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3. Effects of oral anticoagulation for atrial fibrillation after spontaneous intracranial haemorrhage in the UK: a randomised, open-label, assessor-masked, pilot-phase, non-inferiority trial

Author

Al-Shahi Salman, Rustam, Keerie, Catriona, Stephen, Jacqueline, Lewis, Steff, Norrie, John, Dennis, Martin S., Newby, David E., Wardlaw, Joanna M., Lip, Gregory Y.H., Parry-Jones, Adrian, White, Philip M., Baigent, Colin, Lasserson, Dan, Oliver, Colin, O'Mahony, Fiach, Amoils, Shannon, Bamford, John, Armitage, Jane, Emberson, Jonathan, Rinkel, Gabriël J.R., Lowe, Gordon, Innes, Karen, Adamczuk, Kasia, Dinsmore, Lynn, Drever, Jonathan, Milne, Garry, Walker, Allan, Hutchison, Aidan, Williams, Carol, Fraser, Ruth, Anderson, Rosemary, Covil, Kate, Stewart, Kelly, Rees, Jessica, Hall, Peter, Bullen, Alistair, Stoddart, Andrew, Moullaali, Tom J., Palmer, Jeb, Sakka, Eleni, Perthen, Joanne, Lyttle, Nicola, Samarasekera, Neshika, MacRaild, Allan, Burgess, Seona, Teasdale, Jessica, Coakley, Michelle, Taylor, Pat, Blair, Gordon, Whiteley, William, Shenkin, Susan, Clancy, Una, Macleod, Malcolm, Sutherland, Rachel, Moullaali, Tom, Barugh, Amanda, Lerpiniere, Christine, Moreton, Fiona, Fethers, Nicholas, Anjum, Tal, Krishnan, Manju, Slade, Peter, Storton, Sharon, Williams, Marie, Davies, Caroline, Connor, Lynda, Gainard, Glyn, Murphy, Carl, Barber, Mark, Esson, Derek, Choulerton, James, Shaw, Louise, Lucas, Suzanne, Hierons, Sarah, Avis, Joanne, Stone, Andrew, Gbadamoshi, Lukuman, Costa, Telma, Pearce, Lauren, Harkness, Kirsty, Richards, Emma, Howe, Jo, Kamara, Christine, Lindert, Ralf, Ali, Ali, Rehan, Jahanzeb, Chapman, Sarah, Edwards, Maria, Bathula, Raj, Cohen, David, Devine, Joseph, Mpelembue, Mushiya, Yesupatham, Priya, Chhabra, Swati, Adewetan, Gbadebo, Ballantine, Robert, Brooks, Daniel, Smith, Gemma, Rogers, Gill, Marsden, Stuart, Clark, Sarah, Wilkinson, Ami, Brown, Ellen, Stephenson, Lynsey, Nyo, Khin, Abraham, Annie, Pai, Yogish, Shim, Gek, Baliga, Vidya, Nair, Anand, Robinson, Matthew, Hawksworth, Catherine, Greig, Jill, Alam, Irfan, Nortcliffe, Tonicha, Ramiz, Ridha, Shaw, Ryan, Lee, Stephanie, Marsden, Tracy, Perez, Jane, Birleson, Emily, Yadava, Rajendra, Sangombe, Mirriam, Stafford, Sam, Hughes, Tom, Knibbs, Lucy, Morse, Bethan, Schwarz, Stefan, Jelley, Benjamin, White, Susan, Richard, Bella, Lawson, Heidi, Moseley, Sally, Tayler, Michelle, Edwards, Mandy, Triscott, Claire, Wallace, Rebecca, Hall, Angela, Dell, Amanda, Rashed, Khalid, Board, Sarah, Buckley, Clare, Tanate, Alfonso, Pitt-Kerby, Tressy, Beesley, Kate, Perry, Jess, Hellyer, Christine, Guyler, Paul, Menon, Nisha, Tysoe, Sharon, Prabakaran, Raji, Cooper, Martin, Rajapakse, Anoja, Wynter, Inez, Smith, Susan, Weir, Nic, Boxall, Cherish, Yates, Hannah, Smith, Simon, Crawford, Pamela, Marigold, James, Smith, Fiona, Harvey, Jake, Evans, Sue, Baldwin, Laura, Hammond, Sarah, Mudd, Paul, Bowring, Angela, Keenan, Samantha, Thorpe, Kevin, Haque, Mohammad, Taaffe, Joanne, Temple, Natalie, Peachey, Tracey, Wells, Kim, Haines, Fiona, Butterworth-Cowin, Nicola, Horne, Zoey, Licenik, Radim, Boughton, Hayley, England, Timothy, Hedstrom, Amanda, Menezes, Brian, Davies, Ruth, Johnson, Venetia, Whittingham-Jones, Simon, Werring, David, Obarey, Sabaa, Watchurst, Caroline, Ashton, Amy, Feerick, Shez, Francia, Nina, Banaras, Azra, Epstein, Daniel, Marinescu, Marilena, Williams, Annick, Robinson, Anna, Humphries, Fiona, Anwar, Ijaz, Annamalai, Arunkumar, Crawford, Susan, Collins, Vicky, Shepherd, Lorna, Siddle, Elaine, Penge, Justin, Qureshi, Sam, Krishnamurthy, Vinodh, Papavasileiou, Vasileios, Waugh, Dean, Veraque, Emelda, Douglas, Nathan, Khan, Numan, Ramachandran, Sankaranarayanan, Sommerville, Peter, Rudd, Anthony, Kullane, Sagal, Bhalla, Ajay, Birns, Jonathan, Ahmed, Rowshanara, Gibbons, Meegan, Klamerus, Eva, Cendreda, Benjie, Muir, Keith, Day, Nicola, Welch, Angela, Smith, Wilma, Elliot, Jennifer, Eltawil, Salwa, Mahmood, Ammad, Hatherley, Kim, Mitchell, Shirley, Bains, Harjit, Quinn, Lauren, Teal, Rachel, Gbinigie, Ivie, Harston, George, Mathieson, Phil, Ford, Gary, Schulz, Ursula, Kennedy, James, Nagaratnam, Kirubananthan, Bangalore, Kiran, Bhupathiraju, Neelima, Wharton, Chris, Fotherby, Ken, Nasar, Ahmad, Stevens, Angie, Willberry, Angela, Evans, Rachel, Rai, Baljinder, Blake, Chloe, Thavanesan, Kamy, Hann, Gail, Changuion, Tanith, Nix, Sara, Whiting, Amanda, Dharmasiri, Michelle, Mallon, Louise, Keltos, Marketa, Smyth, Nigel, Eglinton, Charlotte, Duffy, John, Tone, Ela, Sykes, Lucy, Porter, Emily, Fitton, Carolyn, Kirkineziadis, Nikolaos, Cluckie, Gillian, Kennedy, Kate, Trippier, Sarah, Williams, Rebecca, Hayter, Elizabeth, Rackie, James, Patel, Bhavini, Rita, Ghatala, Blight, Adrian, Jones, Val, Zhang, Liqun, Choy, Lillian, Pereira, Anthony, Clarke, Brian, Al-Hussayni, Samer, Dixon, Lynn, Young, Andrew, Bergin, Adrian, Broughton, David, Raghunathan, Senthil, Jackson, Benjamin, Appleton, Jason, Wilkes, Gwendoline, Buck, Amanda, Richardson, Carla, Clarke, Judith, Fleming, Lucy, Squires, Gemma, Law, Zhe, Hutchinson, Camille, Cvoro, Vera, Couser, Mandy, McGregor, Amanda, McAuley, Sean, Pound, Susan, Cochrane, Patricia, Holmes, Clare, Murphy, Peter, Devitt, Nicola, Osborn, Mairead, Steele, Amy, Guthrie, Lucy