143 results on '"Poacher AT"'
Search Results
2. The impact of the introduction of selective screening in the UK on the epidemiology, presentation, and treatment outcomes of developmental dysplasia of the hip
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Arwel T. Poacher, Isaac Hathaway, Daniel L. Crook, Joseph L. J. Froud, Lily Scourfield, Catherine James, Matthew Horner, and Eleanor C. Carpenter
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developmental dysplasia of the hip ,universal screening ,selective screening ,paediatrics ,paediatric hip ,developmental dysplasia of the hip (ddh) ,epidemiology ,physical examination ,morbidity ,medline ,hips ,surgical treatment ,dislocation of the hip ,hip deformity ,torticollis ,Orthopedic surgery ,RD701-811 - Abstract
Aims: Developmental dysplasia of the hip (DDH) can be managed effectively with non-surgical interventions when diagnosed early. However, the likelihood of surgical intervention increases with a late presentation. Therefore, an effective screening programme is essential to prevent late diagnosis and reduce surgical morbidity in the population. Methods: We conducted a systematic review and meta-analysis of the epidemiological literature from the last 25 years in the UK. Articles were selected from databases searches using MEDLINE, EMBASE, OVID, and Cochrane; 13 papers met the inclusion criteria. Results: The incidence of DDH within the UK over the last 25 years is 7.3/1,000 live births with females making up 86% of the DDH population (odds ratio 6.14 (95% confidence interval 3.3 to 11.5); p < 0.001). The incidence of DDH significantly increased following the change in the Newborn and Infant Physical Examination (NIPE) guidance from 6.5/1,000 to 9.4/1,000 live births (p < 0.001). The rate of late presentation also increased following the changes to the NIPE guidance, rising from 0.7/1,000 to 1.2/1,000 live births (p < 0.001). However, despite this increase in late-presenting cases, there was no change in the rates of surgical intervention (0.8/1,000 live births; p = 0.940). Conclusion: The literature demonstrates that the implementation of a selective screening programme increased the incidence of DDH diagnosis in the UK while subsequently increasing the rates of late presentation and failing in its goal of reducing the rates of surgical intervention for DDH. Cite this article: Bone Jt Open 2023;4(8):635–642.
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- 2023
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3. Application of generative language models to orthopaedic practice
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Andrew Jones, Nicholas Cereceda-Monteoliva, Jessica Caterson, Olivia Ambler, Matthew Horner, and Arwel Tomos Poacher
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Medicine - Abstract
Objective To explore whether large language models (LLMs) Generated Pre-trained Transformer (GPT)-3 and ChatGPT can write clinical letters and predict management plans for common orthopaedic scenarios.Design Fifteen scenarios were generated and ChatGPT and GPT-3 prompted to write clinical letters and separately generate management plans for identical scenarios with plans removed.Main outcome measures Letters were assessed for readability using the Readable Tool. Accuracy of letters and management plans were assessed by three independent orthopaedic surgery clinicians.Results Both models generated complete letters for all scenarios after single prompting. Readability was compared using Flesch-Kincade Grade Level (ChatGPT: 8.77 (SD 0.918); GPT-3: 8.47 (SD 0.982)), Flesch Readability Ease (ChatGPT: 58.2 (SD 4.00); GPT-3: 59.3 (SD 6.98)), Simple Measure of Gobbledygook (SMOG) Index (ChatGPT: 11.6 (SD 0.755); GPT-3: 11.4 (SD 1.01)), and reach (ChatGPT: 81.2%; GPT-3: 80.3%). ChatGPT produced more accurate letters (8.7/10 (SD 0.60) vs 7.3/10 (SD 1.41), p=0.024) and management plans (7.9/10 (SD 0.63) vs 6.8/10 (SD 1.06), p
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- 2024
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4. The cost effectiveness of potential risk factors for developmental dysplasia of the hip within a national screening programme
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Arwel T. Poacher, Joseph L. J. Froud, Jessica Caterson, Daniel L. Crook, Gregor Ramage, Luke Marsh, Gethin Poacher, and Eleanor C. Carpenter
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paediatrics ,developmental dysplasia of the hip ,risk factors ,ddh ,public health ,screening program ,developmental dysplasia of the hip (ddh) ,foot deformities ,ultrasonography ,hips ,ultrasound screening ,dysplasia ,logistic regression ,complete dislocation ,physical examination ,orthopaedic surgery ,Orthopedic surgery ,RD701-811 - Abstract
Aims: Early detection of developmental dysplasia of the hip (DDH) is associated with improved outcomes of conservative treatment. Therefore, we aimed to evaluate a novel screening programme that included both the primary risk factors of breech presentation and family history, and the secondary risk factors of oligohydramnios and foot deformities. Methods: A five-year prospective registry study investigating every live birth in the study’s catchment area (n = 27,731), all of whom underwent screening for risk factors and examination at the newborn and six- to eight-week neonatal examination and review. DDH was diagnosed using ultrasonography and the Graf classification system, defined as grade IIb or above or rapidly regressing IIa disease (≥4o at four weeks follow-up). Multivariate odds ratios were calculated to establish significant association, and risk differences were calculated to provide quantifiable risk increase with DDH, positive predictive value was used as a measure of predictive efficacy. The cost-effectiveness of using these risk factors to predict DDH was evaluated using NHS tariffs (January 2021). Results: The prevalence of DDH that required treatment within our population was 5/1,000 live births. The rate of missed presentation of DDH was 0.43/1000 live births. Breech position, family history, oligohydramnios, and foot deformities demonstrated significant association with DDH (p < 0.0001). The presence of breech presentation increased the risk of DDH by 1.69% (95% confidence interval (CI) 0.93% to 2.45%), family history by 3.57% (95% CI 2.06% to 5.09%), foot deformities by 8.95% (95% CI 4.81% to 13.1%), and oligohydramnios nby 11.6% (95 % CI 3.0% to 19.0%). Primary risk factors family history and breech presentation demonstrated an estimated cost-per-case detection of £6,276 and £11,409, respectively. Oligohydramnios and foot deformities demonstrated a cost-per-case detected less than the cost of primary risk factors of £2,260 and £2,670, respectively. Conclusion: The inclusion of secondary risk factors within a national screening programme was clinically successful as they were more cost and resource-efficient predictors of DDH than primary risk factors, suggesting they should be considered in the national guidance. Cite this article: Bone Jt Open 2023;4(4):234–240.
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- 2023
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5. Oral and maxillofacial surgery and dental health education in undergraduate medicine: a systematic review
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Glossop, Sean, Duffaydar, Hamza, Jones, Harri, Peters, Ethan, Ryan, Timothy, Saleh, Francesca, Scourfield, Lily, and Poacher, Arwel
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- 2024
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6. Undergraduate education of trauma and orthopaedic surgery in the UK: a systematic review
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Arwel T. Poacher, Hari Bhachoo, Jack Weston, Kavita Shergill, Gethin Poacher, and Joe Froud
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medical education ,undergraduate ,training ,orthopaedic ,surgical education ,trauma ,orthopaedic surgery ,medline ,clinicians ,musculoskeletal conditions ,musculoskeletal medicine ,musculoskeletal examinations ,healthcare professionals ,rheumatology ,arthroplasty ,Orthopedic surgery ,RD701-811 - Abstract
Aims: Evidence exists of a consistent decline in the value and time that medical schools place upon their undergraduate orthopaedic placements. This limited exposure to trauma and orthopaedics (T&O) during medical school will be the only experience in the speciality for the majority of doctors. This review aims to provide an overview of undergraduate orthopaedic training in the UK. Methods: This review summarizes the relevant literature from the last 20 years in the UK. Articles were selected from database searches using MEDLINE, EMBASE, ERIC, Cochrane, and Web of Science. A total of 16 papers met the inclusion criteria. Results: The length of exposure to T&O is declining; the mean total placement duration of two to three weeks is significantly less than the four- to six-week minimum advised by most relevant sources. The main teaching methods described in the literature included didactic lectures, bedside teaching, and small group case-based discussions. Students preferred interactive, blended learning teaching styles over didactic methods. This improvement in satisfaction was reflected in improvements in student assessment scores. However, studies failed to assess competencies in clinical skills and examinations, which is consistent with the opinions of UK foundation year doctors, approximately 40% of whom report a “poor” understanding of orthopaedics. Furthermore, the majority of UK doctors are not exposed to orthopaedics at the postgraduate level, which only serves to amplify the disparity between junior and generalist knowledge, and the standards expected by senior colleagues and professional bodies. Conclusion: There is a deficit in undergraduate orthopaedic training within the UK which has only worsened in the last 20 years, leaving medical students and foundation doctors with a potentially significant lack of orthopaedic knowledge. Cite this article: Bone Jt Open 2022;3(7):549–556.
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- 2022
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7. Undergraduate deficits in plastic surgery exposure and awareness of the specialty: a systematic review.
