Rutherford, C.L., Mirza, A.K., Lazim, T., Lim, H.C.C., Duke, D., Ahmed, T., Beasley, W.D., Wilkinson, M.D., Maharaj, G., Malcolm, C., Brown, T.H., Al-Sarireh, B., Shingler, G.M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D.J., Baker, A.L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J.A., Singh-Ranger, D., Hisham, E., Ainley, P., O?Neill, S., Terrace, J., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece-Bolton, O., McGuigan, A., Shahin, Y., Aymon, Luther, A.A., Nicholson, J.A., Rajendran, I., Boal, M., and Ritchie, J.

Subjects
Adult, Male, Scoring tool, medicine.medical_specialty, Patient factors, medicine.medical_treatment, Operative Time, Operative duration, 030230 surgery, Logistic regression, Article, patient factors, 03 medical and health sciences, Laparoscopic cholecystectomy, 0302 clinical medicine, Patient satisfaction, 030202 anesthesiology, Interquartile range, medicine, Humans, theatre utilisation, Propensity Score, Aged, Framingham Risk Score, Receiver operating characteristic, business.industry, prediction, Middle Aged, operative duration, Cholecystectomy, Laparoscopic, ROC Curve, scoring tool, Centre for Surgical Research, Elective Surgical Procedures, Theatre utilisation, Emergency medicine, Cohort, Propensity score matching, Female, Surgery, Cholecystectomy, Prediction, business
Abstract

Background The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p 90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care.

Published
2018

46. Hyperelastic Mechanical Properties of Ex Vivo Normal and Intrauterine Growth Restricted Placenta

Author

Citra Nurfarah Zaini Mattar, May Han Huang Ong, Shier Nee Saw, Choon Hwai Yap, Yu Wei Poh, Arijit Biswas, and Jess Yi Ru Low

Subjects
Adult, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Placenta, Biomedical Engineering, Intrauterine growth restriction, Placental insufficiency, Models, Biological, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Internal medicine, medicine, Humans, reproductive and urinary physiology, 030219 obstetrics & reproductive medicine, Fetal Growth Retardation, medicine.diagnostic_test, business.industry, medicine.disease, Normal placenta, Placental Insufficiency, female genital diseases and pregnancy complications, medicine.anatomical_structure, Hyperelastic material, embryonic structures, Cardiology, Elasticity Imaging Techniques, Female, Elastography, business, Ex vivo
Abstract

Intrauterine Growth Restriction (IUGR) is a serious and prevalent pregnancy complication that is due to placental insufficiency and IUGR babies suffer significantly higher risks of mortality and morbidity. Current detection rate for IUGR is generally poor and thus an alternative diagnostic tool is needed to improve the IUGR detection. Elastography, a non-invasive method that measures the tissue stiffness, has been proposed as one such technique. However, to date, we have limited information on the mechanical properties of IUGR placenta. In this study, we investigated the mechanical properties of normal and IUGR placentae and prescribed a suitable hyperelastic model to describe their mechanical behaviors. A total of 46 normal and 43 IUGR placenta samples were investigated. Results showed that placenta samples were isotropic, but had a high spatial variability of stiffness. The samples also had significant viscoelasticity. IUGR placenta was observed to be slightly stiffer than normal placenta but the difference was significant only at compression rate of 0.25 Hz and with 20% compression depth. Three simple hyperelastic models—Yeoh, Ogden and Fung models, were found to be able to fit the experimentally measured mechanical behaviors, and Fung model performed slightly better. These results may be useful for optimizing placenta elastography for the detection of IUGR.

