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3. How do we explain painful non‐traumatic knee conditions to adolescents? A multiple‐method study to develop credible explanations.

Author

Djurtoft, C., Bruun, M. K., Riel, H., Hoegh, M. S., Darlow, B., and Rathleff, M. S.

Abstract

Background: Perceived diagnostic uncertainty can leave adolescents confused about their condition and impede their ability to understand "what's wrong with me". Our aim is to develop credible explanations about the condition for adolescents suffering from non‐traumatic knee pain. Methods: This multiple‐method study integrated findings from two systematic literature searches of qualitative and quantitative studies, an Argumentative Delphi with international experts (n = 16) and think‐aloud interviews with adolescents (n = 16). Experts provided feedback with arguments on how to communicate credible explanations to meet adolescents' needs; we analysed feedback using thematic analysis. The explanations were tailored based on the adolescent end‐users' input. Results: We screened 3239 titles/abstracts and included 16 papers exploring diagnostic uncertainty from adolescents' and parents' perspectives. Five themes were generated: (1) understanding causes and contributors to the pain experience, (2) feeling stigmatized for having an invisible condition, (3) having a name for pain, (4) controllability of pain, and (5) worried about something being missed. The Argumentative Delphi identified the following themes: (1) multidimensional perspective, (2) tailored to adolescents, (3) validation and reassurance, and (4) careful wording. Merging findings from the systematic search and the Delphi developed three essential domains to address in credible explanations: "What is non‐traumatic knee pain and what does it mean?", "What is causing my knee pain?" and "How do I manage my knee pain?" Conclusions: Six credible explanations for the six most common diagnoses of non‐traumatic knee pain were developed. We identified three domains to consider when tailoring credible explanations to adolescents experiencing non‐traumatic knee pain. Significance: This study provides credible explanations for the six most common diagnoses of non‐traumatic knee pain. Additionally, we identified three key domains that may need to be addressed to reduce diagnostic uncertainty in adolescents suffering from pain complaints. Based on our findings, we believe that clinicians will benefit from exploring adolescents' own perceptions of why they experience pain and perceived management strategies, as this information might capture important clinical information when managing these young individuals. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Clinical reasoning in managing chronic hip pain: One in two Australian and New Zealand physiotherapists diagnosed a case vignette with clinical criteria for hip OA as hip OA. A cross-sectional survey

Author

Haber, T, Hinman, RS, Dobson, F, Vicenzino, B, Darlow, B, Kayll, S, Hall, M, Haber, T, Hinman, RS, Dobson, F, Vicenzino, B, Darlow, B, Kayll, S, and Hall, M

Abstract

OBJECTIVES: Using a case vignette of an adult (George) presenting with hip pain consistent with hip OA, this study aimed to describe: (a) whether physiotherapists make diagnoses and identify bodily structures using either patient history and/or physical examination findings; (b) which diagnoses and bodily structures physiotherapists attribute to the hip pain; (c) how confident physiotherapists were in their clinical reasoning using patient history and physical examination findings; (d) what treatments physiotherapists would offer to George. METHODS: We conducted a cross-sectional online survey of physiotherapists in Australia and New Zealand. We used descriptive statistics to analyse closed questions and content analysis for open-text responses. RESULTS: Two hundred and twenty physiotherapists completed the survey (39% response-rate). After receiving the patient history, 64% diagnosed George's pain and 49% of these as hip OA; 95% attributed George's pain to a bodily structure(s). After receiving the physical examination, 81% diagnosed George's hip pain and 52% of these as hip OA; 96% attributed George's hip pain to a bodily structure(s). Ninety-six percent of respondents were at least somewhat confident in their diagnosis after the patient history, and 95% were similarly confident after the physical examination. Most respondents offered advice (98%) and exercise (99%), but fewer offered treatments for weight loss (31%), medication (11%), and psychosocial factors (<15%). DISCUSSION: About half of the physiotherapists that diagnosed George's hip pain made a diagnosis of hip OA, despite the case vignette including clinical criteria for a diagnosis of OA. Physiotherapists offered exercise and education, but many physiotherapists did not offer other clinically indicated and recommended treatments, such as weight loss and sleep advice.

Published
2023

7. How do we explain painful chronic non-traumatic knee conditions to children and adolescents? A multiple-method study to develop credible explanations

Author

Djurtoft, C, Bruun, MK, Riel, H, Hoegh, MS, Darlow, B, and Rathleff, MS

Subjects
pain medicine
Abstract

INTRODUCTIONPerceived diagnostic uncertainty can leave adolescents confused about their condition and impede their ability to understand "whats wrong with me". Our aim is to develop credible explanations (trustworthy and understandable explanation of the condition) for adolescents suffering from chronic non-traumatic knee pain. METHODSThis multiple-method study integrated findings from a systematic literature search of qualitative studies, an Argumentative Delphi with international experts (n=16) and think-aloud sessions with adolescents (n=7). Experts provided feedback with arguments on how to communicate credible explanations to meet adolescents needs. We analyzed feedback using thematic analysis before tailoring explanations to end-users. RESULTSWe screened 3.239 titles/abstracts and included 16 papers which explored diagnostic uncertainty from adolescents and parents perspectives. Five themes emerged: (1) Understanding causes and contributors to the pain experience, (2) Feeling stigmatized for having an invisible condition, (3) Having a name for pain, Controllability of pain, and (5) Worried about something being missed. The Argumentative Delphi revealed the following themes: (1) Multidimensional perspective, (2) Tailored to adolescents, (3) Validation and reassurance, and (4) Careful wording. Merging findings from the systematic search and the Delphi revealed three essential domains to address in credible explanations: "What is non-traumatic knee pain and what does it mean?", "What is causing my knee pain?" and "How do I manage my knee pain?". CONCLUSIONSSix credible explanations for the six most common diagnoses of chronic non-traumatic knee pain were developed. We identified three domains to consider when tailoring credible explanations to adolescents experiencing non-traumatic knee pain.

Published
2022

9. Feasibility of a randomised controlled trial of two types of written information for people with knee osteoarthritis.

Author

Darlow, B, Brown, M, Hudson, B, Frew, G, Clark, J, Vincent, L, Abbott, JH, Briggs, AM, Grainger, R, Marra, C, McKinlay, E, Stanley, J, Darlow, B, Brown, M, Hudson, B, Frew, G, Clark, J, Vincent, L, Abbott, JH, Briggs, AM, Grainger, R, Marra, C, McKinlay, E, and Stanley, J

Abstract

OBJECTIVE: Test the feasibility of conducting an individually randomised controlled trial recruiting people with knee osteoarthritis (OA) in community pharmacies and evaluate the impacts of a novel information booklet. DESIGN: People with knee OA were identified by pharmacy staff using clinical criteria and randomised to receive a novel information booklet (intervention) or the currently available written OA resource (active control). Mixed-methods process evaluation assessed participant recruitment, retention, and experience. Participant-reported outcome measures, assessing OA illness perceptions, OA knowledge, fear of movement, and pain when walking at baseline and 4-weeks, were analysed using linear regression models (adjusted for baseline). RESULTS: Of 72 eligible people, 64 were randomised to intervention (n ​= ​33) or control (n ​= ​31). The randomisation sequence was followed correctly and no protocol deviations identified. Mean recruitment rate was 2.7 participants per pharmacy per week. One-in-five participants had no educational qualifications and one-in-four had not received a knee OA diagnosis prior to the trial. Three meta-themes emerged from pharmacist and participant qualitative analysis: 'pleased to be asked'; 'easy process'; and 'successful process'. Three participants were lost to follow-up. At 4 weeks, intervention arm Knee Osteoarthritis Knowledge Scale scores improved (mean difference ​= ​3.6, 95%CI 0.7 to 6.5). Brief Illness Perceptions Questionnaire scores were similar between groups (mean difference 0.4, 95%CI -3.7 to 4.5). CONCLUSION: It is feasible to conduct an individually randomised trial in community pharmacy, a potentially effective setting to initiate accessible OA care. A novel information booklet improved OA knowledge, but is unlikely to affect illness perceptions on its own.