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Bhachoo, H, Glossop, SC, Mattey, LR, Pearson, C, Hoade, L, Cereceda-Monteoliva, N, Scourfield, L, and Poacher, AT
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- 2025
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8. Four consecutive yearly point-prevalence studies in Wales indicate lack of improvement in sepsis care on the wards
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Maja Kopczynska, Harry Unwin, Richard J. Pugh, Ben Sharif, Thomas Chandy, Daniel J. Davies, Matthew E. Shield, David E. Purchase, Samuel C. Tilley, Arwel Poacher, Lewis Oliva, Sam Willis, Isabelle E. Ray, John Ng C. Hui, Bethany C. Payne, Eilis F. Wardle, Fiona Andrew, Hei Man Priscilla Chan, Jack Barrington, Jay Hale, Joanna Hawkins, Jess K. Nicholas, Lara E. Wirt, Lowri H. Thomas, Megan Walker, Myat P. Pan, Tallulah Ray, Umair H. Asim, Victoria Maidman, Zeid Atiyah, Zain M. Nasser, Zhao Xuan Tan, Laura J. P. Tan, Tamas Szakmany, and The Welsh Digital Data Collection Platform collaborators
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Medicine ,Science - Abstract
Abstract The ‘Sepsis Six’ bundle was promoted as a deliverable tool outside of the critical care settings, but there is very little data available on the progress and change of sepsis care outside the critical care environment in the UK. Our aim was to compare the yearly prevalence, outcome and the Sepsis Six bundle compliance in patients at risk of mortality from sepsis in non-intensive care environments. Patients with a National Early Warning Score (NEWS) of 3 or above and suspected or proven infection were enrolled into four yearly 24-h point prevalence studies, carried out in fourteen hospitals across Wales from 2016 to 2019. We followed up patients to 30 days between 2016–2019 and to 90 days between 2017 and 2019. Out of the 26,947 patients screened 1651 fulfilled inclusion criteria and were recruited. The full ‘Sepsis Six’ care bundle was completed on 223 (14.0%) occasions, with no significant difference between the years. On 190 (11.5%) occasions none of the bundle elements were completed. There was no significant correlation between bundle element compliance, NEWS or year of study. One hundred and seventy (10.7%) patients were seen by critical care outreach; the ‘Sepsis Six’ bundle was completed significantly more often in this group (54/170, 32.0%) than for patients who were not reviewed by critical care outreach (168/1385, 11.6%; p
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- 2021
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9. Application of generative language models to orthopaedic practice
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Caterson, Jessica, primary, Ambler, Olivia, additional, Cereceda-Monteoliva, Nicholas, additional, Horner, Matthew, additional, Jones, Andrew, additional, and Poacher, Arwel Tomos, additional
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- 2024
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10. Undergraduate deficits in plastic surgery exposure and awareness of the specialty: a systematic review
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Bhachoo, H, primary, Glossop, SC, additional, Mattey, LR, additional, Pearson, C, additional, Hoade, L, additional, Cereceda-Monteoliva, N, additional, Scourfield, L, additional, and Poacher, AT, additional
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- 2024
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11. The Use of Different Sepsis Risk Stratification Tools on the Wards and in Emergency Departments Uncovers Different Mortality Risks: Results of the Three Welsh National Multicenter Point-Prevalence Studies
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Harry J. A. Unwin, MBBCh, BSc, Maja Kopczynska, MBBCh, BSc, Richard Pugh, FRCA, Laura J. P. Tan, MBBS, BSc, Christian P. Subbe, MD, Gemma Ellis, MSc, Paul Morgan, FRCA, Peter Havalda, MD, Ben Sharif, MBBCh, John Burke, MSc, Tamas Szakmany, MD, PhD, FCCM, on behalf of Welsh Digital Data Collection Platform (WDDCP) Collaborators, Maria Hobrok, Moriah Thomas, Annie Burden, Nadia Youssef, Katherine Carnegie, Helena Colling-Sylvester, Natasha Logier, Meshari Alsaeed, Hannah Williams, Arfa Ayob, Nor Farzana, Sweta Parida, David Lawson, Emily Evans, Laura Jane Davis, Billie Atkins, Llywela Wyn Davies, Lee Sanders-Crook, Steffan Treharne Seal, Alice Cains, Richard Pugh, Katy Crisp, Sarah Venning, Ella Sykes, Stephanie Narine, Georgia Parry, Emily Angela Dillon, Qi Zhuang Siah, Ting Yang, Tyler Jones, Parvathi Thara, Emma Wood, Lara Wirt, Georgina St Pier, Richard Betts, Kyriaki Mitsaki, Mari Tachweed Pierce, Sioned Davies, Yakeen Hafouda, Erin Ifan, Grace Lacey, Francesca Mitchell, John Lynch, Michal Mazur, Lezia D’Souza, Bethan Ponting, Terrance Lau, Ruairidh Kerrigan, Lucy Morgan, Roshan Vindla, Claudia Zeicu, Becky James, Amirah Amin Ariff, Wan Binti Wan Azzlan, Charlotte Collins, Elizabeth Wickens, Alisa Norbee, Aliya Zulkefli, Thomas Haddock, Megan Thomas, Matthew Lee, Miriam Cynan, Nik-Syakirah Nik Azis, Imogen Hay, Catherine Russell, Margriet Vreugdenhil, Mustafa Abdimalik, Joseph Davies, Peter Havalda, Angharad Evans, Kate Robertson, Grace Gitau, Mei-yin Gruber, Thomas Telford, Anas Qarout, Naomi Nandra, Hannah Garrard, James Cutler, Rhiannon Tammy Jones, Amy Prideaux, Timothy Spence, Sarah Hardie, Harriet Seymour, Sam Willis, Matthew Warlow, Shanali Thanthilla, Thomas Downs, Nina Foley, Chad McKeown, Akshita Dandawate, Holleh Shayan-Arani, Ellie Taylor, Oliver Kyriakides, Rachel Price, Ffion Haf Mackey, Emily Haines, Samuel Chun, Nilarnti Vignarajah, Tessa Chamberlain, Dongying Zhao, Nayanatara Nadeesha T Tantirige, Naomi Dennehey, Georgina Evans, John Watts, Ceri Battle, Ryan Jones, Selina Jones, Charlotte James, James O’Hanlon, Isabella Bridges, Bethany Hughes, Leo Polchar, Elise Bisson, Charlotte Mykura, Lara Money, Joshua McKenna, Sarah Kinsman, Demiana Hanna, Emily Baker, Harrison Sprague, Liam Sharma, Tom Pontin, Emma Shore, Tamara Hughes, Sam Nightingale, Philby Baby, Matthew Shield, Alice Cross, Jenna Boss, Olivia Ross, George Ashton, Kimaya Pandit, Daniel Davies, Cameron Garbutt, Charlotte Johnston, Marcus Cox, Chantal Roberts, Alessia Waller, Laura Heekin, Kathy Wang, Rhianna Church, Shrina Patel, Marianne Broderick, Hannah Whillis, Daniel Craig Hathaway, Emel Yildirim, Caitlin Atkins, Elin Walters, Carys Durie, Robert James Hamilton Sinnerton, Benjamin Tanner, Julimar Abreu, Kiran Bashir, Vincent Hamlyn, Amelia Tee, Zoe Ann Hinchcliffe, Rita Otto, Georgie Covell, Megan Stone, Victoria Maidman, Katherine Godfray, Rhidian Caradine, Hannah Beetham, Adanna Nicole Anomneze-Collins, Jeanette Tan, Yasmina Abdelrazik, Azizah Khan, Nabihah Malik, Aidan Clack, Lewis Oliva, Tyler Thomas, Adam George Mounce, Anoopama Ramjeeawon, Ndaba Mtunzi, Duncan Soppitt, Jay Hale, Jack Wellington, Robert Buchanan Ross, Danielle Lis, Rebecca Parsonson, Jude Joseph-Gubra, Ajitha Arunthavarajah, Jessica Nicholas, Aaron Harris, Henry Atkinson, Jessica Webster, Tim Burnett, Josephine Raffan Gowar, Sam DeFriend, Jasmine Whitaker, Elizabeth Beasant, Luis Macchiavello, Danyal Usman, Abdullah Mahdi, Tiffany Ye Tze Shan, Nick Savill, Jennifer Gee, Lizzie Hodges, Ami Desai, Hannah Rossiter, Matthew Taylor, Kevin Pinto, Eleanor Hartley, Oscar Emanuel, Rhiannon Long, Megan Selby, Elilis Wardle, Alexandra Urquhart, Jack Barrington, Matthew Ashman, Elizabeth Adcock, Amelia Dickinson, Rebecca Jordache, Rym Chafai El Alaoui, Sophie Stovold, Sam Vickery, Nia Jones, Alice O’Donnell, Monty Cuthbert, Osa Eghosa, Muhammad Karim, Lowri Williams, Louise Tucker, Tom Downs, Rebecca Walford, Annabelle Hook, Adam Mounce, Emily Eccles, Ross Edwards, Kirtika Ramesh, Charlie Hall, Maria Lazarou, Rhidian Jones, Katy McGillian, Hari Singh Bhachoo, Zoe The, Vithusha Inpahas, Ruchi Desai, Yusuf Cheema, Andrew Hughes, Olivia Cranage, Felicity Bee, Khalid Osman, Humza Khan, Jennifer Pitt, Charlotte Pickwick, Jorge Carter, Fiona Andrew, Naseera Seedat, Roshni Patel, Megan Walker, Alicia Boam, Jessica Randall, Beth Bowyer, Josh Edwards, Natasha Jones, Emma Walker, Ailsa MacNaught, Swagath Balachandran, Abbie Shipley, Jennifer Louise Kent, Samuel Tilley, Bethany Davies, Emma Withers, Krishna Parmar, Lucie Webber, Angelica Sharma, Amy Handley, Alexandra Gordon, Lucy Allen, Rebecca Paddock, Harriet Penney, Lopa Banerjee, Chloe Victoria Vanderpump, Kate Harding, John Burke, Orsolya Minik, Nia Jarrett, Ellie Rowe, Adanna Anomneze-Collins, Harry Griffiths, Sarah Pengelly, Ffion Bennett, Ahmed Bilal, Abdullah El-badawey, Bethan Ellis, Luke Cook, Harriet Elizabeth Valentine Maine, Kiri Armstrong, Hannah Beresford, Timia Raven-Gregg, Tom Liddell-Lowe, Caitlin Ong, Harriet Reed, Frederika Alice St John, Weronika Julia Kozuch, Isabelle Ray, Irukshi Anuprabha Silva, Sin Ting Natalie Cheng, Umme-Laila Ali, Noreena Syed, Luke Murphy, Thomas Grother, Harry Smith, Rachel Watson, Omar Marei, Emma Kirby, Anna Gilfedder, Lydia Maw, Sarah O’Connor, Charlotte Maden, Helena Jones, Hazel Preston, Nur Amirah Binti Maliki, Mark Zimmerman, Jessica Webber, Llewelyn Jones, Rebecca Phillips, Lauren McCarthy, Emily Hubbard, Leo Duffy, Abigail Guerrier Sadler, Tamas Szakmany, Owen Richards, Charles King, Charlotte Killick, Yusuf Chema, Kavita Shergill, Yi Huen, Lillian Lau, Hannah Mustafa Ali, Lucas Wilcock, Molly Timlin, Ayeesha Rela, Daniel Smith, Sarah Ireland, Jennifer Evans, Nayanatara Poobalan, Jessica Pearce, Thivya V Vadiveloo, Zoe Black, Daniel Elis Samuel, Humaira Hussain, Joanna Hawkins, Zeid Atiyah, Rebecca Creamer, Maham Zafar, Ahmad Almazeedi, Hannah Brunnock, Zain Nasser, Mekha Jeyanthi, Poorya Moghbel, Katie Kwan, Isobel Sutherland, Frank Davis, Abigail Rogers, Zhao Xuan Tan, Clare Chantrill, Amal Robertson, Jonathan Foulkes, Rahana Khanam, Jomcy John, Sarah Hannah Meehan, Huria Metezai, Hannah Dawson, Navrhinaa Vadivale, Camilla Lee, Amrit Dhadda, Sian Cleaver, Genna Logue, Joy Inns, Isabel Jones, Robyn Howcroft, Carys Gilbert, Matthew Bradley, Louise Pike, Rachel Keeling, Charldré Banks, Eleanor Cochrane, James McFadyen, Matthew Mo, Emily Ireland, Esme Brittain, Ihssen Laid, Charlotte Green, Adriel Mcforrester, Xuong Michelle Ly, Mariana Nalbanti, Raven Joseph, Jack Tagg, David Purchase, Pan Myat, Ayako Niina, Tyler Joshua Jones, Lowri Hughes Thomas, Natalie Hoyle, Patrick Benc, Ellen Davies, Meng-Chieh Wu, David Fellows, Sam Tilley, Eloise Baxendale, Karishma Khan, Andrew Forrester, Oliver Moore, Hse Juinn Lim, Aimee Owen, Faris Hussain, Nima-banu Allybocus, Maneha Sethi, Harry Waring, Adeel Khan, Claire Smith, Nicholas Doyle, Mohammad Yahya Amjad, Luke Galloway, Paul Morgan, Gemma Ellis, Robert Lundin, Haamed Al Hassan, Bethan Markall, Namratha Kaur, Emmanuel Onyango, Heather Beard, Elliot Field, Ellen Nelson-Rowe, Lizzie Adcock, Amelia Stoddart, Frederika St John, Mathoorika Sivananthan, Rhys Jones, Sung Yeon Kwak, Lily Farakish, Holly Rhys-Ellis, Kate Moss, Tallulah