Belle, Smith, Elizabeth, Hewitt, Jonathan, Chaston, Natalie, Myint, Min, Smith, Andrew, Fairlie, Louise, Davis, Michelle, Atkinson, Beth, Woodward, Stephen, Hogg, Valerie, Fawcett, Michelle, Finlay, Louise, Dixit, Anand, Cameron, Eleanor, Keegan, Breffni, Kelly, Jim, Concannon, Dónal, Dutta, Dipankar, Ward, Deborah, Glass, Jon, O'Connell, Susan, Ngeh, Joseph, O'Kelly, Alison, Williams, Emma, Ragab, Suzanne, Jenkinson, Damian, Dube, Judith, Gleave, Laura, Leggett, Jacqui, Kissoon, Nisha, Southern, Louise, Naghotra, Utpal, Bokhari, Maria, McClelland, Beverley, Adie, Katja, Mate, Abhijit, Harrington, Frances, James, Ali, Swanson, Elizabeth, Chant, Terri, Naccache, Miriam, Coutts, Abbie, Courtauld, Gillian, Whurr, Sarah, Webber, Sue, Shead, Emily, Luder, Robert, Bhargava, Maneesh, Murali, Elodie, Cuenoud, Larissa, Pasco, Kath, Speirs, O, Chapman, Lianne, Inskip, Linda, Kavanagh, Lisa, Srinivasan, Meena, Motherwell, Nichola, Mukherjee, Indranil, Tonks, Louise, Donaldson, Denise, Button, Heather, Wilcox, Rebecca, Hurford, Fran, Logan, Rachel, Taylor, Andy, Arden, Tracie, Carpenter, Michael, Datta, Prabal, Zahoor, Tajammal, Jackson, Linda, Needle, Ann, Stanners, Andrew, Ghouri, Imran, Exley, Donna, Akhtar, Salman, Brooke, Hollie, Beadle, Shannen, O'Brien, Eoin, Francis, Jobbin, McGee, Joanne, Amis, Elaine, Mitchell, Jennifer, Finlay, Sarah, Sinha, Devesh, Manoczki, Csilla, King, Sam, Tarka, James, Choudhary, Sumita, Premaruban, Jegamalini, Sutton, Dorothy, Kumar, Pradeep, Culmsee, Charlotte, Winckley, Caroline, Davies, Holly, Thatcher, Hilary, Vasileiadis, Evangelos, Aweid, Basaam, Holden, Melinda, Mason, Cathy, Hlaing, Thant, Madzamba, Gladys, Ingram, Tanya, Linforth, Michelle, Cullen, Claire, Thomas, Nibu, France, John, Saulat, Afaq, Bhaskaran, Biju, Fitzell, Pauline, Horan, Kathleen, Manyoni, Catherine, Garfield-Smith, Josie, Griffin, Hannah, Atkins, Stacey, Redome, Joan, Muddegowda, Girish, Maguire, Holly, Barry, Adrian, Abano, Nenette, Varquez, Resti, Hiden, Joanne, Lyjko, Susan, Remegoso, Alda, Finney, Kay, Butler, Adrian, Strecker, Martin, MaCleod, Mary Joan, Irvine, Janice, Nelson, Sandra, Guzmangutierrez, German, Furnace, Jacqueline, Taylor, Vicky, Ramadan, Hawraman, Storton, Kim, Hassan, Sohail, Abdus Sami, Eman, Bellfield, Ruth, Stewart, Kelvin, Quinn, Outi, Patterson, Chris, Emsley, Hedley, Gregary, Bindu, Ahmed, Shakeel, Patel, Shakeelah, Raj, Sonia, Sultan, Sulaiman, Wright, Fiona, Langhorne, Peter, Graham, Ruth, Quinn, Terry, and McArthur, Kate