Published
2022

10. ADHD symptoms and diagnosis in adult preterms: systematic review, IPD meta-analysis, and register-linkage study

Author

Robinson, R. (Rachel), Girchenko, P. (Polina), Pulakka, A. (Anna), Heinonen, K. (Kati), Lähdepuro, A. (Anna), Lahti-Pulkkinen, M. (Marius), Hovi, P. (Petteri), Tikanmäki, M. (Marjaana), Bartmann, P. (Peter), Lano, A. (Aulikki), Doyle, L. W. (Lex W.), Anderson, P. J. (Peter J.), Cheong, J. L. (Jeanie L. Y.), Darlow, B. A. (Brian A.), Woodward, L. J. (Lianne J.), Horwood, L. J. (L. John), Indredavik, M. S. (Marit S .), Evensen, K. A. (Kari Anne I.), Marlow, N. (Neil), Johnson, S. (Samantha), de Mendonca, M. G. (Marina Goulart), Kajantie, E. (Eero), Wolke, D. (Dieter), Räikkönen, K. (Katri), Robinson, R. (Rachel), Girchenko, P. (Polina), Pulakka, A. (Anna), Heinonen, K. (Kati), Lähdepuro, A. (Anna), Lahti-Pulkkinen, M. (Marius), Hovi, P. (Petteri), Tikanmäki, M. (Marjaana), Bartmann, P. (Peter), Lano, A. (Aulikki), Doyle, L. W. (Lex W.), Anderson, P. J. (Peter J.), Cheong, J. L. (Jeanie L. Y.), Darlow, B. A. (Brian A.), Woodward, L. J. (Lianne J.), Horwood, L. J. (L. John), Indredavik, M. S. (Marit S .), Evensen, K. A. (Kari Anne I.), Marlow, N. (Neil), Johnson, S. (Samantha), de Mendonca, M. G. (Marina Goulart), Kajantie, E. (Eero), Wolke, D. (Dieter), and Räikkönen, K. (Katri)

Abstract

Background: This study examined differences in ADHD symptoms and diagnosis between preterm and term-born adults (≥18 years), and tested if ADHD is related to gestational age, birth weight, multiple births, or neonatal complications in preterm borns. Methods: (1) A systematic review compared ADHD symptom self-reports and diagnosis between preterm and term-born adults published in PubMed, Web of Science, and PROQUEST until April 2021; (2) a one-stage Individual Participant Data(IPD) meta-analysis (n= 1385 preterm, n = 1633 term; born 1978–1995) examined differences in self-reported ADHD symptoms[age 18–36 years]; and (3) a population-based register-linkage study of all live births in Finland (01/01/1987–31/12/1998; n = 37538 preterm, n = 691,616 term) examined ADHD diagnosis risk in adulthood (≥18 years) until 31/12/2016. Results: Systematic review results were conflicting. In the IPD meta-analysis, ADHD symptoms levels were similar across groups (mean z-score difference 0.00;95% confidence interval [95% CI] −0.07, 0.07). Whereas in the register-linkage study, adults born preterm had a higher relative risk (RR) for ADHD diagnosis compared to term controls (RR = 1.26, 95% CI 1.12, 1.41, p < 0.001). Among preterms, as gestation length (RR = 0.93, 95% CI 0.89, 0.97, p < 0.001) and SD birth weight z-score (RR = 0.88, 95% CI 0.80, 0.97, p < 0.001) increased, ADHD risk decreased. Conclusions: While preterm adults may not report higher levels of ADHD symptoms, their risk of ADHD diagnosis in adulthood is higher.

Published
2022

13. Common Core Assessments in follow-up studies of adults born preterm:recommendation of the Adults Born Preterm International Collaboration

Author

Kajantie, E. (Eero), Johnson, S. (Samantha), Heinonen, K. (Kati), Anderson, P. J. (Peter J.), Wolke, D. (Dieter), Evensen, K. A. (Kari Anne I.), Räikkönen, K. (Katri), Darlow, B. A. (Brian A.), van der Pal, S. (Sylvia), Indredavik, M. S. (Marit S.), Jaekel, J. (Julia), Hovi, P. (Petteri), Morrison, K. (Katherine), Verrips, E. (Erik), Doyle, L. W. (Lex W.), and A. A. (APIC Adults Born Preterm International Collaboration)

Subjects
recommendation, birthweight, follow-up, preterm
Abstract

Background: Of all newborns, 1%-2% are born very preterm (VP

Published
2021

14. Knowledge about osteoarthritis: Development of the Hip and Knee Osteoarthritis Knowledge Scales and protocol for testing their measurement properties.

Author

Darlow, B, Abbott, H, Bennell, K, Briggs, AM, Brown, M, Clark, J, Dean, S, French, S, Hinman, RS, Krägeloh, C, Metcalf, B, O'Brien, D, Stanley, J, Whittaker, JL, Darlow, B, Abbott, H, Bennell, K, Briggs, AM, Brown, M, Clark, J, Dean, S, French, S, Hinman, RS, Krägeloh, C, Metcalf, B, O'Brien, D, Stanley, J, and Whittaker, JL

Abstract

OBJECTIVES: 1) Develop unidimensional instruments to measure osteoarthritis (OA) knowledge among people with hip or knee OA, and 2) assess the structural validity, internal consistency, cross-cultural validity/measurement invariance, test-retest reliability, and measurement error of the Hip Osteoarthritis Knowledge Scale (HOAKS) and the Knee Osteoarthritis Knowledge Scale (KOAKS). METHODS: Draft HOAKS and KOAKS were developed and refined following best-practice (COSMIN) guidelines with involvement of consumer research partners. Measurement properties of the HOAKS and KOAKS will be assessed through an online survey. The survey will include the novel HOAKS or KOAKS, the current short form of the Hip or Knee injury and Osteoarthritis Outcome Score (HOOS-12/KOOS-12), and items that gather demographic and OA characteristics and explore self-rated OA knowledge. People will be eligible to participate if aged 18 years and older, can communicate in English, and have either hip or knee OA as diagnosed by a health professional or by meeting diagnostic criteria. We aim to obtain 400 complete HOAKS or KOAKS responses and 100 complete HOAKS or KOAKS retest responses one week after initial completion. Rasch analysis will estimate structural validity, internal consistency and cross-cultural validity/measurement invariance. Assessment will include test-retest reliability (intraclass correlation coefficient) and absolute measurement error (standard error of measurement; smallest detectable change). CONCLUSION: This study will produce robust unidimensional instruments to measure hip and knee OA knowledge. We anticipate that the HOAKS and KOAKS scales will be useful in clinical and research settings to identify knowledge gaps or evaluate interventions designed to improve knowledge.