Ray, Tessa David, Talea Roberts, Annie Quy, Aniket Paranjape, Nutchanun Poolworaluk, Mary Keast, Si Liang Yao, Dion Manning, Isobel Irwin, Umair Asim, Emelia Boggon, Ibrahim Alkurd, Genevieve Lawerece, Jade Brown, Emily Murphy, Evie Lambert, Jeremy Guilford, Beth Payne, Mariam Almulaifi, Arwel Poacher, Sashiananthan Ganesananthan, Berenice Cunningham-Walker, Chloe Spooner, Akanksha Kiran, Nabeegh Nadeem, Vidhi Unadkat, Esme Sparey, David Li, Jessica Smith, India Corrin, Amit Kurani, Paul McNulty, Ceri Brown, Wojciech Groblewski, Szilvia Szoke, Amelia Redman, Esther McKeag, Anastasia Donnir, Gaautham Ravishangar, Emanuela Howard, Charlotte Salmon, Sara Tanatova, Jasmine Kew, Megan Eilis Clark, Ellen Hannay, Olesya Godsafe, Christina Houghton, Francesca Lavric, Rachel Mallinson, Chris Littler, Harsha Reddy, Andrew Campbell, Benedict Soo, Rachel Evans, Georgina Donowho, Alexandra Cawthra, Maddison Davies, Matthew Lawrence Ashman, Jamie Scriven, James Vautrey, Shannon Seet, Imogen Britton, Abigail Hodgson, Emma Twohey, Joseph Robbins, Vanessa Yeo Yung Ling, Kimiya Asjadi, Carven Chin Yee Shean, Zoe McCarroll, Oritseweyimi Amatotsero, Hei Man Priscilla Chan, John Ng Cho Hui, Antonia Ashaye, Josephine Acheampong, Ayowade Adeleye, Saber Ahmed, Alexandra Chrysostomou, Harry Unwin, Eshen Ang, Niamh McSwiney, Yin Yin Lim, Zong Xuan Lee, Svetlana Kulikouskaya, Nur Zulkifili, Sheryl Lim, Lim Xin, Adiya Urazbayeva, Nur Haslina Ahmad Hanif, Yau Ke Ying, Alice Coleclough, Eilis Higgins, Naomi Spencer, Tze Gee Ng, Sam Booth, Stephanie Wai Yee Ng, Christian P Subbe, Isabella Patterson, Wen Li Chia, Abdullah Mukit, Hei Yi Vivian Pak, Felicity Lock, Mariana Nalmpanti, Shôn Alun Thomas, Tanisha Burgher, Alfred Wei Zhen Yeo, Siwan Powell Jones, Charlie Miles, Millicent Perry, Holly Burton, Katharine Powell, Luthfun Nessa, Aalaa Fadlalla, Rhian Morgan, Elizabeth Hodges, Amelia Heal, Chloe Scott, Alice Tayler, Thomas Chandy, Abduahad Taufik, James Cochrane, Samuel Willis, Sieh Yen Heng, Alex Cooper, Henrik Graf von der Pahlen, Isabella Talbot, Robin Gwyn Roberts, Jessica Sharma Smith, Aisling Sweeney, Cerian Roberts, Laura Bausor, Chania, Daniah Thomas, Elen Wyn Puw, Ronan A Lyons, and Judith E Hall
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Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
OBJECTIVES:. To compare the performance of Sequential Organ Failure Assessment, systemic inflammatory response syndrome, Red Flag Sepsis, and National Institute of Clinical Excellence sepsis risk stratification tools in the identification of patients at greatest risk of mortality from sepsis in nonintensive care environments. DESIGN:. Secondary analysis of three annual 24-hour point-prevalence study periods. SETTING:. The general wards and emergency departments of 14 acute hospitals across Wales. Studies were conducted on the third Wednesday of October in 2017, 2018, and 2019. PATIENTS:. We screened all patients presenting to the emergency department and on the general wards. MEASUREMENTS AND MAIN RESULTS:. We recruited 1,271 patients, of which 724 (56.9%) had systemic inflammatory response syndrome greater than or equal to 2, 679 (53.4%) had Sequential Organ Failure Assessment greater than or equal to 2, and 977 (76.9%) had Red Flag Sepsis. When stratified according to National Institute of Clinical Excellence guidelines, 450 patients (35.4%) were in the “High risk” category in comparison with 665 (52.3%) in “Moderate to High risk” and 156 (12.3%) in “Low risk” category. In a planned sensitivity analysis, we found that none of the tools accurately predicted mortality at 90 days, and Sequential Organ Failure Assessment and National Institute of Clinical Excellence tools showed only moderate discriminatory power for mortality at 7 and 14 days. Furthermore, we could not find any significant correlation with any of the tools at any of the mortality time points. CONCLUSIONS:. Our data suggest that the sepsis risk stratification tools currently utilized in emergency departments and on the general wards do not predict mortality adequately. This is illustrated by the disparity in mortality risk of the populations captured by each instrument, as well as the weak concordance between them. We propose that future studies on the development of sepsis identification tools should focus on identifying predicator values of both the short- and long-term outcomes of sepsis.
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- 2021
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12. The effectiveness of shockwave therapy to improve pain and symptom severity in patients with chronic patellar tendinopathy: a literature review
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Poacher, Eddie, primary and Thompson, Jonathan, additional
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- 2023
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13. Undergraduate teaching of surgical skills in the UK: systematic review
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Glossop, Sean C, primary, Bhachoo, Hari, additional, Murray, Thomas M, additional, Cherif, Rayan A, additional, Helo, John Y, additional, Morgan, Evie, additional, and Poacher, Arwel T, additional
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- 2023
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14. Standardization of global hip fracture audit could facilitate learning, improve quality, and guide evidence-based practice
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Johansen, Antony, primary, Hall, Andrew J., additional, Ojeda-Thies, Cristina, additional, Poacher, Arwel T., additional, and Costa, Matthew L., additional
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- 2023
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15. 1012 Evaluation of the ‘Clicky’ Hip in the Diagnosis of Developmental Dysplasia of the Hip (DDH)
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Ross, M, primary, Poacher, A, additional, Froud, J, additional, Morgan, E, additional, Carpenter, E, additional, and Ramage, G, additional
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- 2023
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16. The impact of the introduction of selective screening in the UK on the epidemiology, presentation, and treatment outcomes of developmental dysplasia of the hip
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Poacher, Arwel T., primary, Hathaway, Isaac, additional, Crook, Daniel L., additional, Froud, Joseph L. J., additional, Scourfield, Lily, additional, James, Catherine, additional, Horner, Matthew, additional, and Carpenter, Eleanor C., additional
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- 2023
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17. The cost effectiveness of potential risk factors for developmental dysplasia of the hip within a national screening programme
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Poacher, Arwel T., primary, Froud, Joseph L. J., additional, Caterson, Jessica, additional, Crook, Daniel L., additional, Ramage, Gregor, additional, Marsh, Luke, additional, Poacher, Gethin, additional, and Carpenter, Eleanor C., additional
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- 2023
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18. A cross‐sectional evaluation of the current state of wound healing education in the United Kingdom's undergraduate medical curriculum
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Poacher, Arwel T., primary, Bhachoo, Hari, additional, Jones, Andrew, additional, Weston, Jack, additional, Powell, Katharine, additional, Myaat, Pan, additional, and Morgan‐Jones, Rhidian, additional
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- 2023
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19. THE CLINICAL IMPLICATIONS OF GRAF TYPE IIA HIP DYSPLASIA
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Poacher, A., primary, Ramage, G., additional, Froud, J., additional, and Carpenter, C., additional
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- 2023
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20. A VIRTUAL FRACTURE CLINIC AUDIT: ARE WALES MATCHING THE OUTCOMES IN ENGLAND?
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Ramage, G., primary, Poacher, A., additional, Ramsden, M., additional, Lewis, J., additional, Robertson, A., additional, and Wilson, C., additional
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- 2023
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21. Undergraduate education of trauma and orthopaedic surgery in the UK
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Poacher, Arwel T., primary, Bhachoo, Hari, additional, Weston, Jack, additional, Shergill, Kavita, additional, Poacher, Gethin, additional, and Froud, Joe, additional
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- 2022
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22. Defining sepsis on the wards: results of a multi‐centre point‐prevalence study comparing two sepsis definitions
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Szakmany, T., Pugh, R., Kopczynska, M., Lundin, R. M., Sharif, B., Morgan, P., Ellis, G., Abreu, J., Kulikouskaya, S., Bashir, K., Galloway, L., Al‐Hassan, H., Grother, T., McNulty, P., Seal, S. T., Cains, A., Vreugdenhil, M., Abdimalik, M., Dennehey, N., Evans, G., Whitaker, J., Beasant, E., Hall, C., Lazarou, M., Vanderpump, C. V., Harding, K., Duffy, L., Guerrier Sadler, A., Keeling, R., Banks, C., Ng, S. W. Y., Heng, S. Y., Thomas, D., Puw, E. W., Otahal, I., Battle, C., Minik, O., Lyons, R. A., Hall, J. E., Walters, E., Durie, C., Sinnerton, H., Tanner, B., Cunningham‐Walker, B., Spooner, C., Kiran, A., Nadeem, N., Unadkat, V., Poacher, A., Ganesananthan, S., Hui, J. N. C., Sparey, E., Li, D. C., Smith, J., Corrin, I., Kurani, A., Waring, H., Khan, A., Smith, C., Doyle, N., Baker, E., Shipley, A., Amjad, M. Y., Cynan, M., Azis, N. N., Hay, I., Russell, C., Davies, J., Parsonson, R., Joseph‐Gubral, J., Arunthavarajah, A., Nicholas, J., Harris, A., Hale, J., Atkinson, H., Webster, J., Burnett, T., Gowar, J. R., DeFriend, S., Lawson, D., Maden, C., Jones, H., Preston, H., Maliki, N. A. B., Zimmerman, M., Webber, J., Jones, L., Phillips, R., McCarthy, L., Wirt, L., Hubbard, E., Evans, E., Davis, L. J., Atkins, B., Davies, L. W., Sanders‐Crook, L., Vadivale, N., Lee, C., Dhadda, A., Cleaver, S., Logue, G., Inns, J., Jones, I., Howcroft, R., Gilbert, C., Bradley, M., Pike, L., Urazbayeva, A., Hanif, N. H. A., Ying, Y. K., Coleclough, A., Higgins, E., Morgan, L., Spencer, N., Ng, T. G., Booth, S., Vignarajah, N., Chamberlain, T., Zhao, D., Tantirige, N. N., Watts, J., Walford, R., Prideaux, A., Tee, A., Hook, A., Mounce, A., Eccles, E., Edwards, R., Ramesh, K., Bausor, L., Lambrinudi, C., Sharma, A., Handley, A., Gordon, A., Allen, L., Paddock, R., Penney, H., Banerjee, L., DʼSouza, L., Thomas, K., Havalda, P., Littler, C., West, N., Subbe, C., Hobrok, M., Self, R., and Hamlyn, V.
