49 results on '"Brassey J"'
Search Results
2. Viral cultures for assessing fomite transmission of SARS-CoV-2: a systematic review and meta-analysis
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Onakpoya, I.J., primary, Heneghan, C.J., additional, Spencer, E.A., additional, Brassey, J., additional, Rosca, E.C., additional, Maltoni, S., additional, Plüddemann, A., additional, Evans, D.H., additional, Conly, J.M., additional, and Jefferson, T., additional
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- 2022
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3. Effects of COVID-19 in Care Homes - A Mixed Methods Review
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Heneghan, C, primary, Dietrich, M, additional, Brassey, J, additional, and Jefferson, T, additional
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- 2022
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4. Interventions designed to improve vaccination uptake: Scoping review of systematic reviews and meta-analyses - protocol (version 1)
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Heneghan, CJ, primary, Plüddemann, A, additional, Spencer, EA, additional, Brassey, J, additional, Rosca, EC, additional, Onakpoya, IJ, additional, Evans, DH, additional, Conly, JM, additional, Brewer, NT, additional, and Jefferson, T, additional
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- 2021
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5. The Impact of COVID-19 Restrictions on Childhood Vaccination Uptake: A Rapid Review
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Heneghan, C, primary, Brassey, J, additional, and Jefferson, T., additional
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- 2021
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6. Transmission of SARS-CoV-2 associated with aircraft travel: a systematic review (Version 1)
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Rosca, EC, primary, Heneghan, C, additional, Spencer, EA, additional, Brassey, J, additional, Plüddemann, A, additional, Onakpoya, IJ, additional, Evans, D, additional, Conly, JM, additional, and Jefferson, T, additional
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- 2021
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7. Viral cultures for COVID-19 infectious potential assessment – a systematic review
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Jefferson, T, Spencer, E A, Brassey, J, and Heneghan, C
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Microbiology (medical) ,Infectious Diseases - Published
- 2020
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8. The evidence on transmission dynamics of COVID-19 from pre- and asymptomatic cases: protocol for a systematic review (Version 2)
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Jefferson, T, primary, Plüddemann, A, additional, Spencer, EA, additional, Brassey, J, additional, Rosca, EC, additional, Onakpoya, I, additional, Evans, DH, additional, Conly, JM, additional, and Heneghan, C, additional
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- 2021
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9. Viral cultures for COVID-19 infectivity assessment – a systematic review (Update 4)
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Jefferson, T, Spencer, EA, Brassey, J, and Heneghan, C
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Infectivity ,medicine.medical_specialty ,business.industry ,Viral culture ,law.invention ,Viral replication ,law ,Internal medicine ,False positive paradox ,Medicine ,Sputum ,medicine.symptom ,business ,Viral load ,Feces ,Polymerase chain reaction - Abstract
SummaryObjectiveto review the evidence from studies comparing SARS-CoV-2 culture, the best indicator of current infection and infectiousness with the results of reverse transcriptase polymerase chain reaction (RT-PCR).MethodsWe searched LitCovid, medRxiv, Google Scholar and the WHO Covid-19 database for Covid-19 using the terms ‘viral culture’ or ‘viral replication’ and associated synonyms up to 10 September 2020. We carried out citation matching and included studies reporting attempts to culture or observe SARS-CoV-2 matching with cutoffs for RT-PCR positivity. One reviewer extracted data for each study and a second reviewer checked end edited the extraction and summarised the narratively by sample: fecal, respiratory, environment or mixed.Where necessary we wrote to corresponding authors of the included or background papers for additional information. We assessed quality using a modified QUADAS 2 risk of bias tool.This review is part of an Open Evidence Review on Transmission Dynamics of COVID-19. Summaries of the included studies and the protocol (v1) are available at: https://www.cebm.net/evidence-synthesis/transmission-dynamics-of-covid-19/. Searches are updated every 2 weeks. This is the fourth version of this review that was first published on the 4th of August and updated on the 21t of AugustResultsWe included 29 studies reporting culturing or observing tissue invasion by SARS-CoV in sputum, naso or oropharyngeal, urine, stool, blood and environmental samples from patients diagnosed with Covid-19. The data are suggestive of a relation between the time from collection of a specimen to test, cycle threshold and symptom severity. The quality of the studies was moderate with lack of standardised reporting.Twelve studies reported that Ct values were significantly lower and log copies higher in samples producing live virus culture. Five studies reported no growth in samples based on a Ct cut-off value. These values ranged from CT > 24 for no growth to Ct ≥ 34. Two studies report a strong relationship between Ct value and ability to recover infectious virus and that the odds of live virus culture reduced by 33% for every one unit increase in Ct. A cut-off RT-PCR Ct > 30 was associated with non-infectious samples. One study that analysed the NSP, N and E gene fragments of the PCR result reported different cut-off thresholds depending on the gene fragment analysed. The duration of RNA shedding detected by PCR was far longer compared to detection of live culture. Six out of eight studies reported RNA shedding for longer than 14 days. Yet, infectivity declines after day 8 even among cases with ongoing high viral loads. A very small proportion of people re-testing positive after hospital discharge or with high Ct are likely to be infectious.ConclusionProspective routine testing of reference and culture specimens are necessary for each country involved in the pandemic to establish the usefulness and reliability of PCR for Covid-19 and its relation to patients’ factors. Infectivity is related to the date of onset of symptoms and cycle threshold level.A binary Yes/No approach to the interpretation RT-PCR unvalidated against viral culture will result in false positives with possible segregation of large numbers of people who are no longer infectious and hence not a threat to public health.
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- 2020
10. SARS-CoV-2 and the Role of Orofecal Transmission: Systematic Review
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Heneghan, C, primary, Spencer, EA, additional, Brassey, J, additional, and Jefferson, T, additional
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- 2020
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11. Viral cultures for COVID-19 infectivity assessment – a systematic review (Update 4)
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Jefferson, T, primary, Spencer, EA, additional, Brassey, J, additional, and Heneghan, C, additional
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- 2020
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12. Introducing the EBM Verdict: research evidence relevant to clinical practice
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Heneghan, C, Brassey, J, Aronson, J, and O'Sullivan, J
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Clinical Practice ,Medical education ,Evidence-Based Medicine ,Systematic review ,Current practice ,Verdict ,Humans ,General Medicine ,Periodicals as Topic ,Set (psychology) ,Psychology ,Research evidence - Abstract
The BMJ Evidence-Based Medicine Journal was launched in 1995, with the purpose of alerting clinicians to important advances in medicine, by selecting original articles and reviews whose results were most likely to be both accurate and useful.1 When the Journal was launched, about 10 500 randomised trials were indexed on PubMed. Identifying the trials that affect practice has become harder: 20 years later, over 30 000 trials are published annually. If we focused purely on systematic reviews, we would face similar problems: over 19 000 systematic reviews were indexed on PubMed in 2017. Identifying the evidence that matters, keeping up to date and applying evidence in practice is a significant challenge for busy clinicians. As a result, we as a journal have set out to identify, and focus on, the research evidence that provides definitive conclusions and research that confirms, refutes or improves current practice. We have focused on two questions: (1) does this research apply to the patients we see in practice? and (2) what difference could this evidence make to my patient? In doing so, we can remove a substantial amount of research that does not matter. Much of it does not include patients typically seen in clinical practice, …
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- 2019
13. Fitting entrepreneurial, firm-level and environmental contingencies for better performance: A study into the complex world of entrepreneurship within Belgium
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van Witteloostuijn, A., Dejardin, M., Hermans, J., Ramdani, D., Vanderstraeten, J., Brassey, J., Slabbinck, H., Tilburg University [Netherlands], Centre interdisciplinaire de recherche Travail Etat et Société (CIRTES), Université Catholique de Louvain = Catholic University of Louvain (UCL), Centre de Recherches en Economie Régionale et Politique Economique (CERPE), Facultés Universitaires Notre Dame de la Paix (FUNDP), Universiteit Antwerpen [Antwerpen], Universiteit Gent = Ghent University [Belgium] (UGENT), Belgian Federal Science Policy Office (BELSPO), and Department of Economics
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JEL: M - Business Administration and Business Economics • Marketing • Accounting • Personnel Economics/M.M0 - General ,Competitive Strategy ,Economics ,Performance ,Strategy ,Entrepreneurship ,Business Strategy ,SMEs ,Growth ,Small Business ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance - Abstract
International audience; This book reports the outcomes of a BELSPO (the Belgian Federal Science Policy Office) research project. The authors develop and estimate (parts of) a comprehensive model in which the micro-performance of SMEs is determined by a complex web of factors. These are situated at the level of the entrepreneur, organization and environment. In this modeling, a fit between individual, strategy, structure and environment is key to attain better performance in terms of, for example, efficiency or profitability. Strategy is assumed to be the linking pin between the entrepreneur’s (or his or her venture’s) strengths and weaknesses, and the opportunities and threats in the environment. In line with this contingency approach, the authors utilize a multi-disciplinary theoretical lens in combination with analysis techniques that allow for the identification of fits (and misfits), such as the analysis of conditional processes or dynamic multi-level QCA fit analysis.
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- 2015
14. Just in time information: what clinicians need. An evaluation of the ATTRACT Project.
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Brassey, J., Elwyn, G., Price, C., Kinnersley, P., Brassey, J., Elwyn, G., Price, C., and Kinnersley, P.
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- Published
- 2001
15. "Hitting the Headlines" is useful resource
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Brassey, J. R, primary
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- 2003
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16. Just in time information for clinicians: a questionnaire evaluation of the ATTRACT project
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Brassey, J., primary
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- 2001
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17. Elucidation of structural abnormalities of the X chromosome using fluorescence in situ hybridisation with a Y chromosome painting probe.
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Howell, R T, primary, Millener, R, additional, Thorne, S, additional, O'Loughlin, J, additional, Brassey, J, additional, and McDermott, A, additional
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- 1994
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18. Can we rely on the best trial? A comparison of individual trials and systematic reviews
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Shepperd Sasha, Glasziou Paul P, and Brassey Jon
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Medicine (General) ,R5-920 - Abstract
Abstract Background The ideal evidence to answer a question about the effectiveness of treatment is a systematic review. However, for many clinical questions a systematic review will not be available, or may not be up to date. One option could be to use the evidence from an individual trial to answer the question? Methods We assessed how often (a) the estimated effect and (b) the p-value in the most precise single trial in a meta-analysis agreed with the whole meta-analysis. For a random sample of 200 completed Cochrane Reviews (January, 2005) we identified a primary outcome and extracted: the number of trials, the statistical weight of the most precise trial, the estimate and confidence interval for both the highest weighted trial and the meta-analysis overall. We calculated the p-value for the most precise trial and meta-analysis. Results Of 200 reviews, only 132 provided a meta-analysis of 2 or more trials, with a further 35 effect estimates based on single trials. The average number of trials was 7.3, with the most precise trial contributing, on average, 51% of the statistical weight to the summary estimate from the whole meta-analysis. The estimates of effect from the most precise trial and the overall meta-analyses were highly correlated (rank correlation of 0.90). There was an 81% agreement in statistical conclusions. Results from the most precise trial were statistically significant in 60 of the 167 evaluable reviews, with 55 of the corresponding systematic reviews also being statistically significant. The five discrepant results were not strikingly different with respect to their estimates of effect, but showed considerable statistical heterogeneity between trials in these meta-analyses. However, among the 101 cases in which the most precise trial was not statistically significant, the corresponding meta-analyses yielded 31 statistically significant results. Conclusions Single most precise trials provided similar estimates of effects to those of the meta-analyses to which they contributed, and statistically significant results are generally in agreement. However, "negative" results were less reliable, as may be expected from single underpowered trials. For systematic reviewers we suggest that: (1) key trial(s) in a review deserve greater attention (2) systematic reviewers should check agreement of the most precise trial and the meta analysis. For clinicians using trials we suggest that when a meta-analysis is not available, a focus on the most precise trial is reasonable provided it is adequately powered.
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- 2010
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19. Clinical Q&A. Head lice.
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Carrier J and Brassey J
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Questions answered on headlice infestations and steroid injections for the management of hay fever. [ABSTRACT FROM AUTHOR]
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- 2008
20. Clinical Q&A. Clinical guidance on steroid injections.
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Carrier J and Brassey J
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Questions answered on headlice infestations and steroid injections for the management of hay fever. [ABSTRACT FROM AUTHOR]
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- 2008
21. Clinical Q&A. Double immunizations.
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Carrier J and Brassey J
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Questions answered on double-dosing a feverish child and boule doses of immunizations; and Martin Davies returns with his view. [ABSTRACT FROM AUTHOR]
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- 2008
22. Clinical Q&A. Double-dosing a feverish child.
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Carrier J and Brassey J
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Questions answered on double-dosing a feverish child and boule doses of immunizations; and Martin Davies returns with his view. [ABSTRACT FROM AUTHOR]
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- 2008
23. Clinical Q&A. Treating dog bites.
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Carrier J and Brassey J
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Questions answered on antibiotics and suturing for treating dog bites. [ABSTRACT FROM AUTHOR]
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- 2008
24. Vaccinate after chemotherapy?
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Carrier J and Brassey J
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- 2008
25. Delay in hepatitis B booster.
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Carrier J and Brassey J
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- 2008
26. Clinical Q&A. Treatments for lactose intolerance.
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Carrier J and Brassey J
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- 2007
27. Clinical Q&A. Dietary advice for patients using warfarin.
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Carrier J and Brassey J
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- 2007
28. Morphometric and adhesion studies on the normal human dermo-epidermal junction.
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Tidman, M. J., Eady, R. A. J., Brassey, J. E. E., and Corbett, M. F.
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EPIDERMIS ,SEX differences (Biology) ,CELL adhesion ,BASAL lamina ,TRANSMISSION electron microscopy ,HEMIDESMOSOMES - Abstract
This article focuses on a study in which possible sex differences in ultrastructural components of the dermo-epidermal junction in skin have been examined and it has been checked whether measurable adhesiveness of the dermo-epidermal junction could be correlated with structural characteristics, as anchoring fibril (AF) may traverse the basal lamina (BL) and cross the lamina lucida (LL). Skin samples from defined areas on the lower leg, thigh and upper arm from five healthy women were processed for transmission electron microscopy. The population densities of hemidesmosomes (HD), plasmalemmal vesicles and AF were calculated, and thickness of BL and LL, associated and between HD, were measured.
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- 1983
29. Removal of hydrogen sulfide from air streams
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Brassey, J
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- 1986
30. Oro-faecal transmission of SARS-CoV-2: A systematic review of studies employing viral culture from gastrointestinal and other potential oro-faecal sources and evidence for transmission to humans.
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Gandini S, Conly J, Spencer EA, Evans D, Rosca EC, Brassey J, Maltoni S, Onakpoya I, Plüddemann A, Jefferson T, and Heneghan C
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- Humans, Virus Cultivation, COVID-19 transmission, COVID-19 virology, Feces virology, SARS-CoV-2 physiology
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The extent to which the oro-faecal route contributes to the transmission of SARS-CoV-2 is not established.We systematically reviewed the evidence on the presence of infectious SARS-CoV-2 in faeces and other gastrointestinal sources by examining studies that used viral culture to investigate the presence of replication-competent virus in these samples. We conducted searches in the WHO COVID-19 Database, LitCovid, medRxiv, and Google Scholar for SARS-CoV-2 using keywords and associated synonyms, with a search date up to 28 November 2023.We included 13 studies involving 229 COVID-19 subjects - providing 308 faecal or rectal swab SARS-CoV2 reverse transcription-polymerase chain reaction (RT-PCR)-positive samples tested with viral culture. The methods used for viral culture across the studies were heterogeneous. Three studies (two cohorts and one case series) reported observing replication-competent SARS-CoV-2 confirmed by quantitative RT-PCR (qPCR) and whole-genome sequencing, and qPCR including appropriate cycle threshold changes. Overall, six (1.9%) of 308 faecal samples subjected to cell culture showed replication-competent virus. One study found replication-competent samples from one immunocompromised patient. No studies were identified demonstrating direct evidence of oro-faecal transmission to humans.Our review found a relatively low frequency of replication-competent SARS-CoV-2 in faecal and other gastrointestinal sources. Although it is biologically plausible, more research is needed using standardized cell culture methods, control groups, adequate follow-up, and robust epidemiologic methods, including whether secondary infections occurred, to determine the role of the oro-faecal route in the transmission of SARS-CoV-2.