Published
2021

15. Barriers and facilitators experienced by osteopaths in implementing a biopsychosocial (BPS) framework of care when managing people with musculoskeletal pain – a mixed methods systematic review

Author

Sampath, KK, Darlow, B, Tumilty, S, Shillito, W, Hanses, M, Devan, H, Thomson, OP, Sampath, KK, Darlow, B, Tumilty, S, Shillito, W, Hanses, M, Devan, H, and Thomson, OP

Abstract

BACKGROUND: Clinical practice guidelines commonly recommend adopting a biopsychosocial (BPS) framework by practitioners managing musculoskeletal pain. However, it remains unclear how osteopaths implement a BPS framework in the management of musculoskeletal pain. Hence, the objective of this review was to systematically appraise the literature on the current practices, barriers and facilitators experienced by osteopaths in implementing a BPS framework of care when managing people with musculoskeletal pain. METHODS: The following electronic databases from January 2005 to August 2020 were searched: PubMed, CINAHL, Science Direct, Google Scholar, ProQuest Central and SCOPUS. Two independent reviewers reviewed the articles retrieved from the databases to assess for eligibility. Any studies (quantitative, qualitative and mixed methods) that investigated the use or application of the BPS approach in osteopathic practice were included in the review. The critical appraisal skills program (CASP) checklist was used to appraise the qualitative studies and the Mixed Methods Appraisal Tool (MMAT) was used to appraise quantitative or mixed methods studies. Advanced convergent meta-integration was used to synthesise data from quantitative, qualitative and mixed methods studies. RESULTS: A total of 6 studies (two quantitative, three qualitative and one mixed methods) were included in the final review. While two key concepts (current practice and embracing a BPS approach) were generated using advanced meta-integration synthesis, two concepts (barriers and enablers) were informed from qualitative only data. DISCUSSION: Our review finding showed that current osteopathic practice occurs within in the biomedical model of care. Although, osteopaths are aware of the theoretical underpinnings of the BPS model and identified the need to embrace it, various barriers exist that may prevent osteopaths from implementing the BPS model in clinical practice. Ongoing education and/or workshops may b

Published
2021

24. The International Network for Evaluating Outcomes (iNeo) of neonates: evolution, progress and opportunities

Author

Shah, PS, Lui, K, Reichman, B, Norman, M, Kusuda, S, Lehtonen, L, Adams, M, Vento, M, Darlow, BA, Modi, N, Rusconi, F, Hakansson, S, San Feliciano, L, Helenius, KK, Bassler, D, Hirano, S, Lee, SK, Marshall, P, Schmidt, P, Dhawan, A, Craven, P, De Waal, K, Simmer, K, Gill, A, Pillow, J, Stack, J, Birch, P, Cooke, L, Casalaz, D, Holberton, J, Stewart, A, Downe, L, Stewart, M, Bajuk, B, Berry, A, Hunt, R, Kilburn, C, De Paoli, T, Bolisetty, S, Paradisis, M, Rieger, I, Koorts, P, Kuschel, C, Numa, A, Carlisle, H, Badawi, N, Loughran-Fowlds, A, Koh, G, Davis, J, Luig, M, Andersen, C, Chambers, G, Austin, N, Lynn, A, Darlow, B, Edmonds, L, Mildenhall, L, Buksh, M, Battin, M, Van den Boom, J, Bourchier, D, Richardson, V, Dineen, F, Rajadurai, VS, Fung, G, Harrison, A, Synnes, A, Ting, J, Cieslak, Z, Sherlock, R, Yee, W, Aziz, K, Toye, J, Fajardo, C, Kalapesi, Z, Sankaran, K, Daspal, S, Seshia, M, Alvaro, R, Mukerji, A, Da Silva, O, Nwaesei, C, Lee, K-S, Dunn, M, Lemyre, B, Dow, K, Pelausa, E, Barrington, K, Drolet, C, Piedboeuf, B, Claveau, M, Beltempo, M, Bertelle, V, Masse, E, Canning, R, Mabry, H, Ojah, C, Monterrosa, L, Deshpandey, A, Afifi, J, Kajetanowicz, A, Andersson, S, Tammela, O, Sankilampi, U, Saarela, T, Prazad, P, Noguchi, A, McWan, K, Button, B, Stratton, W, Hamvus, A, Raghaven, A, Derrick, M, Hadley, R, Covert, R, Lablanc, O, Weiss, M, Bell, A, Shareef, M, Silvestri, J, Heymann, E, Zangen, S, Smolkin, T, Mimouni, F, Bader, D, Rothschild, A, Strauss, Z, Felszer, C, Oman, H, Toy-Friedman, SE, Bar-Oz, B, Feldman, M, Saad, N, Flidel-Rimon, O, Weisbrod, M, Lubin, D, Litmanovitz, I, Kngelman, A, Shinwell, E, Klinger, G, Nijim, Y, Bin-Nun, A, Golan, A, Mandel, D, Fleisher-Sheffer, V, Kohelet, D, Bakhrakh, L, Hattori, S, Shirai, M, Ishioka, T, Mori, T, Amiznka, T, Huchimukai, T, Yoshida, H, Sasaki, A, Shimizu, J, Nakamura, T, Maruyama, M, Matsumoto, H, Hosokawa, S, Taki, A, Nakagawa, M, Ko, K, Uozumi, A, Nakata, S, Shimazaki, A, Yoda, T, Numata, O, Imamura, H, Kobayashi, A, Tokuriki, S, Uchida, Y, Arai, T, Ito, M, Ieda, K, Ono, T, Hayashi, M, Maki, K, Yamakawa, M, Kawai, M, Fujii, N, Shiomi, K, Nozaki, K, Wada, H, Kim, T, Tokunaga, Y, Takatera, A, Oshima, T, Sumida, H, Michinomae, Y, Knsumoto, Y, Yoshimoto, S, Morisawa, T, Ohashi, T, Takahashi, Y, Sugimoto, M, Ono, N, Miyagawa, S, Saijo, T, Yamagami, T, Koyano, K, Kobayashi, S, Kanda, T, Sakemi, Y, Aoki, M, Iida, K, Goshi, M, Maruyama, Y, Avila-Alvarez, A, Luis Fernandez-Trisac, J, Couce Pico, ML, Fernandez Seara, MJ, Martinez Gutierrez, A, Vizcaino, C, Salvador Iglesias, M, Sanchez Zaplana, H, Fernandez Colomer, B, Garcia Lopez, JE, Garcia Mozo, R, Gonzalez Martinez, MT, Muro Sebastian, MD, Balart Carbonell, M, Badia Bamnsell, J, Domingo Puiggros, M, Figueras Aloy, J, Botet Mussons, F, Anquela Sanz, I, Ginovart Galiana, G, Coroleu, W, Iriondo, M, Vilella, LC, Porta, R, Demestre, X, Martinez Nadal, S, De Frutos Martinez, C, Lopez Cuesta, MJ, Esquivel Mora, D, Ortiz Tardio, J, Benavente, I, Alonso, A, Aguilera Olmos, R, Garcia Cabezas, MA, Martinez Jimenez, MD, Jaraba Caballero, MF, Ordofiez Diaz, MD, Fagundo, AT, Canals, LM, Garcia-Munoz Rodrigo, F, Urquia Marti, L, Moreno Galdo, MF, Hurtado Suazo, JA, Narbona Lopez, E, Uberos Fernandez, J, Cortajarena Altana, MA, Mora Navarro, D, Teresa Dominguez, M, Ruiz del Prado, MY, Esteban Diez, I, Palau Benavides, MT, Lapena, S, Prada, T, Soler Mir, E, Corredera Sanchez, A, Criado Vega, E, Del Prado, N, Fernandez, C, Cabanillas Vilaplana, L, Cuadrado Perez, I, Lopez Gomez, L, Domingo Comeche, L, Llana Martin, I, Gonzalez Armengod, C, Munoz Labian, C, Santos Munoz, MJ, Blanco Bravo, D, Perez, V, Elorza Fernandez, MD, Diaz Gonzalez, C, Ares Segura, S, Lopez Azorin, M, Belen Jimenez, A, Sanchez-Tamayo, T, Tapia Moreno, E, Gonzalez, M, Sanchez Martinez, JE, Lloreda Garcia, JM, Goni Orayen, C, Vilas Gonzalez, J, Suarez Albo, M, Gonzalez Colmenero, E, Gutierrez Gonzalez, EP, Vacas del Arco, B, Marquez Fernandez, J, Acosta Gordillo, L, Granero Asensio, M, Macias Diaz, C, Albujar, M, Fuster Jorge, P, Romero, S, Rivero Falero, M, Escobar Izquierdo, AB, Estan Capell, J, Izquierdo Macian, MI, Montejo Vicente, MM, Izquierdo Caballero, R, Mercedes Martinez, M, Euba, A, Rodriguez Serna, A, De Heredia Goya, JML, Perez Legorburu, A, Gutierrez Amoros, A, Marugan Isabel, VM, Hernandez Gonzalez, N, Rite Gracia, S, Ventura Faci, MP, Samper Villagrasa, MP, Kofron, J, Brodd, KS, Odlind, A, Alberg, L, Arwehed, S, Hafstrom, O, Kasemo, A, Nederman, K, Ahman, L, Ingemarsson, F, Petersson, H, Thum, P, Albinsson, E, Selander, B, Abrahamsson, T, Heimdahl, I, Sveinsdottir, K, Wejryd, E, Hedlund, A, Soderberg, MK, Hallberg, B, Brune, T, Backstrom, J, Robinson, J, Farooqi, A, Normann, E, Fredriksson, M, Palm, A, Rosenqvist, U, Hagman, C, Ohlin, A, Floral, R, Smedsaas-Lofvenberg, A, Meyer, P, Anderegg, C, Schulzke, S, Nelle, M, Wagner, B, Riedel, T, Kaczala, G, Walde, B, Pfister, RE, Tolsa, J-F, Roth, M, Stocker, M, Laubscher, B, Malzacher, A, Micallef, JP, Hegi, L, Arlettaz, R, Bernet, V, Dani, C, Fiorini, P, Boldrini, A, Tomasini, B, Mittal, A, Kefas, J, Kamalanathan, A, Jayachandran, Yoxall, B, McBride, T, Webb, D, Garr, R, Hassan, A, Ambadkar, P, Dyke, M, McDevitt, K, Rewitzky, G, D'Amore, A, Panasa, N, Settle, P, Maddock, N, Edi-Osagie, N, Zipitis, C, Heal, C, Birch, J, Hasib, A, Soe, A, Kumar, N, Kisat, H, Vasu, V, Lama, M, Gupta, R, Rawlingson, C, Wickham, T, Theron, M, Kendall, G, Gupta, A, Aladangady, N, Ali, I, Alsford, L, Lopez, W, Murthy, V, Sullivan, C, Thomas, M, Bate, T, Godambe, S, Watts, T, Kuna, J, Chang, J, Pai, V, Huddy, C, Yasin, S, Nicholl, R, Pandey, P, Kairamkonda, V, Muogbo, D, Harry, L, Simmons, P, Nycyk, J, Gallagher, A, Pillay, T, Deshpande, S, Mahadevan, Moore, A, Clark, S, Garbash, M, Lal, M, Abu-Harb, M, Allwood, A, Selter, M, Munyard, P, Bartle, D, Paul, S, Whincup, G, Mallik, A, Amess, P, Godden, C, Reynolds, P, Misra, I, De Halpert, P, Salgia, S, Sanghavi, R, Wigfield, R, Deketelaere, A, Khashu, M, Hall, M, Groves, C, Brown, N, Brennan, N, Vamvakiti, K, McIntyre, J, Pirie, S, Jones, S, Mannix, P, Cairns, P, Eaton, M, Schwarz, K, Gibson, D, Miall, L, Krishnamurthy, University of Zurich, Shah, Prakesh S, Canadian Institutes of Health Research (CIHR), and Neonid NPO