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- 2018
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23. Crash Course in Orthopaedics: Development and Evaluation of a 12-Week Online Trauma and Orthopaedics Teaching Program for Medical Students During the COVID-19 Pandemic
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Catherine James, Karen Chui, Alex Brown, Arwel Poacher, Claire Carpenter, and Edwin Jesudason
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General Engineering - Abstract
Introduction The COVID-19 pandemic caused significant disruption in clinical placements of medical students in the United Kingdom (UK), including trauma and orthopaedic surgery (TO) rotations. Based on the British Orthopaedic Association (BOA) undergraduate syllabus, a 12-week online teaching program was designed to supplement TO teaching for medical students across the UK while lockdown and social-distancing restrictions were in place. This study aims to describe the process of designing an online teaching program, evaluate the effectiveness of online education, explore medical student perceptions of the virtual learning environment, and report the lessons learned from this 12-week online program. Methods The "Crash Course in Orthopaedics" consisted of 12 webinars, with topics covering a range of acute and chronic TO conditions, and was delivered through the online platform Zoom. Attendees were invited to complete a post-course questionnaire retrospectively and the results were used in this study. Qualitative data was assessed using thematic analysis. Quantitative data were presented as descriptive statistics. Results The webinar series was attended by approximately 5150 participants, with the largest demographic group being clinical medical students (49%). Results from the survey revealed three broad themes which were: 1). Interactivity: question + answer (Q+A), multiple choice questions (MCQs), online tools 2). Content: case examples, orthopaedic examinations, objective structure clinical examination (OSCE) tips 3). Accessibility: slides, recordings, duration of the session. Our study found that the online teaching program improved students' clinical knowledge of TO and they found learning through interactive methods such as polls, the chat function on zoom, and case-based discussions to be most useful. Also, from the results of this study, a guide on "How to Run a Successful Webinar Series for Medical Students" was developed. Conclusion Online webinars effectively supplement TO teaching and experience for medical students whose TO placements were disrupted during the COVID-19 pandemic. The results will be a helpful guide to those planning medical education webinars in the future.
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- 2022
24. Crash Course in Orthopaedics: Development and Evaluation of a 12-Week Online Trauma and Orthopaedics Teaching Program for Medical Students During the COVID-19 Pandemic
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James, Catherine, primary, Chui, Karen, additional, Brown, Alex, additional, Poacher, Arwel, additional, Carpenter, Claire, additional, and Jesudason, Edwin, additional
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- 2022
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25. 1027 DEVELOPING A MINIMUM COMMON DATASET FOR HIP FRACTURE AUDIT
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A Poacher, C Ojeda-Thies, A Hall, E Ahern, L Brent, M Costa, and A Johansen
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Aging ,General Medicine ,Geriatrics and Gerontology - Abstract
Introduction National hip fracture audits share a common heritage in the work of Rikshöft and the Standardised Audit of Hip Fracture in Europe. However, as more countries develop audit programmes and these evolve to address local needs, divergence in the data they collect compromises their scope for learning from clinical, audit and quality improvement work in other nations. Method In 2021 we compared all ten established national hip fracture audits: England/Wales/Northern Ireland; Scotland; Australia/New Zealand; Ireland; Germany; the Netherlands; Sweden; Norway; Denmark; Spain. We tabulated all questions included in each, and cross-referenced them against the 32 questions of the minimum common dataset (MCD) defined by the global Fragility Fracture Network (FFN) in 2014. We identified those consistently used in most national audits, and additional fields that might need to form part of a revised MCD. Any MCD must meet the needs of both developed and developing countries. We presented these findings at the Asia-Pacific FFN meeting, and used an online questionnaire to capture feedback from different countries. A draft revision was presented at the Global FFN conference in September 2021, with feedback again used to finalise this revised MCD. Results We tabulated a total of 215 possible questions. Only 72 (34%) were used in >1 national audit, and only 32 (15%) by more than half of audits. Adherence to the 2014 MCD was disappointing; all 32 fields were used by at least one audit, but 5/32 only by one audit. Only 21/32 (65%) were used in the majority, and only three (anaesthetic grade, operation and date/time of surgery) by all ten established audits. Discussion This revised MCD will help aspirant nations establish new audit programmes, facilitate the integration of novel analytic techniques and greater multinational collaboration, and serve as an internationally-accepted standard for monitoring and improving hip fracture services.
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- 2022
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26. Developing a minimum common dataset for hip fracture audit to help countries set up national audits that can support international comparisons
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Antony, Johansen, Cristina, Ojeda-Thies, Arwel T, Poacher, Andrew J, Hall, Louise, Brent, Emer C, Ahern, and Matt L, Costa
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Benchmarking ,Hip Fractures ,Spain ,Germany ,Humans ,Orthopedics and Sports Medicine ,Surgery ,Registries - Abstract
Aims The aim of this study was to explore current use of the Global Fragility Fracture Network (FFN) Minimum Common Dataset (MCD) within established national hip fracture registries, and to propose a revised MCD to enable international benchmarking for hip fracture care. Methods We compared all ten established national hip fracture registries: England, Wales, and Northern Ireland; Scotland; Australia and New Zealand; Republic of Ireland; Germany; the Netherlands; Sweden; Norway; Denmark; and Spain. We tabulated all questions included in each registry, and cross-referenced them against the 32 questions of the MCD dataset. Having identified those questions consistently used in the majority of national audits, and which additional fields were used less commonly, we then used consensus methods to establish a revised MCD. Results A total of 215 unique questions were used across the ten registries. Only 72 (34%) were used in more than one national audit, and only 32 (15%) by more than half of audits. Only one registry used all 32 questions from the 2014 MCD, and five questions were only collected by a single registry. Only 21 of the 32 questions in the MCD were used in the majority of national audits. Only three fields (anaesthetic grade, operation, and date/time of surgery) were used by all ten established audits. We presented these findings at the Asia-Pacific FFN meeting, and used an online questionnaire to capture feedback from expert clinicians from different countries. A draft revision of the MCD was then presented to all 95 nations represented at the Global FFN conference in September 2021, with online feedback again used to finalize the revised MCD. Conclusion The revised MCD will help aspirant nations establish new registry programmes, facilitate the integration of novel analytic techniques and greater multinational collaboration, and serve as an internationally-accepted standard for monitoring and improving hip fracture services. Cite this article: Bone Joint J 2022;104-B(6):721–728.