Published
2021
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9. Exploring the views of Point of Care Ultrasound practitioners for widespread implementation in community settings in the UK

Author

Akanuwe, Joseph, Siriwardena, Niro, Bidaut, Luc, Mitchell, Pauline, Bird, Paul, Lasserson, Dan, Lilford, Richard, Akanuwe, Joseph, Siriwardena, Niro, Bidaut, Luc, Mitchell, Pauline, Bird, Paul, Lasserson, Dan, and Lilford, Richard

Abstract

Exploring the views of Point of Care Ultrasound practitioners for widespread implementation in community settings in the UK The problem: Point of Care Ultrasound (POCUS) is a currently available and rapidly developing technology but still not widely used in the UK. Community POCUS in prehospital and primary care settings could help to prioritise initial treatment, procedures and appropriate patient referral or conveyance to an appropriate secondary care setting. Recent reviews suggest that image quality, portability and cost of ultrasound devices are improving, that POCUS is increasingly being used by general practitioners and emergency practitioners across the world, and that generalists can safely use ultrasound in a range of clinical settings to aid diagnosis. As further evidence of community POCUS use and impact is needed in the UK, we aimed to explore the views of practitioners who use ultrasound in practice on the role of POCUS and perceived barriers and facilitators for implementation in UK community settings. The approach: We conducted a qualitative interview study with practitioners who use point of care ultrasound in practice. Participants were from community and secondary care settings, and interviews were conducted online via Microsoft Teams. A purposive sampling approach was used to recruit eligible participants through an inclusion criterion. Following ethics approval, participants were recruited by using a flyer advertising the study on social media (Twitter) and websites of relevant research groups. This was enhanced by a snowballing technique, with participants already identified serving as key informants to recruit further eligible and willing participants to the study. Data were collected using individual semi-structured interviews lasting 40 – 60 minutes. Interviews were recorded, transcribed verbatim and analysed using a Framework approach assisted by NVivo 12 software. Findings: In total, 16 practitioners, aged between 40 and 62, with a range o

Published
2022

10. Role of Point of Care Ultrasound in Prehospital care: an interview study

Author

Akanuwe, Joseph, Siriwardena, Niro, Bidaut, Luc, Mitchell, Pauline, Bird, Paul, Lasserson, Dan, Lilford, Richard, Akanuwe, Joseph, Siriwardena, Niro, Bidaut, Luc, Mitchell, Pauline, Bird, Paul, Lasserson, Dan, and Lilford, Richard

Abstract

Background: Point of Care Ultrasound (PoCUS) is a currently available and rapidly developing technology albeit still not widely used in the UK. Prehospital PoCUS could help to prioritise initial treatment, procedures and appropriate patient conveyance. A recent literature review suggests that the image quality, portability and cost of ultrasound devices are improving with widening indications for prehospital PoCUS but evidence of prehospital use and impact is needed. We aimed to explore the views of practitioners (who use ultrasound in practice) on the potential role of PoCUS, the challenges and facilitators associated with its use in prehospital care. Methods: We conducted a qualitative interview study using purposive sampling through social media and a snowballing technique to recruit eligible participants. Individual interviews were conducted online via Microsoft Teams. The interviews were recorded, transcribed and analysed using a Thematic Framework approach assisted by NVivo 12 software until data saturation. Results: In total, 16 practitioners - aged between 36 and 62 years, with a range of professional backgrounds including paramedics and prehospital emergency physicians - participated in interviews. Participants identified several facilitators to support a widespread implementation of PoCUS in prehospital care: resource requirements for purchase and deployment of devices, sufficient time and a skilled workforce; special attention to training, education and support needs; proper organisational governance, guidelines and quality assurance; enabling ease of use in aiding decision making and taking unintended consequences or incidental findings into consideration. In addition, more robust evidence to support perceptions of improved patient outcomes and experience is needed; workforce considerations should include supportive staff, champions and leadership. Conclusions: Prehospital PoCUS could be useful for care processes and pathways. However, the facilitators i

Published
2022

12. Point of care testing using rapid automated antigen testing for SARS-COV-2 in care homes – an exploratory safety, usability and diagnostic agreement evaluation

Author

Micocci, Massimo, primary, Buckle, Peter, additional, Hayward, Gail, additional, Allen, A Joy, additional, Davies, Kerrie, additional, Kierkegaard, Patrick, additional, Spilsbury, Karen, additional, Thompson, Carl, additional, Astle, Anita, additional, Heath, Ros, additional, Sharpe, Claire, additional, Akrill, Cyd, additional, Lasserson, Dan, additional, Perera, Rafael, additional, Body, Richard, additional, and Gordon, Adam L, additional

Published
2021
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13. The National Institute for Health Research (NIHR) Global Health Research Group on Atrial Fibrillation management

Author

Lip, Gregory YH, Guo, Yutao, Lotufo, Paulo, Surenthirakumaran, Rajendra, Humphreys, Lindsey, Thomas, G Neil, Arasalingam, Ajini, Bensenor, Isabela, Brocklehurst, Peter, Cheng, Kar Keung, Feng, Mei, Goulart, Alessandra, Greenfield, Sheila, Guruparan, Mahesan, Gusso, Gustavo, Hao, Wang, Kumarendran, Balachandran, Jolly, Kate, Jowett, Sue, Kirchhof, Paulus, Lancashire, Emma, Lane, Deirdre, Lasserson, Dan, Li, Xuewen, Lobban, Trudie, Manseki-Holland, Semira, Moore, David, Nirantharakumar, Krishnarajah, Olmos, Rodrigo, Shantsila, Alena, Szmigin, Isabelle, Subaschandren, Kumaran, and Investigators, NIHR Global Reach AF