Subjects
medicine.medical_specialty, NEW-ZEALAND, Population, 610 Medicine & health, RETINOPATHY, Review Article, Audit, Pediatrics, outcomes research, MORBIDITY, Nursing, neonatal intensive care, Health care, medicine, LOW-BIRTH-WEIGHT, 2735 Pediatrics, Perinatology and Child Health, education, education.field_of_study, Science & Technology, EXTREMELY PRETERM INFANTS, business.industry, MORTALITY, Public health, Health services research, Preterm infants, Capacity building, BRONCHOPULMONARY DYSPLASIA, Benchmarking, 10027 Clinic for Neonatology, INTENSIVE-CARE UNITS, TRENDS, CANADA, Pediatrics, Perinatology and Child Health, Outcomes research, business, Life Sciences & Biomedicine
Abstract

Neonates born very preterm (before 32 weeks’ gestational age), are a significant public health concern because of their high-risk of mortality and life-long disability. In addition, caring for very preterm neonates can be expensive, both during their initial hospitalization and their long-term cost of permanent impairments. To address these issues, national and regional neonatal networks around the world collect and analyse data from their constituents to identify trends in outcomes, and conduct benchmarking, audit and research. Improving neonatal outcomes and reducing health care costs is a global problem that can be addressed using collaborative approaches to assess practice variation between countries, conduct research and implement evidence-based practices. The International Network for Evaluating Outcomes (iNeo) of neonates was established in 2013 with the goal of improving outcomes for very preterm neonates through international collaboration and comparisons. To date, 10 national or regional population-based neonatal networks/datasets participate in iNeo collaboration. The initiative now includes data on >200,000 very preterm neonates and has conducted important epidemiological studies evaluating outcomes, variations and trends. The collaboration has also surveyed >320 neonatal units worldwide to learn about variations in practices, healthcare service delivery, and physical, environmental and manpower related factors and support services for parents. The iNeo collaboration serves as a strong international platform for Neonatal-Perinatal health services research that facilitates international data sharing, capacity building, and global efforts to improve very preterm neonate care.