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- 2022
27. Body mass index and complications following major gastrointestinal surgery
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Sanchez A, Varo Muñoz A, Martinez Rios CE, Aliseda-Jover D, Fernandez Nieto D, Alvarez Reyes I, Dominguez Rodriguez LM, Hernandez Ros MI, Esteban Sinovas O, Bartrina Soler P, Villarejo Campos P, Laguna Román S, Fontanet-Soler S, Raurich-Leandro J, Dominguez-Prieto V, Segura-Sampedro JJ, Alconchel-Gago F, Salazar-García C, Gezen AE, Sahin A, Atasoy H, Yuksek B, Arslan E, Ozmen BB, Sen AY, Erol HI, Ucar E, Aktas MK, Yurdaor SS, Mermer S, Seyhan U, Tosun V, Gunaydin Y, Ekinci ZB, Yazkan Z, Choi J, Yeoh TSL, Jones CS, Venturini S, Saat MI, Loo J, Pike G, Davies SC, Kabariti R, Olivier J, Hurný M, Žebrák R, Machačová A, Schulzová M, Smolák P, Široká M, Palyzová H, Jaroš J, Dušek T, Šimáčková B, Bartoš M, Sotona O, Pös M, Karásek D, Higgins P, Hacking S, Arora E, Coughlan G, Palanivail N, Quill S, Zhang AA, Malak M, Maan DS, Cheema J, Goh AWJ, Shamsul Badrin AK, Guinness F, Howard James N, Neary A, Sebaoui S, Gilroy D, Petrov G, Craven K, MacDonald A, Redmond A, Brennan D, Roche D, O'Dwyer M, Collins P, Edwards S, Doyle J, Tiedt L, Arthurs B, O'Byrne L, Kiely A, Glynn M, Sproule L, Heaney A, Li Hi Shing S, Goh W, Al-Nasser Z, Al-Nasser A, Teh JW, De Boni D, Goldin E, Ciccioli E, Vendramin E, Marchese N, Bruno M, Vinci A, Harder G, Morandi V, Magnoli M, Suppa A, Palmieri A, Martorana M, Sette M, Balagna P, Cruciani C, Corte M, Ciano P, Bagaglini G, Montuori M, Di Benedetto L, Arcudi C, Pezzuto R, Saraceno F, Milana F, Franceschilli M, Rizzi A, Sampietro G, Rampulla V, Bianco F, Boschetti ME, Ghignone F, Bianchini S, Esposto R, Riva L, Riva M, Cannavò M, Arrigo A, Giavarini L, Colombo EM, Trompetto M, Clerico G, Catalano M, Dosa T, El Mabruk M, Barone V, Pallara E, Pasqualoni M, Caudullo G, Mastandrea Bonaviri GN, Muro M, Pistola I, Verardi L, Ferrara D, Gerardi S, Remore LM, Belia F, Del Coco F, Larotonda C, Botrugno EM, Cammarota A, Di Girolami L, Laterza V, Laurino A, Paolo G, Santocchi P, Puccioni C, Truma A, Giardino FR, Giuffrida A, Ripa M, Cautiero R, Patturelli M, 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Ven AWH, de Vos Tot Nederveen Cappel RJ, de Castro SMM, Meijerink WJHJ, Mulder IM, Acherman YIZ, van Leeuwen BL, Schasfoort RA, Kloppenberg FWH, Wiezer R, Consten ECJ, Van Grevenstein WMU, Schiphorst A, Wijffels N, Uittenbogaart M, Klinkert M, Koppe M, de Hingh I, Konsten J, Polat F, Berends F, Langenhoff B, Zimmerman D, van Engelenburg T, Vries JJM, Baeten CIM, Bastiaansen AJNM, van Geloven A, Khan I, Girones J, Barrera Gomez M, Sanz Ortega G, Duran Muñoz-Cruzado VM, Ruiz Montesinos I, Enriquez-Navascues JM, Portugal Porras V, Baixauli J, Garcia Florez LJ, Alonso Gonçalves S, Parajo A, Sanchez-Guillen L, Lujan Mompean JA, Soria Aledo V, Arenal JJ, Blanco Antona F, Badia JM, Roura J, Garcia Garcia J, Elía-Guedea M, Millan M, Viñas-Salas J, Garcia-Olmo D, Prieto-Nieto MI, Medina-Fernández FJ, Romero-Simó M, Frasson M, Espí Macías A, Tirnaksiz MB, Leventoglu S, Kara E, Taşçı Y, Pehlivan M, Guner A, Ozben V, Agalar C, Albayrak D, Ertekin C, Oncel M, Sakman G, Guler SA, Firat O, Akkucuk S, Ozbalci GS, Sozuer EM, Sengul N, Schizas A, Horgan PG, Singh B, Harikrishnan A, Stechman M, Hayat J, Coyne P, Wilson T, Arun C, Manvydas V, Moroni P, Lo Secco G, Argenti F, Romano F, Calcagno P, Steccanella F, Cisternino G, Bottini C, Realis Luc A, Apicella M, Candilio G, Gubbiotti F, De Luca E, Casagranda B, Decorato A, Aquilino F, Badii B, Rahmee CNS, Kleine E, Yauw S, de Zeeuw S, Aarts E, Teixeira da Silva M, Brueren L, Bokkerink G, Schok T, Graafland M, Fliers JM, Gonzalez de Chaves PE, Jimenez-Gomez LM, García Galocha JL, Palos Campos MC, Jimenez Escovar F, Hernandez-Lizoáin JL, Monzonis Hernandez X, Dominguez Sanchez JM, Vives-Rodriguez E, Abrisqueta Carrion J, Beltrán de Heredia J, Padilla Valverde D, Alcazar Montero JA, Córdoba-Díaz de Laspra E, Franco Chacón M, Muriel P, Pastor-Riquelme P, Peinado Iribar B, Alonso Hernandez N, Costa-Navarro D, Martínez Chillarón E, Secilmis E, Bamac E, Koç F, Kayaci Durak M, Bayram S, Ekrem M, Uzun S, Gok AFK, Gorguner F, Yildiz T, Dalci K, 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JA, McLure SW, Pal S, Rangedara A, Baker AN, Asbjoernsen CA, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan YP, Ng JCK, Kumar AN, Park JH, Tan D, Choo KP, Raman KP, Buakuma P, Xiao C, Govinden S, Thompson OD, Charalambos MA, Karsan RB, Dogra T, Bullman LM, Dawson PM, Frank AL, Abid H, Tung L, Qureshi U, Tahmina A, Matthews BW, Harris RT, O'Connor A, Mazan K, Iqbal S, Stanger SA, Thompson JD, Sullivan JAL, Uppal E, MacAskill A, Bamgbose FA, Neophytou C, Carroll AF, Rookes CW, Datta U, Dhutia AJ, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore CD, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar SS, Burney LJ, Patel JB, Al-Obaedi O, Roberts AW, Mahboob S, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley PC, Brewster O, Xu GX, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street AN, Thakker CE, O'Reilly D, Bravo M, Pizzolato A, Khokhar HA, Ryan M, Cheskes L, Carr R, Salih AE, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar MA, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima CP, Peroos S, Kosasih SR, Chin H, Ashken L, Pearse RJ, O'Loughlin RA, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema IA, Kotecha D, Afzal Z, Syeed JA, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull JA, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly ME, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron RM, Trimble A, Cox SE, Ashfaq U, Campbell J, Holliday RBS, McCabe G, Morris F, Priestland R, Vernon OK, Ledsam A, Vaughan R, Lim D, Bakewell ZR, Hughes RK, Koshy RM, Jackson HR, Narayan P, Cardwell AE, Jubainville CL, Arif T, Elliott LE, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman YN, North AS, McClymont LF, Hussain N, Ibrahim I, Ng GS, Wong V, Lim AE, Harris LN, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer HZ, Narwani V, Sandhu KK, Wingfield LR, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Bucko AM, Meek J, Boxall N, Heywood EG, Wiltshire JJ, Toh C, Ward AE, Shurovi BN, Horth D, Patel BY, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan AA, Ng JQ, Hirst F, Brewer CF, Logan AE, Lockey JW, Forrest PR, Keelty N, Wood AD, Springford LR, Avery P, Schulz TM, Bemand TP, Howells L, Collier H, Khajuria A, Tharakan RG, Parsons S, Buchan AM, McGalliard RJ, Mason JD, Cundy OJ, Li N, Redgrave NA, Watson RP, Pezas TP, Dennis YF, Segall E, Hameed M, Lynch AS, Chamberlain M, Peck FS, Neo YN, Russell G, Elseedawy M, Foster NL, Soo YH, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn CE, Walford RA, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid KG, Williams MR, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes MJV, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner RH, Yong N, Atraszkiewicz BA, Mehdi A, Tahir M, Sherliker GXJ, Tear AK, Pandey A, Broyd A, Omer HM, Raphael M, Chaudhry WW, Shahidi S, Jawad AS, Gill CK, Hindle Fisher I, Adeleja I, Clark IJ, Aidoo-Micah GE, Stather PW, Salam GJ, Glover TE, Deas G, Sim NK, Obute RD, Wynell-Mayow WM, Sait MS, Mitha N, de Bernier GL, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley GH, Keane CP, Shatkar V, Maxwell-Armstrong C, Henderson LA, Maple N, Manson R, Adams RD, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell PD, Whatling EA, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson DT, Deekonda P, Abid A, Harrison PLM, Aildasani L, Turley H, Sherif MA, Pandey G, Filby JJ, Johnston A, Burke E, Mohamud M, Gohil K, Tsui AY, Singh R, Lim SJ, O'Sullivan K, McKelvey LL, O'Neill S, Roberts HF, Brown FS, Cao Y, Buckle RT, Liew Y, Sii S, Ventre CM, Graham CJ, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell GS, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance HD, English W, Lakhani SM, Ashraf SF, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig AR, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher SE, Hewitt CM, Stoddart MT, Kerai A, Trist AJ, Cole SJ, Knight CL, Stevens S, Cooper GE, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins TC, Reehal RS, Bookless LR, McLean RC, Stone EJ, Wright EV, Abdikadir HR, Roberts C, Spence O, Srikantharajah M, Ruiz EM, Matthews JH, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani SA, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith DNE, Mistry BD, Hickling SL, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Carter D, Khonsari P, Burgess A, Patel B, Kong C, Ponweera A, Cody A, Tan Y, Ng AYL, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh AD, McKerr CN, Edison MA, Patel BA, Dear K, Hardy MR, Williams P, Hassan S, Sajjad U, O'Neill EM, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo SB, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim JW, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith ACD, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui ZH, Lim S, Piquet A, Anderson SM, McCormack DR, Gulati J, Ibrahim A, Murray SE, Walsh SL, McGrath A, Ziprin P, Chua EY, Lou CN, Bloomer J, Paine HR, Osei-Kuffour D, White CJ, Szczap A, Gokani S, Patel K, Malys MK, Reed A, Torlot GE, Cumber EM, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye MI, Cheung F, Coffey D, Heer RS, Singh S, Seager E, Cumming S, Suresh RS, Verma S, Ptacek IB, Gwozdz AM, Yang T, Khetarpal AA, Shumon S, Fung TMP, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor BP, Shanahan D, Yan A, Jafree DJ, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis PM, Miranda BH, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates JA, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett RD, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee JY, Abdulmajid A, Chung A, Warwick HL, Livesey A, Holton P, Theodoreson MD, Jenkin SL, Turner J, Entwisle JH, Marchal ST, O'Connor S, Blege HK, Aithie JM, Sabine LM, Stewart GE, Jackson S, Kishore A, Lankage CM, Acquaah F, Joyce HL, McKevitt KL, Coffey CJ, Fawaz AS, Dolbec KS, O'Sullivan DA, Geraghty JM, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill PM, Harbhajan Singh GS, Loughran D, Golding DM, Keeling RE, Williams RP, Whitham RDJ, Yoganathan S, Nachiappan R, Egan RJ, Owasil R, Kwan ML, He A, Goh RW, Bhome R, Wilson H, Teoh PJ, Raji K, Jayakody N, Matthams J, Chong J, Luk CY, Greig RJ, Trail M, Charalambous G, Rocke AS, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown EJ, Khanijau R, Gandhi K, Morris S, Boulton AJ, Chandan N, Barthorpe AE, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer CH, Clarke AK, Heskin J, Hurst PC, Farmer JD, O'Flynn LD, Doan L, Shuker BA, Stott GD, Vithanage NA, Hoban KA, Nesargikar PN, Kennedy HR, Grossart CM, Tan ESM, Roy CSD, Sim P, Leslie KE, Sim D, Abul MH, Cody N, Tay AY, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing VC, Mills H, Li MM, Barrow TR, Balaji S, Jordan HEM, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi AMA, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison CJ, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie HD, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Abd Ghaffar MK., Nepogodiev, Dmitri, Rosati, Riccardo, Nepogodiev, D., and Robotics and image-guided minimally-invasive surgery (ROBOTICS)
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Male ,obesity ,Multivariate analysis ,Gastrointestinal Diseases ,IMPACT ,Settore MED/18 - CHIRURGIA GENERALE ,Body mass index ,Body weight ,Digestive tract ,Gastrointestinal tract ,Obesity ,Postoperative complications ,Gastroenterology ,digestive tract ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,0302 clinical medicine ,Risk Factors ,Medicine ,Prospective Studies ,Prospective cohort study ,Aged ,Europe ,Female ,Gastrointestinal Neoplasms ,Humans ,Middle Aged ,Postoperative Complications ,Body Mass Index ,OUTCOMES ,body mass index ,body weight ,gastrointestinal tract ,030220 oncology & carcinogenesis ,Meta-analysis ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,Cohort ,030211 gastroenterology & hepatology ,Cohort study ,medicine.medical_specialty ,Malignancy ,NO ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,business.industry ,postoperative complications ,MORTALITY ,medicine.disease ,Settore MED/18 ,Surgery ,Postoperative complication ,Postoperative Complications, Obesity, Digestive Tract, Gastrointestinal Tract, Body Mass Index, Body Weight ,business - Abstract
Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data.Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results.Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49-2.96, P Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease.