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- 2024
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31. Transmission of SARS-CoV-2 Associated with Cruise Ship Travel: A Systematic Review.
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Rosca EC, Heneghan C, Spencer EA, Brassey J, Plüddemann A, Onakpoya IJ, Evans D, Conly JM, and Jefferson T
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Background: Maritime and river travel may be associated with respiratory viral spread via infected passengers and/or crew and potentially through other transmission routes. The transmission models of SARS-CoV-2 associated with cruise ship travel are based on transmission dynamics of other respiratory viruses. We aimed to provide a summary and evaluation of relevant data on SARS-CoV-2 transmission aboard cruise ships, report policy implications, and highlight research gaps. Methods: We searched four electronic databases (up to 26 May 2022) and included studies on SARS-CoV-2 transmission aboard cruise ships. The quality of the studies was assessed based on five criteria, and relevant findings were reported. Results: We included 23 papers on onboard SARS-CoV-2 transmission (with 15 reports on different aspects of the outbreak on Diamond Princess and nine reports on other international cruises), 2 environmental studies, and 1 systematic review. Three articles presented data on both international cruises and the Diamond Princess. The quality of evidence from most studies was low to very low. Index case definitions were heterogeneous. The proportion of traced contacts ranged from 0.19 to 100%. Studies that followed up >80% of passengers and crew reported attack rates (AR) up to 59%. The presence of a distinct dose−response relationship was demonstrated by findings of increased ARs in multi-person cabins. Two studies performed viral cultures with eight positive results. Genomic sequencing and phylogenetic analyses were performed in individuals from three cruises. Two environmental studies reported PCR-positive samples (cycle threshold range 26.21−39.00). In one study, no infectious virus was isolated from any of the 76 environmental samples. Conclusion: Our review suggests that crowding and multiple persons per cabin were associated with an increased risk of transmission on cruise ships. Variations in design, methodology, and case ascertainment limit comparisons across studies and quantification of transmission risk. Standardized guidelines for conducting and reporting studies on cruise ships of acute respiratory infection transmission should be developed.
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- 2022
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32. A Hierarchical Framework for Assessing Transmission Causality of Respiratory Viruses.
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Jefferson T, Heneghan CJ, Spencer E, Brassey J, Plüddemann A, Onakpoya I, Evans D, and Conly J
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- Humans, Pandemics prevention & control, SARS-CoV-2, COVID-19, Viruses genetics
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Systematic reviews of 591 primary studies of the modes of transmission for SARS-CoV-2 show significant methodological shortcomings and heterogeneity in the design, conduct, testing, and reporting of SARS-CoV-2 transmission. While this is partly understandable at the outset of a pandemic, evidence rules of proof for assessing the transmission of this virus are needed for present and future pandemics of viral respiratory pathogens. We review the history of causality assessment related to microbial etiologies with a focus on respiratory viruses and suggest a hierarchy of evidence to integrate clinical, epidemiologic, molecular, and laboratory perspectives on transmission. The hierarchy, if applied to future studies, should narrow the uncertainty over the twin concepts of causality and transmission of human respiratory viruses. We attempt to address the translational gap between the current research evidence and the assessment of causality in the transmission of respiratory viruses with a focus on SARS-CoV-2. Experimentation, consistency, and independent replication of research alongside our proposed framework provide a chain of evidence that can reduce the uncertainty over the transmission of respiratory viruses and increase the level of confidence in specific modes of transmission, informing the measures that should be undertaken to prevent transmission.
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- 2022
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33. Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) from pre and asymptomatic infected individuals: a systematic review.
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Jefferson T, Spencer EA, Brassey J, Onakpoya IJ, Rosca EC, Plüddemann A, Evans DH, Conly JM, and Heneghan CJ
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- Bias, Humans, Pandemics, Reproducibility of Results, COVID-19, SARS-CoV-2
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Background: The role of SARS-Cov-2-infected persons who develop symptoms after testing (presymptomatics) or not at all (asymptomatics) in the pandemic spread is unknown., Objectives: To determine infectiousness and probable contribution of asymptomatic persons (at the time of testing) to pandemic SARS-CoV-2 spread., Data Sources: LitCovid, medRxiv, Google Scholar, and WHO Covid-19 databases (to 31 March 2021) and references in included studies., Study Eligibility Criteria: Studies with a proven or hypothesized transmission chain based either on serial PCR cycle threshold readings and/or viral culture and/or gene sequencing, with adequate follow-up., Participants: People exposed to SARS-CoV-2 within 2-14 days to index asymptomatic (at time of observation) infected individuals., Interventions: Reliability of symptom and signs was assessed within contemporary knowledge; transmission likelihood was assessed using adapted causality criteria., Methods: Systematic review. We contacted all included studies' corresponding authors requesting further details., Results: We included 18 studies from a diverse setting with substantial methodological variation (this field lacks standardized methodology). At initial testing, prevalence of asymptomatic cases was 12.5-100%. Of these, 6-100% were later determined to be presymptomatic, this proportion varying according to setting, methods of case ascertainment and population. Nursing/care home facilities reported high rates of presymptomatic: 50-100% (n = 3 studies). Fourteen studies were classified as high risk of, and four studies as at moderate risk of symptom ascertainment bias. High-risk studies may be less likely to distinguish between presymptomatic and asymptomatic cases. Six asymptomatic studies and four presymptomatic studies reported culturing infectious virus; data were too sparse to determine infectiousness duration. Three studies provided evidence of possible and three of probable/likely asymptomatic transmission; five studies provided possible and two probable/likely presymptomatic SARS-CoV-2 transmission., Conclusion: High-quality studies provide probable evidence of SARS-CoV-2 transmission from presymptomatic and asymptomatic individuals, with highly variable estimated transmission rates., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2022
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34. Viral Cultures for Coronavirus Disease 2019 Infectivity Assessment: A Systematic Review.
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Jefferson T, Spencer EA, Brassey J, and Heneghan C
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- Humans, Prospective Studies, RNA, Viral, Reproducibility of Results, SARS-CoV-2, Serologic Tests, COVID-19
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Background: We aimed to review the evidence from studies relating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) culture with the results of reverse-transcription polymerase chain reaction (RT-PCR) and other variables that may influence the interpretation of the test, such as time from symptom onset., Methods: We searched LitCovid, medRxiv, Google Scholar, and the World Health Organization coronavirus disease 2019 (COVID-19) database for COVID-19 up to 10 September 2020. We included studies attempting to culture or observe SARS-CoV-2 in specimens with RT-PCR positivity. Studies were dual-extracted and the data summarized narratively by specimen type. Where necessary, we contacted corresponding authors of included papers for additional information. We assessed quality using a modified Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS 2) risk-of-bias tool., Results: We included 29 studies reporting attempts at culturing, or observing tissue infection by, SARS-CoV-2 in sputum, nasopharyngeal or oropharyngeal, urine, stool, blood, and environmental specimens. The quality of the studies was moderate with lack of standardized reporting. The data suggest a relationship between the time from onset of symptom to the timing of the specimen test, cycle threshold (Ct), and symptom severity. Twelve studies reported that Ct values were significantly lower and log copies higher in specimens producing live virus culture. Two studies reported that the odds of live virus culture were reduced by approximately 33% for every 1-unit increase in Ct. Six of 8 studies reported detectable RNA for >14 days, but infectious potential declined after day 8 even among cases with ongoing high viral loads. Four studies reported viral culture from stool specimens., Conclusions: Complete live viruses are necessary for transmission, not the fragments identified by PCR. Prospective routine testing of reference and culture specimens and their relationship to symptoms, signs, and patient co-factors should be used to define the reliability of PCR for assessing infectious potential. Those with high Ct are unlikely to have infectious potential., (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
- Published
- 2021
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35. Transmission of SARS-CoV-2 associated with aircraft travel: a systematic review.