Published
2017

47. Pronator Teres Transfer for Forearm and Wrist Deformity in Cerebral Palsy Children

Author

Shier-Chieg Huang, Jeng-Yi Shieh, Kuan-Wen Wu, Ken N. Kuo, Jimmy J.T. Ho, and Ting-Ming Wang

Subjects
Male, medicine.medical_specialty, Contracture, Modified Ashworth scale, Taiwan, Wrist, Cerebral palsy, Physical medicine and rehabilitation, Forearm, Wrist flexion contracture, medicine, Spastic, Humans, Orthopedics and Sports Medicine, Postoperative Period, Range of Motion, Articular, Child, Muscle, Skeletal, Retrospective Studies, Hand Strength, business.industry, Cerebral Palsy, Gross Motor Function Classification System, Recovery of Function, General Medicine, medicine.disease, Surgery, body regions, Treatment Outcome, medicine.anatomical_structure, Tissue Transplantation, Pediatrics, Perinatology and Child Health, Female, Range of motion, business
Abstract

BACKGROUND Forearm pronation and wrist flexion contracture can be a disability for daily living care and 2-hand function in cerebral palsy (CP) children. It may be beneficial to improve their posture and hand-grip power for better functional outcome. The purpose of our study was to investigate the outcome of pronator transfer in CP children. METHODS Seventeen spastic CP patients (14 hemiplegic, 3 diplegic; 14 male, 3 female; mean age, 12 y 5 mo) underwent pronator teres transfer for forearm pronation and wrist flexion contractures. The mean follow-up period was 46 months. We recorded Gross Motor Function Classification System level, modified Ashworth scale, forearm and wrist range of motion, forearm resting position, grip power, and 3 basic daily living skills preoperatively and postoperatively. Paired t test was used for statistical analysis. RESULTS The average forearm active supination gained 80.9 degrees (P

Published
2015

48. Neighborhood Environment and Children's Physical Activity and Body Mass Index: Evidence from Military Personnel Installation Assignments

Author

Ashlesha Datar, Nancy Nicosia, Elizabeth Wong, and Victoria Shier

Subjects
Male, Parents, Gerontology, Pediatric Obesity, Multivariate statistics, Adolescent, Adolescent Nutritional Physiological Phenomena, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Health Behavior, Level design, Motor Activity, complex mixtures, Body Mass Index, Developmental psychology, Residence Characteristics, Perception, Humans, Child, Exercise, media_common, Nutrition and Dietetics, Original Articles, equipment and supplies, Military personnel, Military Personnel, Socioeconomic Factors, Walkability, Pediatrics, Perinatology and Child Health, Military Family, bacteria, Environment Design, Female, Energy Intake, Psychology, Relocation, Body mass index, Follow-Up Studies
Abstract

The majority of existing studies use observed, rather than experimental or quasi-experimental, variation in individuals' neighborhood environments to study their influence on body weight and related behaviors.This study leverages the periodic relocation of military personnel to examine the relationship between neighborhood environment and children's physical activity (PA) and BMI in military families.This study utilizes data on 12- and 13-year-old children from the Military Teenagers Environments, Exercise, and Nutrition Study (N=903). Multivariate regression models are estimated, separately for families living on- and off-post, to examine the relationship between parents' perceptions of the neighborhood environment, measured using the Neighborhood Environment Walkability Scale-Youth Version (NEWS-Y), and children's self-reported PA and BMI.Different features of the neighborhood environment were significant for off- versus on-post families. For children living off-post, a 1 standard deviation (SD) increase in the proximity-to-recreational-facilities subscale was associated with 16.5 additional minutes per week (p0.05) of moderate PA (MPA), but street connectivity had a significant negative association with vigorous activity. For children living on-post, a 1 SD increase on the crime safety subscale was associated with 22.9 additional minutes per week (p0.05) of MPA. None of the NEWS-Y subscales were associated with children's BMI.Efforts to increase children's PA in military families should take into account that different aspects of the neighborhood environment matter for children living on- versus off-post.