Published
2019

26. The International Network for Evaluating Outcomes (iNeo) of neonates: evolution, progress and opportunities

Author

Shah P, Lui K, Reichman B, Norman M, Kusuda S, Lehtonen L, Adams M, Vento M, Darlow B, Modi N, Rusconi F, Hakansson S, San Feliciano L, Helenius K, Bassler D, Hirano S, Lee S, Marshall P, Schmidt P, Dhawan A, Craven P, de Waal K, Simmer K, Gill A, Pillow J, Stack J, Birch P, Cooke L, Casalaz D, Holberton J, Stewart A, Downe L, Stewart M, Bajuk B, Berry A, Hunt R, Kilburn C, De Paoli T, Bolisetty S, Paradisis M, Rieger I, Koorts P, Kuschel C, Numa A, Carlisle H, Badawi N, Loughran-Fowlds A, Koh G, Davis J, Luig M, Andersen C, Chambers G, Austin N, Lynn A, Edmonds L, Mildenhall L, Buksh M, Battin M, van den Boom J, Bourchier D, Richardson V, Dineen F, Rajadurai V, Fung G, Harrison A, Synnes A, Ting J, Cieslak Z, Sherlock R, Yee W, Aziz K, Toye J, Fajardo C, Kalapesi Z, Sankaran K, Daspal S, Seshia M, Alvaro R, Mukerji A, Da Silva O, Nwaesei C, Lee K, Dunn M, Lemyre B, Dow K, Pelausa E, Barrington K, Drolet C, Piedboeuf B, Claveau M, Beltempo M, Bertelle V, Masse E, Canning R, Mabry H, Ojah C, Monterrosa L, Deshpandey A, Afifi J, Kajetanowicz A, Andersson S, Tammela O, Sankilampi U, Saarela T, Prazad P, Noguchi A, McWan K, Button B, Stratton W, Hamvus A, Raghaven A, Derrick M, Hadley R, Covert R, Lablanc O, Weiss M, Bell A, Shareef M, Silvestri J, Heymann E, Zangen S, Smolkin T, Mimouni F, Bader D, Rothschild A, Strauss Z, Felszer C, Oman H, Toy-Friedman S, Bar-Oz B, Feldman M, Saad N, Flidel-Rimon O, Weisbrod M, Lubin D, Litmanovitz I, Kngelman A, Shinwell E, Klinger G, Nijim Y, Bin-Nun A, Golan A, Mandel D, Fleisher-Sheffer V, Kohelet D, Bakhrakh L, Hattori S, Shirai M, Ishioka T, Mori T, Amiznka T, Huchimukai T, Yoshida H, Sasaki A, Shimizu J, Nakamura T, Maruyama M, Matsumoto H, Hosokawa S, Taki A, Nakagawa M, Ko K, Uozumi A, Nakata S, Shimazaki A, Yoda T, Numata O, Imamura H, Kobayashi A, Tokuriki S, Uchida Y, Arai T, Ito M, Ieda K, Ono T, Hayashi M, Maki K, Yamakawa M, Kawai M, Fujii N, Shiomi K, Nozaki K, Wada H, Kim T, Tokunaga Y, Takatera A, Oshima T, Sumida H, Michinomae Y, Knsumoto Y, Yoshimoto S, Morisawa T, Ohashi T, Takahashi Y, Sugimoto M, Ono N, Miyagawa S, Saijo T, Yamagami T, Koyano K, Kobayashi S, Kanda T, Sakemi Y, Aoki M, Iida K, Goshi M, Maruyama Y, Avila-Alvarez A, Fernandez-Trisac J, Pico M, Seara M, Gutierrez A, Vizcaino C, Iglesias M, Zaplana H, Colomer B, Lopez J, Mozo R, Martinez M, Sebastian M, Carbonell M, Bamnsell J, Puiggros M, Aloy J, Mussons F, Sanz I, Galiana G, Coroleu W, Iriondo M, Vilella L, Porta R, Demestre X, Nadal S, Martinez C, Cuesta M, Mora D, Tardio J, Benavente I, Alonso A, Olmos R, Cabezas M, Jimenez M, Caballero M, Diaz M, Fagundo A, Canals L, Rodrigo F, Marti L, Galdo M, Suazo J, Lopez E, Fernandez J, Altana M, Navarro D, Dominguez M, del Prado M, Diez I, Benavides M, Lapena S, Prada T, Mir E, Sanchez A, Vega E, del Prado N, Fernandez C, Vilaplana L, Perez I, Gomez L, Comeche L, Martin I, Armengod C, Labian C, Munoz M, Bravo D, Perez V, Fernandez M, Gonzalez C, Segura S, Azorin M, Jimenez A, Sanchez-Tamayo T, Moreno E, Gonzalez M, Martinez J, Garcia J, Orayen C, Gonzalez J, Albo M, Colmenero E, Gonzalez E, del Arco B, Gordillo L, Asensio M, Diaz C, Albujar M, Jorge P, Romero S, Falero M, Izquierdo A, Capell J, Macian M, Vicente M, Caballero R, Euba A, Serna A, Goya J, Legorburu A, Amoros A, Isabel V, Gonzalez N, Gracia S, Faci M, Villagrasa M, Kofron J, Brodd K, Odlind A, Alberg L, Arwehed S, Hafstrom O, Kasemo A, Nederman K, Ahman L, Ingemarsson F, Petersson H, Thum P, Albinsson E, Selander B, Abrahamsson T, Heimdahl I, Sveinsdottir K, Wejryd E, Hedlund A, Soderberg M, Hallberg B, Brune T, Backstrom J, Robinson J, Farooqi A, Normann E, Fredriksson M, Palm A, Rosenqvist U, Hagman C, Ohlin A, Floral R, Smedsaas-Lofvenberg A, Meyer P, Anderegg C, Schulzke S, Nelle M, Wagner B, Riedel T, Kaczala G, Walde B, Pfister R, Tolsa J, Roth M, Stocker M, Laubscher B, Malzacher A, Micallef J, Hegi L, Arlettaz R, Bernet V, Dani C, Fiorini P, Boldrini A, Tomasini B, Mittal A, Kefas J, Kamalanathan A, Jayachandran, Yoxall B, McBride T, Webb D, Garr R, Hassan A, Ambadkar P, Dyke M, McDevitt K, Rewitzky G, D'Amore A, Panasa N, Settle P, Maddock N, Edi-Osagie N, Zipitis C, Heal C, Birch J, Hasib A, Soe A, Kumar N, Kisat H, Vasu V, Lama M, Gupta R, Rawlingson C, Wickham T, Theron M, Kendall G, Gupta A, Aladangady N, Ali I, Alsford L, Lopez W, Murthy V, Sullivan C, Thomas M, Bate T, Godambe S, Watts T, Kuna J, Chang J, Pai V, Huddy C, Yasin S, Nicholl R, Pandey P, Kairamkonda V, Muogbo D, Harry L, Simmons P, Nycyk J, Gallagher A, Pillay T, Deshpande S, Mahadevan, Moore A, Clark S, Garbash M, Lal M, Abu-Harb M, Allwood A, Selter M, Munyard P, Bartle D, Paul S, Whincup G, Mallik A, Amess P, Godden C, Reynolds P, Misra I, De Halpert P, Salgia S, Sanghavi R, Wigfield R, Deketelaere A, Khashu M, Hall M, Groves C, Brown N, Brennan N, Vamvakiti K, McIntyre J, Pirie S, Jones S, Mannix P, Cairns P, Eaton M, Schwarz K, Gibson D, Miall L, Krishnamurthy, and Int Network Evaluating Outcomes iN

Subjects
outcomes research, neonatal intensive care, Preterm infants
Abstract

Neonates born very preterm (before 32 weeks' gestational age), are a significant public health concern because of their high-risk of mortality and life-long disability. In addition, caring for very preterm neonates can be expensive, both during their initial hospitalization and their long-term cost of permanent impairments. To address these issues, national and regional neonatal networks around the world collect and analyse data from their constituents to identify trends in outcomes, and conduct benchmarking, audit and research. Improving neonatal outcomes and reducing health care costs is a global problem that can be addressed using collaborative approaches to assess practice variation between countries, conduct research and implement evidence-based practices. The International Network for Evaluating Outcomes (iNeo) of neonates was established in 2013 with the goal of improving outcomes for very preterm neonates through international collaboration and comparisons. To date, 10 national or regional population-based neonatal networks/datasets participate in iNeo collaboration. The initiative now includes data on >200,000 very preterm neonates and has conducted important epidemiological studies evaluating outcomes, variations and trends. The collaboration has also surveyed >320 neonatal units worldwide to learn about variations in practices, healthcare service delivery, and physical, environmental and manpower related factors and support services for parents. The iNeo collaboration serves as a strong international platform for Neonatal-Perinatal health services research that facilitates international data sharing, capacity building, and global efforts to improve very preterm neonate care.