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- 2018
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28. The impact of adopting low-molecular-weight heparin in place of aspirin as routine thromboprophylaxis for patients with hip fracture.
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Poacher, Arwel T., Hoskins, Hannah C., Protty, Majd B., Pettit, Rebecca, and Johansen, Antony
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HIP fractures ,LOW-molecular-weight heparin ,MEDICAL students ,ASPIRIN ,COMPRESSION stockings ,DEMOGRAPHIC characteristics - Published
- 2023
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29. 1027 DEVELOPING A MINIMUM COMMON DATASET FOR HIP FRACTURE AUDIT
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Poacher, A, primary, Ojeda-Thies, C, additional, Hall, A, additional, Ahern, E, additional, Brent, L, additional, Costa, M, additional, and Johansen, A, additional
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- 2022
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30. The impact of adopting low-molecular-weight heparin in place of aspirin as routine thromboprophylaxis for patients with hip fracture
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Arwel T Poacher, Hannah C Hoskins, Majd B Protty, Rebecca Pettit, and Antony Johansen
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General Medicine - Abstract
Purpose of the studyIn 2010, the National Institute for Health and Care Excellence (NICE) recommended the use of anticoagulants rather than aspirin as pharmacological thromboprophylaxis after hip fracture. We examine the impact of implementing this change in guidance on the clinical incidence of deep vein thrombosis (DVT).Study designDemographic, radiographic and clinical data were retrospectively collected for 5039 patients admitted to a single tertiary centre in the UK for hip fracture between 2007 and 2017. We calculated rates of lower-limb DVT and examined the impact of the June 2010 change of departmental policy, from use of aspirin to use of low-molecular-weight heparins (LMWH) in hip fracture patients.ResultsDoppler scans were performed in 400 patients in the 180 days after a hip fracture, and identified 40 ipsilateral and 14 contralateral DVTs (pConclusionsThe rate of clinical DVT halved following the change from aspirin to LMWH for pharmacological thromboprophylaxis, but the number needed to treat was 127. A figure of
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- 2022
31. THE CLINICAL IMPLICATIONS OF GRAF TYPE IIA HIP DYSPLASIA
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A. Poacher, G. Ramage, J. Froud, and C. Carpenter
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IntroductionThere is little evidence surrounding the clinical implications of a diagnosis of IIa hip dysplasia with no consensus as to its efficacy as a predictor pathological dysplasia or treatment. Therefore, we evaluated the importance of categorising 2a hip dysplasia in to 2a- and 2a+ to better understand the clinical outcomes of each.MethodsA 9-year retrospective cohort study of patients with a diagnosis of type IIa hip dysplasia between 2011 – 2020 (n=341) in our centre. Ultrasound scans were graded using Graf's classification, assessment of management and DDH progression was completed through prospective data collection by the authors.ResultsThe prevalence of IIa hip dysplasia within our population was 6.7/1000 live births. There was significantly higher incidence of treatment in the IIa- (31.4%, n=17/54) group when compared to the 2a+ group (10%, n=28/287), (pConclusionThis study has demonstrated the significant clinical impact of a IIa- diagnosis on progression to pathological dysplasia and therefore higher rates of treatment in IIa- hips. Furthermore, we have demonstrated the importance of detection of IIa hips through a national screening program, to allow for timely intervention to prevent missing the acetabular maturation window. Therefore, it is our recommendation that all patients with additional anatomical abnormalities and those with a diagnosis of type IIa- hip dysplasia be considered for immediate treatment or urgent follow up following their diagnosis to prevent late conservative intervention.
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- 2023
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32. A VIRTUAL FRACTURE CLINIC AUDIT: ARE WALES MATCHING THE OUTCOMES IN ENGLAND?
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G. Ramage, A. Poacher, M. Ramsden, J. Lewis, A. Robertson, and C. Wilson
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IntroductionVirtual fracture clinics (VFC's) aim to reduce the number of outpatient appointments while improving the clinical effectiveness and patients experience through standardisation of treatment pathways. With 4.6% of ED admissions due to trauma the VFC prevents unnecessary face to face appointments providing a cost savings benefit to the NHS.MethodsThis project demonstrates the importance of efficient VFC process in reducing the burden on the fracture clinics. We completed preformed a retrospective cross-sectional study, analysing two cycles in May (n=305) and September (n=332) 2021. We reviewed all VFC referrals during this time assessing the quality of the referral, if they went on to require a face to face follow up and who the referring health care professional was. Following the cycle in May we provided ongoing education to A&E staff before re-auditing in September.ResultsBetween the two cycles there was an average 19% improvement in quality of the referrals, significant reduction in number of inappropriate referrals for soft tissue knee and shoulder injuries from 15.1% (n=50) to 4.5% (n=15) following our intervention. There was an 8% increase in number of fracture clinic appointments to 74.4% (n=247), primarily due to an increase number of referrals from nurse practitioners. Radial head fractures were targeted as one group that were able to be successfully managed in VFC, despite this 64% (n=27) of patients were still seen in the outpatient department following VFC referral.ConclusionDespite the decrease in the number of inappropriate referrals, and the increase in quality of referrals following our intervention. The percentage of VFC referrals in CAVUHB is still higher than other centres in with established VFCs in England. This possibly highlights the need for further education to emergency staff around describing what injuries are appropriate for referral, specifically soft tissue injuries and radial head fractures. In order to optimise the VFC process and provide further cost savings benefits while reducing the strain on fracture clinics.
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- 2023
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33. Appendicitis risk prediction models in children presenting with right iliac fossa pain (RIFT study): a prospective, multicentre validation study
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Dmitri Nepogodiev, Richard JW Wilkin, Catherine J Bradshaw, Clare Skerritt, Alasdair Ball, Waaka Moni-Nwinia, Ruth Blanco-Colino, Priyesh Chauhan, Thomas M Drake, Matteo Frasson, Oliver Gee, James C Glasbey, Jacob H Matthews, Gabriella L Morley, David N Naumann, Francesco Pata, Antonio S Soares, Aneel Bhangu, SH Abbas, AM Abdelgadir, A Abdelrahman, M Abdelrahman, A Abdelwahed, Y Abou El Ella, M Abulafi, A Acharya, ME Adam, RE Adams, SO Adegbola, A Adimonye, M Adnan, S Afshar, A Ahad, J Ahel, DP Ahern, A Ahmad Asmadi, B Ahmed, G Ahmed, OS Ahmed, S Ahmed, K Akbari, O Akinsola, W Al-Khyatt, B Al-Sarireh, M Al-Sheikh, M Alani, R Alexander, T Alhammali, M Ali, A Aljorfi, M Allen, J Allington, A Alshafei, R Amarasinghe, A Amayo, V Amin, Thuva Amuthalingam, L Anandan, O Anderson, SM Andreani, B Andrews, A Ang, B Aravind, JE Archer, MA Aremu, S Arunachalam, N Aruparayil, DL Ashmore, O Ashour, N Ashraf, N Assaf, H Avalapati, OO Awokoya, J Ayube-Brown, T Badenoch, R Bagga, A Baginski, S Bailey, STR Bailey, C Baird, B Baker, EJ Balai, A Balasubramaniam, SK Bandyopadhyay, A Banks, H Bansal, W Barnieh, A Barrie, CA Barter, J Bastianpillai, WD Beasley, CR Bell, J Bell, D Beral, BJM