Subjects
medicine.medical_specialty, business.industry, Family medicine, MEDLINE, Global health, Medicine, Atrial fibrillation, Cardiology and Cardiovascular Medicine, business, medicine.disease
Published
2019
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14. Is point-of-care testing feasible and safe in care homes in England? An exploratory usability and accuracy evaluation of a point-of-care polymerase chain reaction test for SARS-CoV-2

Author

Micocci, Massimo, primary, Gordon, Adam L, additional, Seo, Mikyung Kelly, additional, Allen, A Joy, additional, Davies, Kerrie, additional, Lasserson, Dan, additional, Thompson, Carl, additional, Spilsbury, Karen, additional, Akrill, Cyd, additional, Heath, Ros, additional, Astle, Anita, additional, Sharpe, Claire, additional, Perera, Rafael, additional, Hayward, Gail, additional, and Buckle, Peter, additional

Published
2021
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16. Is Point-of-Care testing feasible and safe in care homes in England? An exploratory usability and accuracy evaluation of Point-of-Care Polymerase Chain Reaction test for SARS-COV-2

Author

Micocci, Massimo, primary, Gordon, Adam, additional, Seo, Mikyung Kelly, additional, Allen, Joy A, additional, Davies, Kerrie, additional, Lasserson, Dan, additional, Thompson, Carl, additional, Spilsbury, Karen, additional, Akrill, Cyd, additional, Heath, Ros, additional, Astle, Anita, additional, Sharpe, Claire, additional, Perera, Rafael, additional, Hayward, Gail, additional, and Buckle, Peter, additional

Published
2020
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19. Start or STop Anticoagulants Randomised Trial (SoSTART) after spontaneous intracranial haemorrhage v1

Author

Al-Shahi Salman, Rustam, primary, S. Dennis, Martin, additional, Adamczuk, Kasia, additional, Innes, Karen, additional, Fraser, Ruth, additional, Drever, Jonathan, additional, Dinsmore, Lynn, additional, Williams, Carol, additional, Lewis, Steff, additional, M. White, Philip, additional, E. Newby, David, additional, Y.H. Lip, Gregory, additional, Parry-Jones, Adrian, additional, Lasserson, Dan, additional, Oliver, Colin, additional, Wardlaw, Joanna, additional, and Norrie, John, additional

Published
2020
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20. Examining the effect of evaluation sample size on the sensitivity and specificity of COVID-19 diagnostic tests in practice: a simulation study.

Author

Sammut-Powell, Camilla, Reynard, Charles, Allen, Joy, McDermott, John, Braybrook, Julian, Parisi, Rosa, Lasserson, Daniel, Body, Richard, on behalf of the CONDOR steering committee, Hayward, Gail, Buckle, Peter, Dark, Paul, Davis, Kerrie, Cook, Eloise, Gordon, Adam, Halstead, Anna, Lasserson, Dan, Lewington, Andrew, Nicholson, Brian, and Perera-Salazar, Rafael

Published
2022
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26. Decision-making in acute medicine

Author

Cooksley, Tim, Lovell, Ben, Nanayakkara, Prabath, Bhatia, Praveen, Brabrand, Mikkel, Heaps, Tom, Holland, Mark, Lasserson, Dan, Murch, Nick, Subbe, Chris, van Galen, Louise, Vaughan, Louella, APH - Quality of Care, ACS - Diabetes & metabolism, and Internal medicine

Published
2019

27. What are the basic self-monitoring components for cardiovascular risk management?

Author

Nunan David, Lasserson Dan, Perera Rafael, Heneghan Carl, Ward Alison M, Mant David, and Glasziou Paul