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Rosca EC, Heneghan C, Spencer EA, Brassey J, Plüddemann A, Onakpoya IJ, Evans DH, Conly JM, and Jefferson T
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- Aircraft, Humans, Phylogeny, SARS-CoV-2, Travel, Air Travel, COVID-19
- Abstract
Rationale for the Review: Air travel may be associated with viruses spread via infected passengers and potentially through in-flight transmission. Given the novelty of the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, transmission associated with air travel is based on transmission dynamics of other respiratory viruses. Our objective was to provide a rapid summary and evaluation of relevant data on SARS-CoV-2 transmission aboard aircraft, report policy implications and to highlight research gaps requiring urgent attention., Methods: We searched four electronic databases (1 February 2020-27 January 2021) and included studies on SARS-CoV-2 transmission aboard aircraft. We assessed study quality based on five criteria and reported important findings., Key Findings: We included 18 studies on in-flight SARS-CoV-2 transmission (130 unique flights) and 2 studies on wastewater from aircraft. The quality of evidence from most published studies was low. Two wastewater studies reported PCR-positive samples with high cycle threshold values (33-39). Index case definition was heterogeneous across studies. The proportion of contacts traced ranged from 0.68 to 100%. Authors traced 2800/19 729 passengers, 140/180 crew members and 8/8 medical staff. Altogether, 273 index cases were reported, with 64 secondary cases. Three studies, each investigating one flight, reported no secondary cases. Secondary attack rate among studies following up >80% of passengers and crew (including data on 10 flights) varied between 0 and 8.2%. The studies reported on the possibility of SARS-CoV-2 transmission from asymptomatic, pre-symptomatic and symptomatic individuals. Two studies performed viral cultures with 10 positive results. Genomic sequencing and phylogenetic analysis were performed in individuals from four flights., Conclusion: Current evidence suggests SARS-CoV-2 can be transmitted during aircraft travel, but published data do not permit any conclusive assessment of likelihood and extent. The variation in design and methodology restricts the comparison of findings across studies. Standardized guidelines for conducting and reporting future studies of transmission on aircraft should be developed., (© International Society of Travel Medicine 2021. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)
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- 2021
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36. SARS-CoV-2 and the role of close contact in transmission: a systematic review.
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Onakpoya IJ, Heneghan CJ, Spencer EA, Brassey J, Plüddemann A, Evans DH, Conly JM, and Jefferson T
- Abstract
Background: SARS-CoV-2 transmission has been reported to be associated with close contact with infected individuals. However, the mechanistic pathway for transmission in close contact settings is unclear. Our objective was to identify, appraise and summarise the evidence from studies assessing the role of close contact in SARS-CoV-2 transmission. Methods: This review is part of an Open Evidence Review on Transmission Dynamics of SARS-CoV-2. We conduct ongoing searches using WHO Covid-19 Database, LitCovid, medRxiv, PubMed and Google Scholar; assess study quality based on the QUADAS-2 criteria and report important findings on an ongoing basis. Results: We included 278 studies: 258 primary studies and 20 systematic reviews. The settings for primary studies were predominantly in home/quarantine facilities (39.5%) and acute care hospitals (12%). The overall reporting quality of the studies was low-to-moderate. There was significant heterogeneity in design and methodology. The frequency of attack rates (PCR testing) varied between 2.1-75%; attack rates were highest in prison and wedding venues, and in households. The frequency of secondary attack rates was 0.3-100% with rates highest in home/quarantine settings. Three studies showed no transmission if the index case was a recurrent infection. Viral culture was performed in four studies of which three found replication-competent virus; culture results were negative where index cases had recurrent infections. Eighteen studies performed genomic sequencing with phylogenetic analysis - the completeness of genomic similarity ranged from 77-100%. Findings from systematic reviews showed that children were significantly less likely to transmit SARS-CoV-2 and household contact was associated with a significantly increased risk of infection. Conclusions: The evidence from published studies demonstrates that SARS-CoV-2 can be transmitted in close contact settings. The risk of transmission is greater in household contacts. There was a wide variation in methodology. Standardized guidelines for reporting transmission in close contact settings should be developed., Competing Interests: Competing interests: TJ received a Cochrane Methods Innovations Fund grant to develop guidance on using regulatory data in Cochrane reviews (2015 to 2018). From 2014 to 2016, he was a member of three advisory boards for Boehringer Ingelheim. TJ was a member of an independent data monitoring committee for a Sanofi Pasteur clinical trial on an influenza vaccine. Market research companies occasionally interview TJ about phase I or II pharmaceutical products for which he receives fees (current). TJ was a member of three advisory boards for Boehringer Ingelheim (2014 to 16). TJ was a member of an independent data monitoring committee for a Sanofi Pasteur clinical trial on an influenza vaccine (2015 to 2017). TJ is a relator in a False Claims Act lawsuit on behalf of the United States that involves sales of Tamiflu for pandemic stockpiling. If resolved in the United States favour, he would be entitled to a percentage of the recovery. TJ is coholder of a Laura and John Arnold Foundation grant for the development of a RIAT support centre (2017 to 2020) and Jean Monnet Network Grant, 2017 to 2020 for The Jean Monnet Health Law and Policy Network. TJ is an unpaid collaborator to the Beyond Transparency in Pharmaceutical Research and Regulation led by Dalhousie University and funded by the Canadian Institutes of Health Research (2018 to 2022). TJ consulted for Illumina LLC on next-generation gene sequencing (2019 to 2020). TJ was the consultant scientific coordinator for the HTA Medical Technology programme of the Agenzia per I Servizi Sanitari Nazionali (AGENAS) of the Italian MoH (2007 to 2019). TJ is Director Medical Affairs for BC Solutions, a market access company for medical devices in Europe. TJ was funded by NIHR UK and the World Health Organization (WHO) to update Cochrane review A122, Physical Interventions to interrupt the spread of respiratory viruses. Oxford University funds TJ to carry out a living review on the transmission epidemiology of COVID 19. Since 2020, TJ receives fees for articles published by The Spectator and other media outlets. TJ is part of a review group carrying out a Living rapid literature review on the modes of transmission of SARS CoV 2 (WHO Registration 2020/1077093 0). He is a member of the WHO COVID 19 Infection Prevention and Control Research Working Group, for which he receives no funds. TJ is funded to co-author rapid reviews on the impact of Covid restrictions by the Collateral Global Organisation. CJH holds grant funding from the NIHR, the NIHR School of Primary Care Research, the NIHR BRC Oxford and the World Health Organization for a series of Living rapid reviews on the modes of transmission of SARs CoV 2, reference WHO registration No2020/1077093, and to carry out a scoping review of systematic reviews of interventions to improve vaccination uptake, reference WHO Registration 2021/1138353-0. He has received financial remuneration from an asbestos case and given legal advice on mesh and hormone pregnancy tests cases. He has received expenses and fees for his media work, including occasional payments from BBC Radio 4 Inside Health and The Spectator. He receives expenses for teaching EBM and is also paid for his GP work in NHS out of hours (contract Oxford Health NHS Foundation Trust). He has also received income from the publication of a series of toolkit books and appraising treatment recommendations in non-NHS settings. He is the Director of CEBM, an NIHR Senior Investigator and an advisor to Collateral Global. DHE holds grant funding from the Canadian Institutes for Health Research and Li Ka Shing Institute of Virology relating to the development of Covid 19 vaccines and the Canadian Natural Science and Engineering Research Council concerning Covid 19 aerosol transmission. He is a recipient of World Health Organization and Province of Alberta funding which supports the provision of BSL3 based SARS CoV 2 culture services to regional investigators. He also holds public and private sector contract funding relating to the development of poxvirus based Covid 19 vaccines, SARS CoV 2 inactivation technologies, and serum neutralisation testing. JMC holds grants from the Canadian Institutes for Health Research on acute and primary care preparedness for COVID 19 in Alberta, Canada and was the primary local Investigator for a Staphylococcus aureus vaccine study funded by Pfizer, for which all funding was provided only to the University of Calgary. He is a co-investigator on a WHO funded study using integrated human factors and ethnography approaches to identify and scale innovative IPC guidance implementation supports in primary care with a focus on low resource settings and using drone aerial systems to deliver medical supplies and PPE to remote First Nations communities during the COVID 19 pandemic. He also received support from the Centers for Disease Control and Prevention (CDC) to attend an Infection Control Think Tank Meeting. He is a member and Chair of the WHO Infection Prevention and Control Research and Development Expert Group for COVID 19 and a member of the WHO Health Emergencies Programme (WHE) Ad hoc COVID 19 IPC Guidance Development Group, both of which provide multidisciplinary advice to the WHO, for which no funding is received and from which no funding recommendations are made for any WHO contracts or grants. He is also a member of the Cochrane Acute Respiratory Infections Group. JB is a major shareholder in the Trip Database search engine (www.tripdatabase.com) as well as being an employee. In relation to this work, Trip has worked with many organisations over the years; none have any links with this work. The main current projects are with AXA and Collateral Global. AP holds grant funding from the NIHR School for Primary Care Research. IJO and EAS have no interests to disclose., (Copyright: © 2022 Onakpoya IJ et al.)