Published
2015

49. A secondary meta-synthesis of qualitative studies of gender and access to cardiac rehabilitation

Author

Kathryn King-Shier, Alexander M. Clark, Susan B. Jaglal, Amanda S. Duncan, James A. Stone, Melisa A. Spaling, and Jan E. Angus

Subjects
Male, Gerontology, Rehabilitation, Heart Diseases, Referral, medicine.medical_treatment, CINAHL, Health Services Accessibility, Data extraction, medicine, Humans, Gender analysis, Female, Psychology, Inclusion (education), Socioeconomic status, General Nursing, Qualitative research, Clinical psychology
Abstract

Aims To discuss issues in the theorization and study of gender observed during a qualitative meta-synthesis of influences on uptake of secondary prevention and cardiac rehabilitation services. Background Women and men can equally benefit from secondary prevention/cardiac rehabilitation and there is a need to understand gender barriers to uptake. Design Meta-method analysis secondary to meta-synthesis. For the meta-synthesis, a systematic search was performed to identify and retrieve studies published as full papers during or after 1995 and contained: a qualitative research component wholly or in a mixed method design, extractable population specific data or themes for referral to secondary prevention programmes and adults ≥18 years. Data sources Databases searched between January 1995–31 October 2011 included: CSA Sociological Abstracts, EBSCOhost CINAHL, EBSCOhost Gender Studies, EBSCOhost Health Source Nursing: Academic Edition, EBSCOhost SPORTDiscus, EBSCOhost SocINDEX. Review methods Studies were reviewed against inclusion/exclusion criteria. Included studies were subject to quality appraisal and standardized data extraction. Results Of 2264 screened articles, 69 were included in the meta-method analysis. Only four studies defined gender or used gender theories. Findings were mostly presented as inherently the characteristic of gendered worldviews of participants. The major themes suggest a mismatch between secondary prevention/cardiac rehabilitation services and consumers’ needs, which are usually portrayed as differing according to gender but may also be subject to intersecting influences such as age or socioeconomic status. Conclusion There is a persistent lack of theoretically informed gender analysis in qualitative literature in this field. Theory-driven gender analysis will improve the conceptual clarity of the evidence base for gender-sensitive cardiac rehabilitation programme development.

Published
2015

50. Factors influencing medication adherence in South Asian people with cardiac disorders: An ethnographic study

Author

Kathryn King-Shier, Twyla A Ens, Charlotte Jones, and Cydnee Seneviratne

Subjects
Male, medicine.medical_specialty, Asia, Heart Diseases, Population, Ethnic group, Pharmacy, Disease, Alberta, Nursing, Health care, Ethnography, medicine, Humans, education, General Nursing, Aged, education.field_of_study, business.industry, Communication Barriers, Middle Aged, Family medicine, Patient Compliance, Female, Thematic analysis, business, Cultural competence
Abstract

Background South Asians experience higher rates of cardiovascular disease than any other ethnic group. Some evidence suggests that South Asians may be less adherent to cardiac medication regimens than Whites residing in Canada. Identification of the key factors contributing to adherence may assist this growing population to optimize their cardiac health. Aim To explore key factors associated with adherence to cardiac medications among South Asian people with cardiac disease. Methods Ethnography was used to highlight population specific themes and domains related to medication adherence. Ethnographic observations were undertaken of patients, as well as their family (primary care) physicians and pharmacists (including their staff), while in physician offices and pharmacies. A purposive sample of patients ( n =8), as well as physicians ( n =3) and pharmacists ( n =2) underwent in-depth interviews. Field note and interview data were transcribed verbatim and analyzed using ethnographic domain and thematic analysis. Results The patients relied on family members for instrumental support in remaining adherent with their medications. Relationships with healthcare professionals who demonstrated clear communication and cultural awareness was associated with enhanced medication adherence. Memory mechanisms needed to be individualized and were generally ‘low technology'. While prepackaging of medications enhanced adherence, patients who used them were less knowledgeable about their medications. Conclusions Healthcare providers should understand the importance of including family members in the care of South Asian people with heart disease. They also need to appreciate that the quality of provider–patient relationships are important to South Asian patients and will influence adherence to healthcare regimens. Expanding the role of nurse in the primary healthcare team could provide a cost-effective means of enhancing medication adherence.

Published
2014

Catalog

Books, media, physical & digital resources
See catalog results