Subjects
Medicine (General), R5-920
Abstract

Abstract Background Self-monitoring is increasingly recommended as a method of managing cardiovascular disease. However, the design, implementation and reproducibility of the self-monitoring interventions appear to vary considerably. We examined the interventions included in systematic reviews of self-monitoring for four clinical problems that increase cardiovascular disease risk. Methods We searched Medline and Cochrane databases for systematic reviews of self-monitoring for: heart failure, oral anticoagulation therapy, hypertension and type 2 diabetes. We extracted data using a pre-specified template for the identifiable components of the interventions for each disease. Data was also extracted on the theoretical basis of the education provided, the rationale given for the self-monitoring regime adopted and the compliance with the self-monitoring regime by the patients. Results From 52 randomized controlled trials (10,388 patients) we identified four main components in self-monitoring interventions: education, self-measurement, adjustment/adherence and contact with health professionals. Considerable variation in these components occurred across trials and conditions, and often components were poorly described. Few trials gave evidence-based rationales for the components included and self-measurement regimes adopted. Conclusions The components of self-monitoring interventions are not well defined despite current guidelines for self-monitoring in cardiovascular disease management. Few trials gave evidence-based rationales for the components included and self-measurement regimes adopted. We propose a checklist of factors to be considered in the design of self-monitoring interventions which may aid in the provision of an evidence-based rationale for each component as well as increase the reproducibility of effective interventions for clinicians and researchers.

Published
2010
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28. Provision of acute medicine services for pregnant women in UK hospitals: Data from the Society for Acute Medicine Benchmarking Audit 2019.

Author

Atkin, Catherine, Prinja, Paarul, Banerjee, Anita, Holland, Mark, and Lasserson, Dan

Subjects
MATERNAL health services, AUDITING, PREGNANT women, BENCHMARKING (Management), MEDICAL protocols, CRITICAL care medicine, DESCRIPTIVE statistics
Abstract

Background: Medical problems during pregnancy are the leading cause of maternal mortality in the UK. Pregnant women often present through acute services to the medical team, requiring timely access to appropriate services, physicians trained to manage medical problems in pregnancy, with locally agreed guidance available. Methods: Data were collected through the Society for Acute Medicine Benchmarking Audit, a national audit of service delivery and patient care in acute medicine over a 24 hour period. Results: One hundred and thirty hospitals participated: 5.5% had an acute medicine consultant trained in obstetric medicine, and 38% of hospitals had a named lead for maternal medicine. This was not related to hospital size (p = 0.313). Sixty-four units had local guidelines for medical problems in pregnancy; 43% had a local guideline for venous thromboembolism in pregnancy. Centres with a named lead had more guidelines (p = 0.019). Conclusion: Current provision of services within acute medicine for pregnant women does not meet national recommendations. [ABSTRACT FROM AUTHOR]

Published
2021
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30. General practitioners' attitudes and decision making regarding admission for older adults with infection: a UK qualitative interview study.

Author

Moore, Abigail, Croxson, Caroline, McKelvie, Sara, Lasserson, Dan, and Hayward, Gail

Subjects
OLDER people, GENERAL practitioners, GROUP decision making, DECISION making, QUALITATIVE research, SEMI-structured interviews
Abstract

Background: The world has an ageing population. Infection is common in older adults; serious infection has a high mortality rate and is associated with unplanned admissions. In the UK, general practitioners (GPs) must identify which older patients require admission to hospital and provide appropriate care and support for those staying at home.Objectives: To explore attitudes of UK GPs towards referring older patients with suspected infection to hospital, how they weigh up the decision to admit against the alternatives and how alternatives to admission could be made more effective.Methods. Qualitative study using semi-structured interviews. GPs were purposively sampled from across the UK to achieve maximum variation in terms of GP role, experience and practice population. Interview transcripts were coded and analysed using a modified framework approach.Results: GPs' key influences on decision making were grouped into patient, GP and system factors. Patient factors included clinical factors, social factors and shared decision making. GP factors included gut instinct, risk management and acknowledging an associated personal emotional burden. System factors involved weighing up the pressure on secondary care beds against increasing GP workload. GPs described that finding an alternative to admission could be more time consuming, complex to arrange or were restricted by lack of capacity.Conclusion: GPs need to be empowered to make safe decisions about place of care for older adults with suspected infection. This may mean developing strategies to support decision making as well as improving the ease of access to, and capacity of, any alternatives to admission. [ABSTRACT FROM AUTHOR]

Published
2019
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35. Retrograde amnesia and the volume of critical brain structures

Author

Kopelman, Michael D., Lasserson, Dan, Kingsley, Derek, Bello, Fernando, Rush, C., Stanhope, Nicola, Stevens, Tom, Goodman, G., Heilpern, G., Kendall, B.E., Colchester, Alan C. F., Kopelman, Michael D., Lasserson, Dan, Kingsley, Derek, Bello, Fernando, Rush, C., Stanhope, Nicola, Stevens, Tom, Goodman, G., Heilpern, G., Kendall, B.E., and Colchester, Alan C. F.