Published
2019

27. Trends in Outcomes for Neonates Born Very Preterm and Very Low Birth Weight in 11 High-Income Countries

Author

Lui K, Lee S, Kusuda S, Adams M, Vento M, Reichman B, Darlow B, Lehtonen L, Modi N, Norman M, Hakansson S, Bassler D, Rusconi F, Lodha A, Yang J, Shah P, Marshall P, Schmidt P, Dhawan A, Craven P, de Waal K, Simmer K, Gill A, Pillow J, Stack J, Birch P, Cooke L, Casalaz D, Holberton J, Stewart A, Downe L, Stewart M, Bajuk B, Berry A, Hunt R, Kilburn C, De Paoli T, Bolisetty S, Paradisis M, Rieger I, Koorts P, Kuschel C, Doyle L, Numa A, Carlisle H, Badawi N, Loughran-Fowlds A, Koh G, Davis J, Luig M, Andersen C, Chambers G, Austin N, Lynn A, Edmonds L, Mildenhall L, Buksh M, Battin M, van den Boom J, Bourchier D, Richardson V, Dineen F, Rajadurai V, Lam S, Fung G, Harrison A, Synnes A, Cieslak Z, Sherlock R, Yee W, Aziz K, Fajardo C, Kalapesi Z, Sankaran K, Daspal S, Seshia M, Alvaro R, Mukerji A, Da Silva O, Nwaesei C, Lee K, Dunn M, Lemyre B, Dow K, Pelausa E, Barrington K, Drolet C, Piedboeuf B, Claveau M, Beltempo M, Bertelle V, Masse E, Canning R, Makary H, Ojah C, Monterrosa L, Deshpandey A, Afifi J, Kajetanowicz A, Andersson S, Tammela O, Sankilampi U, Saarela T, Prazad P, Noguchi A, McWan K, Button B, Stratton W, Hamvus A, Raghaven A, Derrick M, Hadley R, Covert R, Lablanc O, Weiss M, Bell A, Shareef M, Silvestri J, Heymann E, Zangen S, Smolkin T, Mimouni F, Bader D, Rothschild A, Strauss Z, Felszer C, Omari H, Tov-Friedman S, Bar-Oz B, Feldman M, Saad N, Flidel-Rimon O, Weisbrod M, Lubin D, Litmanovitz I, Kugelman A, Shinwell E, Klinger G, Nijim Y, Bin-Nun A, Golan A, Mandel D, Fleisher-Sheffer V, Kohelet D, Bakhrakh L, Hattori S, Shirai M, Ishioka T, Mori T, Amizuka T, Huchimukai T, Yoshida H, Sasaki A, Shimizu J, Nakamura T, Maruyama M, Matsumoto H, Hosokawa S, Taki A, Nakagawa M, Ko K, Uozumi A, Nakata S, Shimazaki A, Yoda T, Numata O, Imamura H, Kobayashi A, Tokuriki S, Uchida Y, Arai T, Ito M, Ieda K, Ono T, Hayashi M, Maki K, Yamakawa M, Kawai M, Fujii N, Shiomi K, Nozaki K, Wada H, Kim T, Tokunaga Y, Takatera A, Oshima T, Sumida H, Michinomae Y, Kusumoto Y, Yoshimoto S, Morisawa T, Ohashi T, Takahashi Y, Sugimoto M, Ono N, Miyagawa S, Saijo T, Yamagami T, Koyano K, Kobayashi S, Kanda T, Sakemi Y, Aoki M, Iida K, Goshi M, Maruyama Y, Avila-Alvarez A, Ting J, Toye J, Fernandez-Trisac J, Pico M, Seara M, Gutierrez A, Vizcaino C, Iglesias M, Zaplana H, Colomer B, Lopez J, Mozo R, Martinez M, Sebastian M, Carbonell M, Barnusell J, Puiggros M, Aloy J, Mussons F, Sanz I, Galiana G, Coroleu W, Iriondo M, Vilella L, Porta R, Demestre X, Nadal S, Martinez C, Cuesta M, Mora D, Tardio J, Benavente I, Alonso A, Olmos R, Cabezas M, Jimenez M, Caballero P, Diaz M, Fagundo A, Canals L, Rodrigo F, Marti L, Galdo M, Suazo J, Lopez E, Fernandez J, Altuna M, Muga O, Navarro D, Dominguez M, del Prado M, Diez I, Benavides M, Lapena S, Prada T, Mir E, Sanchez A, Vega E, del Prado N, Fernandez C, Vilaplana L, Perez I, Gomez L, Comeche L, Martin I, Armengod C, Labian C, Munoz M, Bravo D, Perez V, Fernandez M, Gonzalez C, Segura S, Azorin M, Jimenez A, Sanchez-Tamayo T, Moreno E, Gonzalez M, Martinez J, Garcia J, Orayen C, Gonzalez J, Albo M, Colmenero E, Gonzalez E, del Arco B, Gordillo L, Asensio M, Diaz C, Albujar R, Jorge P, Romero S, Falero M, Izquierdo A, Capell J, Vicente M, Caballero R, Euba A, Serna A, Goya J, Legorburu A, Amoros A, Isabel V, Gonzalez N, Gracia S, Faci P, Villagrasa M, Macian M, Kofron J, Brodd K, Odlind A, Alberg L, Arwehed S, Hafstrom O, Kasemo A, Nederman K, Ahman L, Ingemarsson F, Petersson H, Thurn P, Albinsson E, Selander B, Abrahamsson T, Heimdahl I, Sveinsdottir K, Wejryd E, Hedlund A, Soderberg M, Hallberg B, Brune T, Backstrom J, Robinson J, Farooqi A, Normann E, Fredriksson M, Palm A, Rosenqvist U, Walde B, Hagman C, Ohlin A, Florell R, Smedsaas-Lofvenberg A, Meyer P, Anderegg C, Schulzke S, Nelle M, Wagner B, Riedel T, Kaczala G, Pfister R, Tolsa J, Roth M, Stocker M, Laubscher B, Malzacher A, Micallef J, Hegi L, Arlettaz R, Bernet V, Fiorini P, Boldrini A, Tomasini B, Kefas J, Kamalanathan A, Jayachandran, Yoxall B, McBride T, Webb D, Garr R, Hassan A, Ambadkar P, Dyke M, McDevitt K, Rewitzky G, D'Amore A, Panasa N, Settle P, Maddock N, Edi-Osagie N, Zipitis C, Heal C, Birch J, Hasib A, Soe A, Kumar N, Kisat H, Vasu V, Lama M, Gupta R, Rawlingson C, Wickham T, Theron M, Kendall G, Gupta A, Aladangady N, Ali I, Alsford L, Lopez W, Murthy V, Sullivan C, Thomas M, Bate T, Godambe S, Watts T, Kuna J, Chang J, Pai V, Huddy C, Yasin S, Nicholl R, Pandey P, Cusack J, Kairamkonda V, Muogbo D, Harry L, Simmons P, Nycyk J, Gallagher A, Pillay T, Deshpande S, Mahadevan, Moore A, Clark S, Garbash M, Lal M, Abu-Harb M, Dani C, Mittal A, Allwood A, Selter M, Munyard P, Bartle D, Paul S, Whincup G, Mallik A, Amess P, Godden C, Reynolds P, Misra I, De Halpert P, Salgia S, Sanghavi R, Wigfield R, Deketelaere A, Khashu M, Hall M, Groves C, Brown N, Brennan N, Vamvakiti K, McIntyre J, Pirie S, Jones S, Mannix P, Cairns P, Eaton M, Schwarz K, Gibson D, Miall L, Krishnamurthy, and Int Network Evaluation Outcomes iN

Abstract

Objective To evaluate outcome trends of neonates born very preterm in 11 high-income countries participating in the International Network for Evaluating Outcomes of neonates. Study design In a retrospective cohort study, we included 154 233 neonates admitted to 529 neonatal units between January 1, 2007, and December 31, 2015, at 24(0/7) to 31(6/7) weeks of gestational age and birth weight

Published
2019

33. Confidence and Attitudes Toward Osteoarthritis Care Among the Current and Emerging Health Workforce: A Multinational Interprofessional Study.