Berry, KE Bevan, V Bevan, Shiv Bhanderi, A Bhargava, D Bilku, A Birindelli, OD Blackford, JEM Blackwell, L Blake, Natalie S Blencowe, TD Boam, C Boereboom, M Bogdan, P Bohra, JC Bolger, W Bolton, S Bond, CM Borg, K Borghol, PR Boshier, N Bouhadiba, J Bowen, H Bowerman, CR Bowman, H Boyd-Carson, CJ Bradshaw, G Branagan, P Brennan, M Brett, HK Brewer, H Brewer, C Bronder, A Brown, AG Brown, CE Brown, M Brown, R Brown, S Buckley-Jones, A Budzanowski, W Bukhari, C Bull, JK Bullivant, KM Burns, D Burnside, A Busuttil, BE Byrne, CK Byrnes, M Caldwell, R Callan, FC Cameron, U Campbell, UM Campbell, W Campbell, CA Carden, CFW Carder, K Carney, H Cartwright, P Cay, A Chalk, B Chambers, A Champsi, D Chan, TCW Chan, SB Chandler, J Chapman, A Charalabopoulos, B Chasty, M Chatzikonstantinou, WL Cheah, CS Chean, S Cheng, SA Cheng, M Cheruvu, MY Chin, IA Chishti, S Choi, SM Chok, B Chong, JH Choong, M Chowdhary, F Chowdhury, CH Choy, L Christian, P Christopoulos, K Chui, M Cipparrone, GL Clark, SA Clarke, SJ Cleeve, KD Clement, B Clements, C Clements, JD Clements, JM Clements, JS Clements, JA Clements, R Clingan, L Cloney, ECS Clough, PO Coe, O Collier-Wakefield, DW Colliver, DA Colvin, TM Connelly, MJ Connor, V Cook, F Cooke, F Cooper, AE Cotton, DG Couch, L Cousins, D Coyle, W Creasy, RL Cresner, A Crone, K Cross, J Crozier, P Cunha, NJ Curtis, N D'Souza, H Dagash, S Dalmia, I Daniels, D Danquah-Boateng, FA Dar, K Dart, A Das, R Daureeawoo, S Davidson, JR Davidson, PL Davies, S Davis, V Daya Shetty, A De-Manzoni-Garberini, JA De-Marchi, EA Dean, S Dean, C Delimpalta, S Denley, G Dennison, AA Devine, S Dharamavaram, AA Dhari, F Di Franco, S Di Saverio, C Dobson, JA Docherty, C Doherty, G Donaldson, NO Donohoe, O Donohoe, E Douka, T Doulias, M Downey, C Doyle, N Drye, DT Du, JG Dudek, PG Dunning, ARS Dyal, NJ Eardley, L Earnshaw, S Easdon, SE Edwards, RJ Egan, S El-Masry, O El-Tayar, CR Elbourne, S Elgaddal, M Elseedawy, M Elshaer, OH Elsharnoby, WMA Elzeneini, KM Emslie, NFT Engall, B Ertansel, HD Esmail, C Ettles, J Evans, JD Evans, A Everden, M Fadel, SE Fahmy, CJ Fairfield, BF Fanibi, Valeria Farina, SM Farrell, EZ Farrow, JA Fasuyi, G Faulkner, D Fawkner-Corbett, F Fawzi, M Fehervari, N Ferguson, JG Finch, H Finlayson, T Flack, W Foers, NM Foley, K Ford, A Forgie, A Foster, JD Foster, AMW Fox, N Francis, D Franklin, H Froud, HL Fuller, E Gaines, J Galea, E Gammeri, J Garnham, J Garvin, Z Gates, R Gentry, I Ghaffari, S Ghatorae, AL Gidwani, TG Gilbert, TM Gilbert, S Gill, M Gillespie, J Gillick, A Giorga, K Gopalakrishnan, S Gopalswamy, S Gopinath, R Gormely, G Govind, C Grant, J Graveston, J Gray, RT Gray, D Griffith, JP Griffith, Ewen A Griffiths, SN Griffiths, EJ Griggs, S Grosvenor, T Grove, M Gulamhussein, J Guliani, A Gummaraju, S Gunning, SV Gurjar, S Guru-Naidu, S Gurung, H Habib, L Hackney, James B Haddow, S Hajibandeh, C Halkias, NJ Hall, RN Hamelmann, M Haneef, MS Haneef, Z Hanif, C Hanley, AJ Hann, T Hanna, E Hardy, A Harlinska, F Harper, RL Harries, A Harris, Grant Harris, MP Harris, R Hasan, A Hassane, JR Hatt, Z Haveliwala, W Hawkins, Z Hayat, C Hayes, KRM Hebbar, L Henderson, LT Henderson, PJJ Herrod, P Hever, LM Hickey, G Hicks, JM Hodgson, M Hoff, A Hollingsworth, A Hook, ST Hornby, E Horsfield, EE Howie, L Huang, NJ Hudson-Peacock, DL Hughes, KA Hureibi, A Hussain, N Hussain, SA Hussaini, A Hussein, B Hutchinson, YMS Ibrahim, S Ikram, T Ilozue, E Iosif, MR Iqbal, S Irukulla, R Irwin, N Islam, P Ivey, CR Jackson, A Jackson, SMH Jah, A Jain, S Jain, Sarus Jain, GM Jama, NB Jamieson, S Janardanan, B Jasinski, D Jenner, E Jerome, B Johnson, A Johnstone, S Jokhan, A Jones, CE Jones, CS Jones, E Jones, L Jones, U Kabir, S Kabwama, M Kamal, IW Kamande, V Kanakala, M Kannegieser-Bailey, S Kaptanis, MJ Karim, RS Karwal, G Kaur, R Keegan, A Kelay, ND Kennedy, DA Kent, A Khair, K Khan, S Khan, A Khasria, H Kho, J Kilkenny, R King, J Kinross, EN Kirkham, B Knight, R Kochupapy, C Koh, O Kouli, A Krishnamoorthy, S Krivan, K Kumar, S Kumar, VWS Kung, R Kuo, G Lafaurie, CW Lai, N Lal, S Lawday, S Layman, GR Layton, A Lazzaro, L Lecky-Thompson, KA Lee, KJ Lee, M Lee, SL Lee, PA Leighton, RP Leitch, HC Lennox-Warburton, EL Leung, CH Li, JM Lim, C Limb, G Ljungqvist, G Lloyd, S Lodhia, PC Logan, M Long, P Long, RH Long, A Longshaw, C Louw, JN Lund, C Ly, MJ Lynch Wong, JKY Ma, A Macdonald, EGE Macinnes, T Magro, R Mahapatra, B Mahendran, F Mahmood, A Mahmoud, D Mahon, D Mai, A Maina, CP Major, R Makhija, Y Malam, A Malik, K Malik, SN Malik, VM Manda, KM Manektella, C Mann, P Manoharan, R Manson, S Mansoor, MM Mansour, S Mansour, F Maqboul, D Maragouthakis, G Marangoni, S Mardhiah, H Maripi, P Marriott, L Marsh, G Marshall, A Martin, LM Martin, E Martinou, R Mashar, John Mason, M Masood, G Mathew, K Maude, E Mazumdar, A Mc-Dermott, D Mcarthur, RS Mccain, S McCain, C Mccann, P Mccaughey, SJ Mccluney, J Mccullough, D Mcdonnell, NA Mcdowall, JE McEntee, K McGlynn, D Mcgrath, O Mcgucken, S Mcilwaine, AC Mcilwrath, SC Mckay, MA McKelvie, M Mckenna, J Mckeon, KL Mckevitt, NC Mckinley, D McLaughlin, SV McMahon, D Mcmorran, L McNally, M Mcquaid, DM Mcwhirter, K Mealy, A Mears, D Menzies, H Merai, RJ Mersh, M Miguras, D Milgrom, K Miller, J Milward, S Mirza, AT Misky, D Mistry, MJ Mitchard, RM Mitru, IM Mohamed, Imran Mohamed, TM Mohamed, WO Mohamed, N Mohd, C Moore, J Moradzadeh, TEM Morrison, V Morrison-Jones, Dion G Morton, BS Mothe, Fh Motiwala, D Motter, NG Mowbray, Z Mughal, J Mulsow, N Mundkur, A Muntean, C Murphy, R Murphy, MP Murray, M Muzaffar, A Myatt, A Nadeem, D Nagarajan, S Nagendram, A Nair, MK Nair, MS Nair, KN Naismith, K Nambiar, GR Nana, Z Nash, P Nastro, S Nazarian, G Neagle, A Neale, PM Neary, RC Newton, M Ng, S Ng, O Niaz, S Nickson, D Nicol, E Nimako, MS Noor Mohamed, M Nyeko-Lacek, BR O'Connor, E O'Neill, N O'Neill, D O'Sullivan, J O'Brien, M Oakey, N Obeid, A Odeh, S Ogboru, C Ogbuokiri, B Okekunle, E Okorocha, O Olagbaiye, JB Olivier, R Ooi, P Orawiec, M Orizu, N Orme, R Ormiston, C Paget, A Pal, LK Palani-Velu, Y Pan, N Panda, V Pandey, R Pandya, D Pandya, KR Paramasevon, C Pardy, MJ Parkola, Sandro Pasquali, AS Patel, BY Patel, C Patel, H Patel, N Patel, RT Patel, S Patel, Y Patel, MM Patel, SD Patil, CJ Payne, RE Payne, JCH Pearce, L Pearce, A Pedder, CB Peirce, GB Peiris, A Peleki, Gianluca Pellino, V Pento, D Peprah, HS Perera, MI Perera, L Phelan, D Photiou, R Pierre, JP Pilkington, Thomas D Pinkney, B Pisavadia, A Poacher, M Podda, H Pollard, D Popova, M Poudevigne, A Prideaux, UP Pullabatla Venkata, A Quddus, S Quill, M Rabie, MR Rabie, RW Radwan, JF Rae, A Rahim, LS Rahmani, S Rajagopal, R Rajaram, N Rajaretnam, Y Rajjoub, H Rallage, S Ramcharan, S Ranathunga, M Rao, VSR Rao, A Raofi, M Rashid, A Rate, R Ravindran, M Raymond, SS Raza, A Reddy, EP Redman, AE Redmond, S Rekhraj, S Renshaw, D Rex, M Rezacova, S Rezvani, B Ribeiro, JE Rich, TD Richardson, S Rigby, B Rigney, S Rinkoff, HD Robb, C Robertson, D Robinson, A Robinson, V Rodger, R Rolph, S Roomi, NPG Roth, K Rothnie, C Roy, S Rupani, DG Rutherford, R Sacks, N Saghir, A Saha, SJ Sahay, K Sahnan, Y Salama, S Salim, M Samuel, S Sana, L Sandu, P Sarmah, J Sarveswaran, SMF Saunders, A Savill, F Savioli, JR Schuster Bruce, JF Sebastian, TC Seddon, N Seneviratne, M Seth, T Setshwaelo, E Sezen, P Sgardelis, A Sgrò, C Shah, J Shah, K Shah, SM Shah, Z Shakoor, MS Shalaby, V Shanmuganathan, K Shanmugarajah, A Sharma, P Sharma, OL Sharp, JA Shepherd, MA Sherif, S Shet, G Shingler, MH Shiwani, D Shreshta, T Sian, MN Siddiqui, ZA Siddiqui, KL Siggens, N Sihra, I Silva, A Simioni, LFC Simmonds, DJ Simpson, A Singh, S Singh, T Singhal, P Sivaloganathan, K Sloan, N Smallcombe, CJ Smart, Neil J Smart, R Smith, H Smoker, L Solinas, JEH Souter, EL Springate, GF Stephens, R Stevenson, DJ Stewart, I Stoica, E Strachan, BM Stubbs, W Stupalkowska, A Suliman, A Sultana, H Sunter, S Suriyakumar, NRA Symons, K Szentpali, A Szucs, V Tabain, LE Tague, K Tailor, CY Tan, S Tan, AM Tang, M Tarazi, YH Tay, S Tayeh, M Taylor, NS Taylor, D Taze, E Teasdale, N Thakral, B Thava, N Thavanesan, AJ Thaventhiran, K Theodoropoulou, AT Thomas, L Thomas, DB Thompson, R Thompson, SN Thoukididou, SG Tiboni, LA Tiedt, N Ting, BJ Tinsley, JM