Abstract

There are many controversies concerning the structural basis of retrograde amnesia (RA). One view is that memories are held briefly within a medial temporal store ("hippocampal complex") before being "consolidated" or reorganised within temporal neocortex and/or networks more widely distributed within the cerebral cortex. An alternative view is that the medial temporal lobes are always involved in the storage and retrieval (reactivation) of autobiographical memories (multiple trace theory). The present study used quantitative magnetic resonance imaging (MRI) in 40 patients with focal pathology/volume loss in different sites, to examine the correlates of impairment on three different measures of RA. The findings supported the view that widespread neural networks are involved in the storage and retrieval of autobiographical and other remote memories. Brain volume measures in critical structures could account for 60% of variance on autobiographical memory measures (for incidents and facts) in diencephalic patients and for 60-68% of variance in patients with frontal lesions. Significant correlations with medial temporal lobe volume were found only in the diencephalic group, in whom they were thought to reflect thalamic changes, but not in patients with herpes encephalitis or hypoxia in whom the temporal lobes were particularly implicated. The latter finding fails to support one of the main predictions of multiple trace theory, as presently expounded. (C) 2003 Wiley-Liss, Inc.

Published
2003

37. Structural MRI Volumetric Analysis in Patients with Organic Amnesia, 2: Correlations with Anterograde Memory and Executive Tests in 40 patients

Author

Kopelman, Michael D., Lasserson, Dan, Kingsley, Derek, Bello, Fernando, Rush, C., Stanhope, Nicola, Stevens, T., Goodman, G., Heilpern, G., Kendall, B.E., Colchester, Alan C. F., Kopelman, Michael D., Lasserson, Dan, Kingsley, Derek, Bello, Fernando, Rush, C., Stanhope, Nicola, Stevens, T., Goodman, G., Heilpern, G., Kendall, B.E., and Colchester, Alan C. F.

Published
2001

40. Point of care testing using rapid automated antigen testing for SARS-COV-2 in care homes – an exploratory safety, usability and diagnostic agreement evaluation

Author

Micocci, Massimo, Buckle, Peter, Hayward, Gail, Allen, A Joy, Davies, Kerrie, Kierkegaard, Patrick, Spilsbury, Karen, Thompson, Carl, Astle, Anita, Heath, Ros, Sharpe, Claire, Akrill, Cyd, Lasserson, Dan, Perera, Rafael, Body, Richard, and Gordon, Adam L

Abstract

Introduction Successful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of the contextual and usability factors that affect test results and minimise biosafety risks. This paper presents a scoping-usability and test performance study of a microfluidic immunofluorescence assay for COVID-19 in care homes.Methods A mixed-methods evaluation was conducted in four UK care homes to scope usability and to assess the agreement with qRT-PCR. A dry run with luminescent dye was conducted to explore biosafety issues.Results The agreement analysis was conducted on 227 asymptomatic participants (159 staff and 68 residents) and 14 symptomatic participants (5 staff and 9 residents). Asymptomatic specimens showed 50% (95% CI:1.3%−98.7%) positive agreement and 96% (95% CI: 92.5%−98.1%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.911 (95% CI: 0.857−0.965). Symptomatic specimens showed 83.3% (95% CI: 35.9%−99.6%) positive agreement and 100% (95% CI: 63.1%−100%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.857 (95% CI: 0.549−1). The dry run highlighted four main sources of contamination that led to the modification of the standard operating procedures. Simulation post-modification showed no further evidence of contamination.Conclusion Careful consideration of biosafety issues and contextual factors associated with care home are mandatory for safe use the POCT. Whilst POCT may have some utility for ruling out COVID-19, further diagnostic accuracy evaluations are needed to promote effective adoption.

Published
2021
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