Author

Briggs, AM, Hinman, RS, Darlow, B, Bennell, KL, Leech, M, Pizzari, T, Greig, AM, MacKay, C, Bendrups, A, Larmer, PJ, Francis-Cracknell, A, Houlding, E, Desmond, LA, Jordan, JE, Minaee, N, Slater, H, Briggs, AM, Hinman, RS, Darlow, B, Bennell, KL, Leech, M, Pizzari, T, Greig, AM, MacKay, C, Bendrups, A, Larmer, PJ, Francis-Cracknell, A, Houlding, E, Desmond, LA, Jordan, JE, Minaee, N, and Slater, H

Abstract

OBJECTIVE: To measure confidence and attitudes of the current and emerging interprofessional workforce concerning osteoarthritis (OA) care. METHODS: Study design is a multinational (Australia, New Zealand, Canada) cross-sectional survey of clinicians (general practitioners [GPs], GP registrars, primary care nurses, and physiotherapists) and final-year medical and physiotherapy students. GPs and GP registrars were only sampled in Australia/New Zealand and Australia, respectively. The study outcomes are as follows: confidence in OA knowledge and skills (customized instrument), biomedical attitudes to care (Pain Attitudes Beliefs Scale [PABS]), attitudes toward high- and low-value care (customized items), attitudes toward exercise/physical activity (free-text responses). RESULTS: A total of 1886 clinicians and 1161 students responded. Although a number of interprofessional differences were identified, confidence in OA knowledge and skills was consistently greatest among physiotherapists and lowest among nurses (eg, the mean difference [95% confidence interval (CI)] for physiotherapist-nurse analyses were 9.3 [7.7-10.9] for knowledge [scale: 11-55] and 14.6 [12.3-17.0] for skills [scale: 16-80]). Similarly, biomedical attitudes were stronger in nurses compared with physiotherapists (6.9 [5.3-8.4]; scale 10-60) and in medical students compared with physiotherapy students (2.0 [1.3-2.7]). Some clinicians and students agreed that people with OA will ultimately require total joint replacement (7%-19% and 19%-22%, respectively), that arthroscopy is an appropriate intervention for knee OA (18%-36% and 35%-44%), and that magnetic resonance imaging is informative for diagnosis and clinical management of hip/knee OA (8%-61% and 21%-52%). Most agreed (90%-98% and 92%-97%) that exercise is indicated and strongly supported by qualitative data. CONCLUSION: Workforce capacity building that de-emphasizes biomedical management and promotes high-value first-line care options is needed.

Published
2019

34. Confidence and Attitudes Toward Osteoarthritis Care Among the Current and Emerging Health Workforce: A Multinational Interprofessional Study

Author

Briggs, Andrew, Hinman, R.S., Darlow, B., Bennell, K.L., Leech, M., Pizzari, T., Greig, A.M., Mackay, C., Bendrups, A., Larmer, P.J., Francis-Cracknell, A., Houlding, E., Desmond, L.A., Jordan, J.E., Minaee, N., Slater, Helen, Briggs, Andrew, Hinman, R.S., Darlow, B., Bennell, K.L., Leech, M., Pizzari, T., Greig, A.M., Mackay, C., Bendrups, A., Larmer, P.J., Francis-Cracknell, A., Houlding, E., Desmond, L.A., Jordan, J.E., Minaee, N., and Slater, Helen

Abstract

Objective. To measure confidence and attitudes of the current and emerging interprofessional workforce concerning osteoarthritis (OA) care. Methods. Study design is a multinational (Australia, New Zealand, Canada) cross-sectional survey of clinicians (general practitioners [GPs], GP registrars, primary care nurses, and physiotherapists) and final-year medical and physiotherapy students. GPs and GP registrars were only sampled in Australia/New Zealand and Australia, respectively. The study outcomes are as follows: Confidence in OA knowledge and skills (customized instrument), biomedical attitudes to care (Pain Attitudes Beliefs Scale [PABS]), attitudes toward high- and low-value care (customized items), attitudes toward exercise/physical activity (free-text responses). Results. A total of 1886 clinicians and 1161 students responded. Although a number of interprofessional differences were identified, confidence in OA knowledge and skills was consistently greatest among physiotherapists and lowest among nurses (eg, the mean difference [95% confidence interval (CI)] for physiotherapist-nurse analyses were 9.3 [7.7-10.9] for knowledge [scale: 11-55] and 14.6 [12.3-17.0] for skills [scale: 16-80]). Similarly, biomedical attitudes were stronger in nurses compared with physiotherapists (6.9 [5.3-8.4]; scale 10-60) and in medical students compared with physiotherapy students (2.0 [1.3-2.7]). Some clinicians and students agreed that people with OA will ultimately require total joint replacement (7%-19% and 19%-22%, respectively), that arthroscopy is an appropriate intervention for knee OA (18%-36% and 35%-44%), and that magnetic resonance imaging is informative for diagnosis and clinical management of hip/knee OA (8%-61% and 21%-52%). Most agreed (90%-98% and 92%-97%) that exercise is indicated and strongly supported by qualitative data. Conclusion. Workforce capacity building that de-emphasizes biomedical management and promotes high-value first-line care options is needed.

Published
2019

35. Health professionals and students encounter multi-level barriers to implementing high-value osteoarthritis care: a multi-national study

Author

Briggs, Andrew, Houlding, E., Hinman, R.S., Desmond, L.A., Bennell, K.L., Darlow, B., Pizzari, T., Leech, M., MacKay, C., Larmer, P.J., Bendrups, A., Greig, A.M., Francis-Cracknell, A., Jordan, J.E., Slater, Helen, Briggs, Andrew, Houlding, E., Hinman, R.S., Desmond, L.A., Bennell, K.L., Darlow, B., Pizzari, T., Leech, M., MacKay, C., Larmer, P.J., Bendrups, A., Greig, A.M., Francis-Cracknell, A., Jordan, J.E., and Slater, Helen

Abstract

Objective: Consistent evidence-practice gaps in osteoarthritis (OA) care are observed in primary care settings globally. Building workforce capacity to deliver high-value care requires a contemporary understanding of barriers to care delivery. We aimed to explore barriers to OA care delivery among clinicians and students. Design: A cross-sectional, multinational study sampling clinicians (physiotherapists, primary care nurses, general practitioners (GPs), GP registrars; total possible denominator: n = 119,735) and final-year physiotherapy and medical students (denominator: n = 2,215) across Australia, New Zealand and Canada. Respondents answered a survey, aligned to contemporary implementation science domains, which measured barriers to OA care using categorical and free-text responses. Results: 1886 clinicians and 1611 students responded. Items within the domains ‘health system’ and ‘patient-related factors’ represented the most applicable barriers experienced by clinicians (25–42% and 20–36%, respectively), whereas for students, ‘knowledge and skills’ and ‘patient-related factors’ (16–24% and 19–28%, respectively) were the most applicable domains. Meta-synthesis of qualitative data highlighted skills gaps in specific components of OA care (tailoring exercise, nutritional/overweight management and supporting positive behaviour change); assessment, measurement and monitoring; tailoring care; managing case complexity; and translating knowledge to practice (especially among students). Other barriers included general infrastructure limitations (particularly related to community facilities); patient-related factors (e.g., beliefs and compliance); workforce-related factors such as inconsistent care and a general knowledge gap in high-value care; and system and service-level factors relating to financing and time pressures, respectively. Conclusions: Clinicians and students encounter barriers to delivery of high-value OA care in clinical practice/training (micro-level); w

Published
2019

41. Protocol for the Lactoferrin Infant Feeding Trial (LIFT) : A randomised trial of adding lactoferrin to the feeds of very-low birthweight babies prior to hospital discharge

Author

Martin, A., Ghadge, A., Manzoni, P., Lui, K., Brown, R., Tarnow-Mordi, W., Lu, K., Simes, J., Hague, W., Osborn, D., Deshpande, G., Kochar, A., Lewis, T., Watkins, A., Pritchard, M., Schofield, D., Mohamed, A. L., Soll, R., Darlow, B., Isaacs, D., Wilkinson, D., Wood, A., Mckenzie, A., Despande, G., Verry, H., Wright, I., Askie, L., Cruz, M., Berry, N., Mcguire, W., Broom, M., Osoborn, D., Reid, S., Sinn, J., Kwan, P., Tracy, M., Hua, C., Travadi, J., Black, R., Tobiansky, R., Darcy, D., Tai, S. N. H., Michalowski, J., Bhaskaracharya, A., Yeomans, E., Elsayed, K., Collins, C., Noble, E., Koorts, P., Lack, G., Mckeown, L., Liley, H., Nie, W., Morris, S., Cornthwaite, K., Goodchild, L., Austin, N., Graham, T., Patel, H., Sanchez, D., Mckinlay, C., Modi, N., Marschner, I., Stenson, B., and Espinoza, D.