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- 2021
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37. SARS-CoV-2 and the role of fomite transmission: a systematic review.
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Onakpoya IJ, Heneghan CJ, Spencer EA, Brassey J, Plüddemann A, Evans DH, Conly JM, and Jefferson T
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- Hospitals, Humans, RNA, Viral, SARS-CoV-2, COVID-19, Fomites
- Abstract
Background: SARS-CoV-2 RNA has been detected in fomites which suggests the virus could be transmitted via inanimate objects. However, there is uncertainty about the mechanistic pathway for such transmissions. Our objective was to identify, appraise and summarise the evidence from primary studies and systematic reviews assessing the role of fomites in transmission. Methods: This review is part of an Open Evidence Review on Transmission Dynamics of SARS-CoV-2. We conduct ongoing searches using WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar; assess study quality based on five criteria and report important findings on an ongoing basis. Results: We found 64 studies: 63 primary studies and one systematic review (n=35). The settings for primary studies were predominantly in hospitals (69.8%) including general wards, ICU and SARS-CoV-2 isolation wards. There were variations in the study designs including timing of sample collection, hygiene procedures, ventilation settings and cycle threshold. The overall quality of reporting was low to moderate. The frequency of positive SARS-CoV-2 tests across 51 studies (using RT-PCR) ranged from 0.5% to 75%. Cycle threshold values ranged from 20.8 to 44.1. Viral concentrations were reported in 17 studies; however, discrepancies in the methods for estimation prevented comparison. Eleven studies (17.5%) attempted viral culture, but none found a cytopathic effect. Results of the systematic review showed that healthcare settings were most frequently tested (25/35, 71.4%), but laboratories reported the highest frequency of contaminated surfaces (20.5%, 17/83). Conclusions: The majority of studies report identification of SARS-CoV-2 RNA on inanimate surfaces; however, there is a lack of evidence demonstrating the recovery of viable virus. Lack of positive viral cultures suggests that the risk of transmission of SARS-CoV-2 through fomites is low. Heterogeneity in study designs and methodology prevents comparisons of findings across studies. Standardized guidelines for conducting and reporting research on fomite transmission is warranted., Competing Interests: Competing interests: CJH holds grant funding from the NIHR, the NIHR School of Primary Care Research, the NIHR BRC Oxford and the World Health Organization for a series of Living rapid review on the modes of transmission of SARs-CoV-2 reference WHO registration No2020/1077093. He has received financial remuneration from an asbestos case and given legal advice on mesh and hormone pregnancy tests cases. He has received expenses and fees for his media work including occasional payments from BBC Radio 4 Inside Health and The Spectator. He receives expenses for teaching EBM and is also paid for his GP work in NHS out of hours (contract Oxford Health NHS Foundation Trust). He has also received income from the publication of a series of toolkit books and for appraising treatment recommendations in non-NHS settings. He is Director of CEBM, an NIHR Senior Investigator and an advisor to Collateral Global. He is also an editor of the Cochrane Acute Respiratory Infections Group. JB is a major shareholder in the Trip Database search engine (www.tripdatabase.com) as well as being an employee. In relation to this work Trip has worked with a large number of organisations over the years, none have any links with this work. The main current projects are with AXA and Collateral Global. AP is Senior Research Fellow at the Centre for Evidence-Based Medicine and reports grant funding from NIHR School of Primary Care Research (NIHR SPCR ESWG project 390 and project 461), during the conduct of the study; and occasionally receives expenses for teaching Evidence-Based Medicine. DHE holds grant funding from the Canadian Institutes for Health Research and Li Ka Shing Institute of Virology relating to the development of Covid-19 vaccines as well as the Canadian Natural Science and Engineering Research Council concerning Covid-19 aerosol transmission. He is a recipient of World Health Organization and Province of Alberta funding which supports the provision of BSL3-based SARS-CoV-2 culture services to regional investigators. He also holds public and private sector contract funding relating to the development of poxvirus-based Covid-19 vaccines, SARS-CoV-2-inactivation technologies, and serum neutralization testing. JMC holds grants from the Canadian Institutes for Health Research on acute and primary care preparedness for COVID 19 in Alberta, Canada and was the primary local Investigator for a Staphylococcus aureus vaccine study funded by Pfizer for which all funding was provided only to the University of Calgary. He is a co investigator on a WHO funded study using integrated human factors and ethnography approaches to identify and scale innovative IPC guidance implementation supports in primary care with a focus on low resource settings and using drone aerial systems to deliver medical supplies and PPE to remote First Nations communities during the COVID 19 pandemic. He also received support from the Centers for Disease Control and Prevention (CDC) to attend an Infection Control Think Tank Meeting. He is a member of the WHO Infection Prevention and Control Research and Development Expert Group for COVID 19 and the WHO Health Emergencies Programme (WHE) Ad hoc COVID 19 IPC Guidance Development Group, both of which provide multidisciplinary advice to the WHO, for which no funding is received and from which no funding recommendations are made for any WHO contracts or grants. He is also a member of the Cochrane Acute Respiratory Infections Group. TJ was in receipt of a Cochrane Methods Innovations Fund grant to develop guidance on the use of regulatory data in Cochrane reviews (2015-018). In 2014–2016, he was a member of three advisory boards for Boehringer Ingelheim. TJ was a member of an independent data monitoring committee for a Sanofi Pasteur clinical trial on an influenza vaccine. TJ is occasionally interviewed by market research companies about phase I or II pharmaceutical products for which he receives fees (current). TJ was a member of three advisory boards for Boehringer Ingelheim (2014-16). TJ was a member of an independent data monitoring committee for a Sanofi Pasteur clinical trial on an influenza vaccine (2015-2017). TJ is a relator in a False Claims Act lawsuit on behalf of the United States that involves sales of Tamiflu for pandemic stockpiling. If resolved in the United States favor, he would be entitled to a percentage of the recovery. TJ is coholder of a Laura and John Arnold Foundation grant for development of a RIAT support centre (2017-2020) and Jean Monnet Network Grant, 2017-2020 for The Jean Monnet Health Law and Policy Network. TJ is an unpaid collaborator to the project Beyond Transparency in Pharmaceutical Research and Regulation led by Dalhousie University and funded by the Canadian Institutes of Health Research (2018-2022). TJ consulted for Illumina LLC on next generation gene sequencing (2019-2020). TJ was the consultant scientific coordinator for the HTA Medical Technology programme of the Agenzia per i Servizi Sanitari Nazionali (AGENAS) of the Italian MoH (2007-2019). TJ is Director Medical Affairs for BC Solutions, a market access company for medical devices in Europe. TJ was funded by NIHR UK and the World Health Organization (WHO) to update Cochrane review A122, Physical Interventions to interrupt the spread of respiratory viruses. TJ is funded by Oxford University to carry out a living review on the transmission epidemiology of COVID-19. Since 2020, TJ receives fees for articles published by The Spectator and other media outlets. TJ is part of a review group carrying out Living rapid literature review on the modes of transmission of SARS-CoV-2 (WHO Registration 2020/1077093-0). He is a member of the WHO COVID-19 Infection Prevention and Control Research Working Group for which he receives no funds. TJ is funded to co-author rapid reviews on the impact of Covid restrictions by the Collateral Global Organisation. He is also an editor of the Cochrane Acute Respiratory Infections Group. TJ’s competing interests are also online https://restoringtrials.org/competing-interests-tom-jefferson IJO and EAS have no interests to disclose., (Copyright: © 2021 Onakpoya IJ et al.)