Subjects
Male, Pediatrics, Enterocolitis, infant, lactoferrin, necrotizing, premature, sepsis, Clinical Protocols, Female, Hospital Mortality, Humans, Infant, Infant Mortality, Infant, Newborn, Intensive Care Units, Neonatal, Lactoferrin, Infant Food, Infant, Very Low Birth Weight, 0302 clinical medicine, Neonatal, Protocol, 030212 general & internal medicine, 2. Zero hunger, Enterocolitis, necrotizing, biology, Retinopathy of prematurity, General Medicine, 3. Good health, Intensive Care Units, Necrotizing enterocolitis, Gestation, medicine.symptom, medicine.medical_specialty, infant, premature, Breast milk, Sepsis, 03 medical and health sciences, 030225 pediatrics, medicine, business.industry, Very Low Birth Weight, Paediatrics, Newborn, medicine.disease, Infant mortality, biology.protein, business
Abstract

IntroductionVery-low birthweight (VLBW, Methods and analysisThis trial tests whether adding bovine lactoferrin (bLF) to feeds in VLBW infants improves (1) survival to hospital discharge free from brain injury, late-onset sepsis, NEC and treated retinopathy of prematurity (primary composite end point); (2) each component of the primary composite end point and (3) time to reach full enteral feeds, number of blood transfusions, chronic lung disease and length of hospital stay. It includes a cost-effectiveness analysis of bLF in improving survival free from major morbidity, and evaluates the effect of bLF on survival and developmental outcomes at 24 to 36 months corrected gestational age.This is a multicentre, two-arm, randomised trial comparing the treatment group receiving bLF added to breast milk or formula milk daily (up to 250 mg/kg/day bLF) versus the control group receiving no bLF supplementation. The intervention is administered until 34 completed weeks corrected gestation or for 2 weeks, whichever is longer, or until discharge home, if earlier. The target sample size of 1500 participants yields 85% power, at the two-sided 5% level significance, to detect a difference in proportions meeting the primary outcome assuming the true probability is 74% in controls and 80.5% in the bLF group.Ethics and disseminationThis protocol was approved by Northern Sydney Local Human Research Ethics Committee in January 2017 (Version 2.0, Reference 1003-118M) and other relevant ethics committees. The findings of the trial will be disseminated through peer-reviewed journals and conference presentations.Trial registration numberACTRN12611000247976; Pre-results.

Published
2018

42. Multi-level reform is required to support high-value osteoarthritis care delivery: outcomes of a multinational survey of clinicians and students

Author

Briggs, A.M., primary, Hinman, R.S., additional, Darlow, B., additional, Bennell, K.L., additional, Houlding, E., additional, Pizzari, T., additional, Leech, M., additional, Larmer, P.J., additional, MacKay, C., additional, Greig, A.M., additional, Desmond, L.A., additional, Bendrups, A., additional, Francis-Cracknell, A., additional, Jordan, J.E., additional, and Slater, H., additional

Published
2019
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48. How Twitter is revolutionising the healthcare landscape – for you and your profession (yes you!)

Author

Fuller, M, Westerink, A, Steering Group, Anzmrrn, Hayes, J, Murrell, C, Do, H, Smith, H, Macilquham, G, Sloan, J, Cannell, L, Pearce, A, Islam, A, Cavenagh, J, Coleman, K, Darlow, B, McKinlay, E, Donovan, S, Beckingsale, L, Gallagher, P, Gray, B, Neser, H, Perry, M, Stanley, J, Pullon, S, Carmichael, M.-A, Matthews, K, Kane, P, Halkett, G, McKay, J, Kearvell, R, Davis, M, Cutt, D, Krawiec, M, Maresse, S, House, M, Rampant, P, Berg, M, Ebert, M, Ho, H, Bonnett, D, Straker, H, Caro, T, Lac, C, Hiscock, R, Mzenda, B, Falkov, A, Lathouras, M, Sen, A, Reiss, A, Moses, B, Penchev, B, Chaushev, B, Pencheva, L, Bray, S, Lombardo, M, Pontre, B, Druva, R, Smith, T, Sweeney, R.-J, Weterings, L, Peska, S, Al Mahrooqi, K, Murray, L, Webb, E, Harriman, A, McKenzie, A, Marsh, A, Kumar, S, Whiting, S, Anderson, C, Tonks, M, Fletcher, K, Caine, H, Whalley, D, Kneebone, A, Cox, J, Eade, T, Le Mottee, M, Geddes, V, Batumalai, V, Liney, G, Rai, R, Boxer, M, Delaney, G, Holloway, L, Wheatley, A, O'Connell, A, Seeley, A, Holmes, K, McCarthy, J, McCabe, H, McKerrow, M, Settimio, T, Steward, A, Harris, J, Chesson, B, Gawthrop, J, Butler, S, Skidmore, C, Touma, N, Tongs, C. D, Tagaro, J. D, Wintour, A, Chamberlain, M, Nagar, T, Radburnd, K, Ghandourh, W, Pierce, V, Jum'ee, F, Matthews, D, Short, M, Potter, A, Lockwood, H, Pook, J, and Burgess, E

Subjects
Saturday 25 July, 0830–1000 Plenary Session, Saturday 25 July, 1330–1500 Concurrent Session: Medical Imaging 1, General, Saturday 25 July, 1330–1500 Concurrent Session: Radiation Therapy 3, Management, Saturday 25 July, 1_1120–1230 Concurrent Session: Radiation Therapy 2, Dosimetry, Saturday 25 July, 1330–1500 Concurrent Session: Radiation Therapy 2, Patient Positioning, Saturday 25 July, 1_1120–1230 Concurrent Session: Radiation Therapy 1, Education, Saturday 25 July, 1_1120–1230 Concurrent Session: Medical Imaging 1, CT/MRI/PET, Saturday 25 July, 1330–1500 Concurrent Session: Radiation Therapy 1, Imaging, Saturday 25 July, 1530–1700 Session: Student, Saturday 25 July, 1_1120–1230 Concurrent Session: Medical Imaging 2, Education, Saturday 25 July, 1_1120–1230 Concurrent Session: Student, Saturday 25 July, 1330–1500 Concurrent Session: Student, Abstracts From the 2015 Nzimrt-Air Scientific Meeting “the Cloud: Shaping Our Future” Wellington, New Zealand 24–26 July 2015, Saturday 25 July, 0830–1000 Concurrent Session: Student
Published
2015

49. Late-onset infections of infants in neonatal units

Author

ISAACS, D, BARFIELD, C, CLOTHIER, T, DARLOW, B, DIPLOCK, R, EHRLICH, J, GRIMWOOD, K, HUMPHREY, I, JEFFERY, H, KOHAN, R, McNEIL, R, McPHEE, A, MINUTILLO, C, MOREY, F, TUDEHOPE, D, and WONG, M

Published
1996

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