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- 2021
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38. SARS-CoV-2 and the role of orofecal transmission: a systematic review.
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Heneghan CJ, Spencer EA, Brassey J, Plüddemann A, Onakpoya IJ, Evans DH, Conly JM, and Jefferson T
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- COVID-19 Testing, Cohort Studies, Humans, RNA, Viral, COVID-19, SARS-CoV-2
- Abstract
Background: Modes of transmission of SARS-CoV-2 are of key public health importance. SARS-CoV-2 has been detected in the feces of some COVID-19 patients, suggesting the possibility that the virus could, in addition to droplet and fomite transmission, be transmitted via the orofecal route., Methods: This review is part of an Open Evidence Review on Transmission Dynamics of COVID-19. We conduct ongoing searches using WHO COVID-19 Database, LitCovid, medRxiv, and Google Scholar; assess study quality based on five criteria and report important findings. Where necessary, authors are contacted for further details on the content of their articles., Results: We include searches up until 20 December 2020. We included 110 relevant studies: 76 primary observational studies or reports, and 35 reviews (one cohort study also included a review) examining the potential role of orofecal transmission of SARS-CoV-2. Of the observational studies, 37 were done in China. A total of 48 studies (n=9,081 patients) reported single cases, case series or cohort data on individuals with COVID-19 diagnosis or their contacts and 46 (96%) detected binary RT-PCR with 535 out of 1358 samples positive for SARS-CoV-2 (average 39.4%). The results suggest a long duration of fecal shedding, often recorded after respiratory samples tested negative, and symptoms of gastrointestinal disease were reported in several studies. Twenty-nine studies reported finding SARS-CoV-2 RNA in wastewater, river water or toilet areas. Six studies attempted viral culture from COVID-19 patients' fecal samples: culture was successful in 3 of 6 studies, and one study demonstrated invasion of the virus into intestinal epithelial cells., Conclusions: Varied observational and mechanistic evidence suggests SARS-CoV-2 can infect and be shed from the gastrointestinal tract, including some data demonstrating viral culture in fecal samples. To fully assess these risks, quantitative data on infectious virus in these settings and infectious dose are needed., Competing Interests: Competing interests: CH holds grant funding from the NIHR School of Primary Care Research, the NIHR BRC Oxford and the World Health Organization for a series of Living rapid review on the modes of transmission of SARs-CoV-2 reference WHO registration No2020/1077093. He has received expenses and fees for his media work. He receives expenses for teaching EBM and is also paid for his GP work in NHS out of hours (contract Oxford Health NHS Foundation Trust) and for appraising treatment recommendations in non-NHS settings. He is the Director of CEBM and is an NIHR Senior Investigator. TJ was in receipt of a Cochrane Methods Innovations Fund grant to develop guidance on the use of regulatory data in Cochrane reviews (2015-018). In 2014–2016, he was a member of three advisory boards for Boehringer Ingelheim. TJ was a member of an independent data monitoring committee for a Sanofi Pasteur clinical trial on an influenza vaccine. TJ is occasionally interviewed by market research companies about phase I or II pharmaceutical products for which he receives fees (current). TJ was a member of three advisory boards for Boehringer Ingelheim (2014-16). TJ was a member of an independent data monitoring committee for a Sanofi Pasteur clinical trial on an influenza vaccine (2015-2017). TJ is a relator in a False Claims Act lawsuit on behalf of the United States that involves sales of Tamiflu for pandemic stockpiling. If resolved in the United States’ favor, he would be entitled to a percentage of the recovery. TJ is co-holder of a Laura and John Arnold Foundation grant for development of a RIAT support centre (2017-2020) and Jean Monnet Network Grant, 2017-2020 for The Jean Monnet Health Law and Policy Network. TJ is an unpaid collaborator to the project Beyond Transparency in Pharmaceutical Research and Regulation led by Dalhousie University and funded by the Canadian Institutes of Health Research (2018-2022). TJ consulted for Illumina LLC on next generation gene sequencing (2019-2020). TJ was the consultant scientific coordinator for the HTA Medical Technology programme of the Agenzia per i Serivizi Sanitari Nazionali (AGENAS) of the Italian MoH (2007-2019). TJ is Director Medical Affairs for BC Solutions, a market access company for medical devices in Europe. TJ is funded by NIHR UK and the World Health Organization (WHO) to update Cochrane review A122, “Physical Interventions to interrupt the spread of respiratory viruses”. TJ is funded by Oxford University to carry out a living review on the transmission epidemiology of COVID-19. Since 2020, TJ receives fees for articles published by The Spectator and other media outlets. TJ is part of a review group carrying out “Living rapid literature review on the modes of transmission of SARS-CoV-2 (WHO Registration 2020/1077093-0)”. He is a member of the WHO COVID-19 Infection Prevention and Control Research Working Group. JC holds grants from the Canadian Institutes for Health Research on acute and primary care preparedness for COVID-19 in Alberta, Canada and was the primary local Investigator for a Staphylococcus aureus vaccine study funded by Pfizer for which all funding was provided only to the University of Calgary. He also received support from the Centers for Disease Control and Prevention (CDC) to attend an Infection Control Think Tank Meeting. DE holds awards from the Canadian Institutes for Health Research and the Natural Sciences and Engineering Research Council of Canada to support poxvirus research as well as research relating to Covid-19 vaccine development and aerosol transmission. Funding from Alberta Health Services, Alberta Innovates, and the World Health Organization supports research concerning the mechanism of Covid-19 transmission and inactivation technologies. He also holds research contracts and consults with Tonix Pharmaceuticals in support of the development of poxvirus-based Covid-19 vaccines. IJO, EAS, JB, and AP have no interests to disclose., (Copyright: © 2021 Heneghan CJ et al.)
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- 2021
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39. Developing a fully automated evidence synthesis tool for identifying, assessing and collating the evidence.
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Brassey J, Price C, Edwards J, Zlabinger M, Bampoulidis A, and Hanbury A
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- Automation, Humans, Reproducibility of Results, Machine Learning, Natural Language Processing
- Abstract
Evidence synthesis is a key element of evidence-based medicine. However, it is currently hampered by being labour intensive meaning that many trials are not incorporated into robust evidence syntheses and that many are out of date. To overcome this, a variety of techniques are being explored, including using automation technology. Here, we describe a fully automated evidence synthesis system for intervention studies, one that identifies all the relevant evidence, assesses the evidence for reliability and collates it to estimate the relative effectiveness of an intervention. Techniques used include machine learning, natural language processing and rule-based systems. Results are visualised using modern visualisation techniques. We believe this to be the first, publicly available, automated evidence synthesis system: an evidence mapping tool that synthesises evidence on the fly., Competing Interests: Competing interests: Both JB and CP are shareholders in Trip Database. JB is also a member of the editorial board of BMJ EBM. No other declared competing interests from the other authors., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2021
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40. Emotional flexibility and general self-efficacy: A pilot training intervention study with knowledge workers.
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Brassey J, Witteloostuijn AV, Huszka C, Silberzahn T, and Dam NV
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- Adult, Education, Emotional Intelligence, Female, Humans, Job Satisfaction, Male, Mental Health, Netherlands, Occupational Health, Occupational Stress psychology, Pilot Projects, Psychometrics, Young Adult, Emotional Adjustment, Self Efficacy, Workplace psychology
- Abstract
Emotional flexibility advancement has been found to be highly effective in clinical settings to treat, for example, depression, anxiety, and chronic pain. Developing these skills in the working context has also shown very encouraging results in public sector settings. Also, a few studies have revealed effectiveness in a private sector setting, but no studies have yet looked at the effectiveness of developing these skills amongst high-paced, high-demanding, and highly-educated knowledge workers. In this pilot training intervention study, we report evidence that emotional flexibility can be developed in this context. We conducted an experiment with treatment and control groups, with only the treatment group receiving an emotional flexibility training. Emotional flexibility improved significantly for the treatment group, whereas the improvements were minimal or negative for the control group. Furthermore, we reveal that General self-efficacy improved amongst treatment group participants (and not for control group participants), and that this is associated with emotional flexibility. Finally, we show that the improvements were higher for participants starting from a lower baseline., Competing Interests: The 1st author is a part-time employee of the organization where the research was performed and a part-time affiliated researcher at three Universities. The 4th author is an employee of the same organization and invited the research as part of an employee well-being program. None of the other authors are part of this organization and served as academic researchers. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
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- 2020
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41. Rapid reviews may produce different results to systematic reviews: a meta-epidemiological study.
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Marshall IJ, Marshall R, Wallace BC, Brassey J, and Thomas J
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- Epidemiologic Methods, Epidemiologic Studies, Humans, PubMed, Review Literature as Topic, Systematic Reviews as Topic
- Abstract
Objective: To simulate possible changes in systematic review results if rapid review methods were used., Study Design and Setting: We recalculated meta-analyses for binary primary outcomes in Cochrane systematic reviews, simulating rapid review methods. We simulated searching only PubMed, excluding older articles (5, 7, 10, 15, and 20 years before the search date), excluding smaller trials (<50, <100, and <200 participants), and using the largest trial only. We examined percentage changes in pooled odds ratios (ORs) (classed as no important change [<5%], small [<20%], moderate [<30%], or large [≥30%]), statistical significance, and biases observed using rapid methods., Results: Two thousand five hundred and twelve systematic reviews (16,088 studies) were included. Rapid methods resulted in the loss of all data in 3.7-44.7% of meta-analyses. Searching only PubMed had the smallest risk of changed ORs (19% [477/2,512] were small changes or greater; 10% [260/2,512] were moderate or greater). Changes in ORs varied substantially with each rapid review method; 8.4-21.3% were small, 1.9-8.8% were moderate, and 4.7-34.1% were large. Changes in statistical significance occurred in 6.5-38.6% of meta-analyses. Changes from significant to nonsignificant were most common (2.1-13.7% meta-analyses). We found no evidence of bias with any rapid review method., Conclusion: Searching PubMed only might be considered where a ∼10% risk of the primary outcome OR changing by >20% could be tolerated. This could be the case in scoping reviews, resource limitation, or where syntheses are needed urgently. Other situations, such as clinical guidelines and regulatory decisions, favor more comprehensive systematic review methods., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2019
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42. The TRIP database showed most acute respiratory infections questions were already addressed by Cochrane reviews.
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Clark J, Carter M, Scott AM, Brassey J, and Del Mar C
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- Guidelines as Topic, Humans, Mortality, Prognosis, Systematic Reviews as Topic, Treatment Outcome, Databases, Bibliographic standards, Respiratory Tract Infections diagnosis, Respiratory Tract Infections drug therapy
- Abstract
Objectives: Cochrane systematic reviews require more methodological support from Cochrane Review Groups (CRGs) than is customarily received by authors from journals; CRGs must therefore prioritize reviews to conserve resources. The TRIP database provided a data set of questions to guide prioritization for the acute respiratory infections (ARIs) CRG., Study Design and Setting: We extracted the ARI searches from the TRIP database (2010 to 2017) that contained at least one disease and one clinical management term, (defined as a "search"), and tabulated these by frequency., Results: There were 314,346 ARI searches from which we inferred 45,497 clinical questions, covering 365 topics. Two-thirds (30,541) of these addressed 20 clinical questions, of which treatment were the most frequent, followed by diagnosis, mortality, and prognosis. The five most frequent clinical questions were "Influenza + Vaccination" 4,989 (12.1%), "acute otitis media + antibiotics" 3,578 (8.7%), "common cold + vitamin C" 3,528 (8.6%), "meningitis + corticosteroids" 1,910 (4.6%), and "pneumonia + general treatment" 1,765 (4.3%). The 20 most frequent clinical questions were addressed by Cochrane reviews or protocols., Conclusion: ARI questions are common and repeated often. Most may have been addressed by Cochrane reviews. The remainder form the basis of a priority list to assign resources for future Cochrane topics., (Copyright © 2018 Elsevier Inc. All rights reserved.)
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- 2019
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43. Why Cochrane should prioritise sharing data.
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Shokraneh F, Adams CE, Clarke M, Amato L, Bastian H, Beller E, Brassey J, Buchbinder R, Davoli M, Del Mar C, Glasziou P, Gluud C, Heneghan C, Hoffmann T, Ioannidis JP, Jayaram M, Kwong J, Moher D, Ota E, Sheriff RS, Vale L, and Goldacre B
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- Clinical Trials as Topic, Humans, Systematic Reviews as Topic, Biomedical Research, Information Dissemination
- Abstract
Competing Interests: Competing interests. FS is the information specialist of Cochrane Schizophrenia and has voluntarily extracted data for 12 Cochrane groups. CEA promotes Cochrane extensively to the public and policy makers; trains hundreds of reviewers per year, is coordinating editor of Cochrane Schizophrenia, is principal investigator on randomised trials testing the effects of disseminating Cochrane reviews in different forms and on the National Institute for Health Research infrastructure grant for Cochrane Schizophrenia. MC promotes Cochrane to the public, practitioners, and policy makers; provides training in the conduct of randomised trials and systematic reviews, is coordinating editor of the Cochrane Methodology Review Group, and seeks funding and conducts research into the methods using in systematic reviews and other evaluations of health and social care. BG has promoted Cochrane extensively to the public and policy makers; is principal investigator on OpenTrials.net, which has had a data sharing request rejected by Cochrane; has received research funding from the Laura and John Arnold Foundation, the Wellcome Trust, the NHS NIHR School of Primary Care, the Health Foundation, NHS England, the NIHR Oxford Biomedical Research Centre, and the World Health Organization; receives personal income from speaking and writing for lay audiences on the misuse of science; and has a longstanding commitment to open science. LA promotes Cochrane to the public and policy makers; is coordinating editor of Cochrane Drugs and Alcohol Group; has received grant funding from WHO, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the Italian National Institute of Health, and AIFA (Italian Medicines Agency). HB has received access to Cochrane data for projects and services. JB is director and shareholder in the Trip Database, a limited company, and is actively involved in evidence synthesis. Trip has the potential to benefit from better access to the data Cochrane currently restricts. RB promotes Cochrane extensively to the public, clinicians, and policy makers; trains several reviewers a year, is joint coordinating editor of Cochrane Musculoskeletal, is principal investigator on grants developing two living Cochrane reviews and on National Health and Medical Research Council (NHMRC) editorial base funding for Cochrane Musculoskeletal, and has received research funding from the NHMRC, Cabrini Foundation, Medical Research Council, and Patient Centered Outcomes Research Institute. She is funded by an NHMRC Senior Principal Research Fellowship. CDM has received consultancy fees/honorariums from National Prescribing Service MedicineWise , the Royal Australian College of General Practitioners’ “red book” preventive guidelines committee; Therapeutic Guidelines (eTG); Remote Primary Health Care Manuals Editorial Committee for expert advice; editorial work (deputy editor of the Medical Journal of Australia; American College of Physicians’ journal club; The BMJ); Consultation work for Bupa (UK) on shared decision making: Australian Medicine Handbook; royalties for three books (Wiley and BMJ Books) on evidence based medicine and clinical thinking; grants from NHMRC (Australia) two centres for research excellence; NIHR (UK); Human Tissue Authority (UK); from a private donor (for the Cochrane Collaboration Acute Respiratory Infections Group); Australian Commission on Safety and Quality in Health Care. MD is coordinating editor of Cochrane Drugs and Alcohol Group; has received grant funding from WHO, EMCDDA, the Italian National Institute of Health and AIFA, and disseminates Cochrane review results to the public and policy makers. PG is a member of editorial group of the Cochrane Acute Respiratory Infections group. CH has received grant funding from WHO, NIHR and the NIHR School of Primary Care. MJ is an editor at Cochrane Schizophrenia Group. DM is on Cochrane Oversight Committee. RSS is joint coordinating editor of the Cochrane Schizophrenia group. LV holds an NIHR systematic reviews grant for the Cochrane Incontinence. He holds grants from: EU2020, Wellcome, Economic and Social Research Council, MRC, Health Foundation, NIHR for research using systematic review methods. EB, CG, TH, JPAI, JK, and EO have declared no conflict of interests.
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- 2018
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44. The added value of implicit motives for management research Development and first validation of a Brief Implicit Association Test (BIAT) for the measurement of implicit motives.
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Slabbinck H, van Witteloostuijn A, Hermans J, Vanderstraeten J, Dejardin M, Brassey J, and Ramdani D
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- Achievement, Adult, Belgium, Entrepreneurship, Female, Humans, Male, Middle Aged, Personality physiology, Personnel Management, Power, Psychological, Self Concept, Self Efficacy, Surveys and Questionnaires, Motivation, Personality Assessment standards, Research organization & administration, Word Association Tests standards
- Abstract
Many Management (sub-)disciplines, from Organizational Behavior and Marketing to Accounting and Strategy, are interested in antecedents and consequences of individual attitudes and traits. A key aspect of personality profiles are explicit and implicit motives. Yet, Management scholars mainly focus on explicit motives, with limited attention to implicit motives. We argue that this state of affairs probably came into being because current Management researchers mainly rely on implicit motive measures that are either difficult to apply or to develop, hampering researchers from applying implicit motive measures. To overcome the downsides of available instruments, we develop a Brief Implicit Association Test (BIAT) as an efficient, reliable and valid measure of implicit motives, particularly the needs for achievement, affiliation and power. To explore our BIAT's predictive validity, we apply this measure to a specific research domain within Management: Entrepreneurship. We examine implicit motives' association with entrepreneurial self-efficacy, business founding, and financial profitability. Our results show that the introduction of implicit motives can unlock stranded discussions in this research domain. Overall, we argue that implicit motives can help to push the boundaries of the study of deep-level attributes in a wide range of organizational and managerial settings., Competing Interests: The authors have declared that no competing interests exist.
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- 2018
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45. Catalogue of bias: observer bias.
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Mahtani K, Spencer EA, Brassey J, and Heneghan C
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- Bias, Humans, Randomized Controlled Trials as Topic methods, Randomized Controlled Trials as Topic standards, Observer Variation
- Abstract
This article is part of a series featured from the Catalogue of Bias introduced in this volume of BMJ Evidence-Based Medicine that describes biases and outlines their potential impact in research studies. Observer bias is systematic discrepancy from the truth during the process of observing and recording information for a study. Many healthcare observations are at risk of this bias. Evidence shows that treatment effect estimates can be exaggerated by a third to two-thirds in the presence of observer bias in outcome assessment. Preventing observer bias involves proper masking in intervention studies including the use of matched placebo interventions where appropriate and training of observers to make assessment consistent and reduce biases resulting from conscious or unconscious prejudices. Where observers are involved in a research study, it is probably not possible for the study to be entirely free of observer biases., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
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- 2018
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46. Extracting the Population, Intervention, Comparison and Sentiment from Randomized Controlled Trials.
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Zlabinger M, Andersson L, Brassey J, and Hanbury A
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- Humans, Data Mining, Randomized Controlled Trials as Topic, Research Design
- Abstract
In this paper, an identification approach for the Population (e.g. patients with headache), the Intervention (e.g. aspirin) and the Comparison (e.g. vitamin C) in Randomized Controlled Trials (RCTs) is proposed. Contrary to previous approaches, the identification is done on a word level, rather than on a sentence level. Additionally, we classify the sentiment of RCTs to determine whether an Intervention is more effective than its Comparison. Two new corpora were created to evaluate both approaches. In the experiments, an average F1 score of 0.85 for the PIC identification and 0.72 for the sentiment classification was achieved.
- Published
- 2018
47. Evidence base needs among clinicians.
- Author
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Atenstaedt R, Brassey J, Jones P, Martin M, Owen N, and Woods F
- Subjects
- Humans, Nurses, Pharmacists, Physicians, Surveys and Questionnaires, Wales, Attitude of Health Personnel, Evidence-Based Practice
- Published
- 2014
- Full Text
- View/download PDF
48. Can we rely on the best trial? A comparison of individual trials and systematic reviews.
- Author
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Glasziou PP, Shepperd S, and Brassey J
- Subjects
- Probability, Review Literature as Topic, Clinical Trials as Topic, Meta-Analysis as Topic
- Abstract
Background: The ideal evidence to answer a question about the effectiveness of treatment is a systematic review. However, for many clinical questions a systematic review will not be available, or may not be up to date. One option could be to use the evidence from an individual trial to answer the question?, Methods: We assessed how often (a) the estimated effect and (b) the p-value in the most precise single trial in a meta-analysis agreed with the whole meta-analysis. For a random sample of 200 completed Cochrane Reviews (January, 2005) we identified a primary outcome and extracted: the number of trials, the statistical weight of the most precise trial, the estimate and confidence interval for both the highest weighted trial and the meta-analysis overall. We calculated the p-value for the most precise trial and meta-analysis., Results: Of 200 reviews, only 132 provided a meta-analysis of 2 or more trials, with a further 35 effect estimates based on single trials. The average number of trials was 7.3, with the most precise trial contributing, on average, 51% of the statistical weight to the summary estimate from the whole meta-analysis. The estimates of effect from the most precise trial and the overall meta-analyses were highly correlated (rank correlation of 0.90).There was an 81% agreement in statistical conclusions. Results from the most precise trial were statistically significant in 60 of the 167 evaluable reviews, with 55 of the corresponding systematic reviews also being statistically significant. The five discrepant results were not strikingly different with respect to their estimates of effect, but showed considerable statistical heterogeneity between trials in these meta-analyses. However, among the 101 cases in which the most precise trial was not statistically significant, the corresponding meta-analyses yielded 31 statistically significant results., Conclusions: Single most precise trials provided similar estimates of effects to those of the meta-analyses to which they contributed, and statistically significant results are generally in agreement. However, "negative" results were less reliable, as may be expected from single underpowered trials. For systematic reviewers we suggest that: (1) key trial(s) in a review deserve greater attention (2) systematic reviewers should check agreement of the most precise trial and the meta analysis. For clinicians using trials we suggest that when a meta-analysis is not available, a focus on the most precise trial is reasonable provided it is adequately powered.
- Published
- 2010
- Full Text
- View/download PDF
49. Using the Turning Research Into Practice (TRIP) database: how do clinicians really search?
- Author
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Meats E, Brassey J, Heneghan C, and Glasziou P
- Subjects
- Abstracting and Indexing, Humans, Physicians, Databases as Topic, Information Storage and Retrieval methods, Internet
- Abstract
Objectives: Clinicians and patients are increasingly accessing information through Internet searches. This study aimed to examine clinicians' current search behavior when using the Turning Research Into Practice (TRIP) database to examine search engine use and the ways it might be improved., Methods: A Web log analysis was undertaken of the TRIP database-a meta-search engine covering 150 health resources including MEDLINE, The Cochrane Library, and a variety of guidelines. The connectors for terms used in searches were studied, and observations were made of 9 users' search behavior when working with the TRIP database., Results: Of 620,735 searches, most used a single term, and 12% (n = 75,947) used a Boolean operator: 11% (n = 69,006) used "AND" and 0.8% (n = 4,941) used "OR." Of the elements of a well-structured clinical question (population, intervention, comparator, and outcome), the population was most commonly used, while fewer searches included the intervention. Comparator and outcome were rarely used. Participants in the observational study were interested in learning how to formulate better searches., Conclusions: Web log analysis showed most searches used a single term and no Boolean operators. Observational study revealed users were interested in conducting efficient searches but did not always know how. Therefore, either better training or better search interfaces are required to assist users and enable more effective searching.
- Published
- 2007
- Full Text
- View/download PDF
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