Tognarelli, J Torkington, A Torrance, DC Townsend, PJ Tozer, M Trail, F Trew, V Tudyka, L Tullie, A Turnbull, EJ Turner, CS Twum-Barima, Robert Tyler, S Vakis, A La Valle, GI Van Boxel, J Vance-Daniel, M Varcada, N Varma, EM Vaughan, VR Velchuru, R Velho, AK Venkatasubramaniam, ML Venn, V Vijay, Z Vinnicombe, P Vitish-Sharma, S Wagener, K Waite, KJ Walters, U Walters, BG Wardle, SD Wardle, J Warusavitarne, J Watfah, N Watson, J Wauchope, LW Weatherburn, CR Weegenaar, S Welsh, S Wheatstone, HE Whewell, P Whitehouse, E Whiteman, L Whittaker, K Wijesundera, D Wilkinson, GL Williams, M Williams, R Williams, S Williams, EJ Wilson, MSJ Wilson, DC Winter, G Winter, J Wolff, A Wong, CLL Wong, SY Wong, CS Wood, C Woodrow, A Woodward, B Woodward, E Wright, HL Wright, F Wu, S Yalamarthi, P Yang, E Yardimci, T Yasin, SK Yen, S Yoganathan, S Yoong, H Youssef, LPS Yow, A Zaborowski, AZ Zadi, ZA Zarka, MA Zarog, AY Zhang, Nepogodiev, D., Wilkin, R. J., Bradshaw, C. J., Skerritt, C., Ball, A., Moni-Nwinia, W., Blanco-Colino, R., Chauhan, P., Drake, T. M., Frasson, M., Gee, O., Glasbey, J. C., Matthews, J. H., Morley, G. L., Naumann, D. N., Pata, F., Soares, A. S., Bhangu, A., Abbas, S. H., Abdelgadir, A. M., Abdelrahman, A., Abdelrahman, M., Abdelwahed, A., Abou El Ella, Y., Abulafi, M., Acharya, A., Adam, M. E., Adams, R. E., Adegbola, S. O., Adimonye, A., Adnan, M., Afshar, S., Ahad, A., Ahel, J., Ahern, D. P., Ahmad Asmadi, A., Ahmed, B., Ahmed, G., Ahmed, O. S., Ahmed, S., Akbari, K., Akinsola, O., Al-Khyatt, W., Al-Sarireh, B., Al-Sheikh, M., Alani, M., Alexander, R., Alhammali, T., Ali, M., Aljorfi, A., Allen, M., Allington, J., Alshafei, A., Amarasinghe, R., Amayo, A., Amin, V., Amuthalingam, T., Anandan, L., Anderson, O., Andreani, S. M., Andrews, B., Ang, A., Aravind, B., Archer, J. E., Aremu, M. A., Arunachalam, S., Aruparayil, N., Ashmore, D. L., Ashour, O., Ashraf, N., Assaf, N., Avalapati, H., Awokoya, O. O., Ayube-Brown, J., Badenoch, T., Bagga, R., Baginski, A., Bailey, S., Bailey, S. T. R., Baird, C., Baker, B., Balai, E. J., Balasubramaniam, A., Bandyopadhyay, S. K., Banks, A., Bansal, H., Barnieh, W., Barrie, A., Barter, C. A., Bastianpillai, J., Beasley, W. D., Bell, C. R., Bell, J., Beral, D., Berry, B. J. M., Bevan, K. E., Bevan, V., Bhanderi, S., Bhargava, A., Bilku, D., Birindelli, A., Blackford, O. D., Blackwell, J. E. M., Blake, L., Blencowe, N. S., Boam, T. D., Boereboom, C., Bogdan, M., Bohra, P., Bolger, J. C., Bolton, W., Bond, S., Borg, C. M., Borghol, K., Boshier, P. R., Bouhadiba, N., Bowen, J., Bowerman, H., Bowman, C. R., Boyd-Carson, H., Branagan, G., Brennan, P., Brett, M., Brewer, H. K., Brewer, H., Bronder, C., Brown, A., Brown, A. G., Brown, C. E., Brown, M., Brown, R., Buckley-Jones, S., Budzanowski, A., Bukhari, W., Bull, C., Bullivant, J. K., Burns, K. M., Burnside, D., Busuttil, A., Byrne, B. E., Byrnes, C. K., Caldwell, M., Callan, R., Cameron, F. C., Campbell, U., Campbell, U. M., Campbell, W., Carden, C. A., Carder, C. F. W., Carney, K., Cartwright, H., Cay, P., Chalk, A., Chambers, B., Champsi, A., Chan, D., Chan, T. C. W., Chandler, S. B., Chapman, J., Charalabopoulos, A., Chasty, B., Chatzikonstantinou, M., Cheah, W. L., Chean, C. S., Cheng, S., Cheng, S. A., Cheruvu, M., Chin, M. Y., Chishti, I. A., Choi, S., Chok, S. M., Chong, B., Choong, J. H., Chowdhary, M., Chowdhury, F., Choy, C. H., Christian, L., Christopoulos, P., Chui, K., Cipparrone, M., Clark, G. L., Clarke, S. A., Cleeve, S. J., Clement, K. D., Clements, B., Clements, C., Clements, J. D., Clements, J. M., Clements, J. S., Clements, J. A., Clingan, R., Cloney, L., Clough, E. C. S., Coe, P. O., Collier-Wakefield, O., Colliver, D. W., Colvin, D. A., Connelly, T. M., Connor, M. J., Cook, V., Cooke, F., Cooper, F., Cotton, A. E., Couch, D. G., Cousins, L., Coyle, D., Creasy, W., Cresner, R. L., Crone, A., Cross, K., Crozier, J., Cunha, P., Curtis, N. J., D'Souza, N., Dagash, H., Dalmia, S., Daniels, I., Danquah-Boateng, D., Dar, F. A., Dart, K., Das, A., Daureeawoo, R., Davidson, S., Davidson, J. R., Davies, P. L., Davis, S., Daya Shetty, V., De-Manzoni-Garberini, A., De-Marchi, J. A., Dean, E. A., Dean, S., Delimpalta, C., Denley, S., Dennison, G., Devine, A. A., Dharamavaram, S., Dhari, A. A., Di Franco, F., Di Saverio, S., Dobson, C., Docherty, J. A., Doherty, C., Donaldson, G., Donohoe, N. O., Donohoe, O., Douka, E., Doulias, T., Downey, M., Doyle, C., Drye, N., Du, D. T., Dudek, J. G., Dunning, P. G., Dyal, A. R. S., Eardley, N. J., Earnshaw, L., Easdon, S., Edwards, S. E., Egan, R. J., El-Masry, S., El-Tayar, O., Elbourne, C. R., Elgaddal, S., Elseedawy, M., Elshaer, M., Elsharnoby, O. H., Elzeneini, W. M. A., Emslie, K. M., Engall, N. F. T., Ertansel, B., Esmail, H. D., Ettles, C., Evans, J., Evans, J. D., Everden, A., Fadel, M., Fahmy, S. E., Fairfield, C. J., Fanibi, B. F., Farina, V., Farrell, S. M., Farrow, E. Z., Fasuyi, J. A., Faulkner, G., Fawkner-Corbett, D., Fawzi, F., Fehervari, M., Ferguson, N., Finch, J. G., Finlayson, H., Flack, T., Foers, W., Foley, N. M., Ford, K., Forgie, A., Foster, A., Foster, J. D., Fox, A. M. W., Francis, N., Franklin, D., Froud, H., Fuller, H. L., Gaines, E., Galea, J., Gammeri, E., Garnham, J., Garvin, J., Gates, Z., Gentry, R., Ghaffari, I., Ghatorae, S., Gidwani, A. L., Gilbert, T. G., Gilbert, T. M., Gill, S., Gillespie, M., Gillick, J., Giorga, A., Gopalakrishnan, K., Gopalswamy, S., Gopinath, S., Gormely, R., Govind, G., Grant, C., Graveston, J., Gray, J., Gray, R. T., Griffith, D., Griffith, J. P., Griffiths, E. A., Griffiths, S. N., Griggs, E. J., Grosvenor, S., Grove, T., Gulamhussein, M., Guliani, J., Gummaraju, A., Gunning, S., Gurjar, S. V., Guru-Naidu, S., Gurung, S., Habib, H., Hackney, L., Haddow, J. B., Hajibandeh, S., Halkias, C., Hall, N. J., Hamelmann, R. N., Haneef, M., Haneef, M. S., Hanif, Z., Hanley, C., Hann, A. J., Hanna, T., Hardy, E., Harlinska, A., Harper, F., Harries, R. L., Harris, A., Harris, G., Harris, M. P., Hasan, R., Hassane, A., Hatt, J. R., Haveliwala, Z., Hawkins, W., Hayat, Z., Hayes, C., Hebbar, K. R. M., Henderson, L., Henderson, L. T., Herrod, P. J. J., Hever, P., Hickey, L. M., Hicks, G., Hodgson, J. M., Hoff, M., Hollingsworth, A., Hook, A., Hornby, S. T., Horsfield, E., Howie, E. E., Huang, L., Hudson-Peacock, N. J., Hughes, D. L., Hureibi, K. A., Hussain, A., Hussain, N., Hussaini, S. A., Hussein, A., Hutchinson, B., Ibrahim, Y. M. S., Ikram, S., Ilozue, T., Iosif, E., Iqbal, M. R., Irukulla, S., Irwin, R., Islam, N., Ivey, P., Jackson, C. R., Jackson, A., Jah, S. M. H., Jain, A., Jain, S., Jama, G. M., Jamieson, N. B., Janardanan, S., Jasinski, B., Jenner, D., Jerome, E., Johnson, B., Johnstone, A., Jokhan, S., Jones, A., Jones, C. E., Jones, C. S., Jones, E., Jones, L., Kabir, U., Kabwama, S., Kamal, M., Kamande, I. W., Kanakala, V., Kannegieser-Bailey, M., Kaptanis, S., Karim, M. J., Karwal, R. S., Kaur, G., Keegan, R., Kelay, A., Kennedy, N. D., Kent, D. A., Khair, A., Khan, K., Khan, S., Khasria, A., Kho, H., Kilkenny, J., King, R., Kinross, J., Kirkham, E. N., Knight, B., Kochupapy, R., Koh, C., Kouli, O., Krishnamoorthy, A., Krivan, S., Kumar, K., Kumar, S., Kung, V. W. S., Kuo, R., Lafaurie, G., Lai, C. W., Lal, N., Lawday, S., Layman, S., Layton, G. R., Lazzaro, A., Lecky-Thompson, L., Lee, K. A., Lee, K. J., Lee, M., Lee, S. L., Leighton, P. A., Leitch, R. P., Lennox-Warburton, H. C., Leung, E. L., Li, C. H., Lim, J. M., Limb, C., Ljungqvist, G., Lloyd, G., Lodhia, S., Logan, P. C., Long, M., Long, P., Long, R. H., Longshaw, A., Louw, C., Lund, J. N., Ly, C., Lynch Wong, M. J., Ma, J. K. Y., Macdonald, A., Macinnes, E. G. E., Magro, T., Mahapatra, R., Mahendran, B., Mahmood, F., Mahmoud, A., Mahon, D., Mai, D., Maina, A., Major, C. P., Makhija, R., Malam, Y., Malik, A., Malik, K., Malik, S. N., Manda, V. M., Manektella, K. M., Mann, C., Manoharan, P., Manson, R., Mansoor, S., Mansour, M. M., Mansour, S., Maqboul, F., Maragouthakis, D., Marangoni, G., Mardhiah, S., Maripi, H., Marriott, P., Marsh, L., Marshall, G., Martin, A., Martin, L. M., Martinou, E., Mashar, R., Mason, J., Masood, M., Mathew, G., Maude, K., Mazumdar, E., Mc-Dermott, A., Mcarthur, D., Mccain, R. S., Mccain, S., Mccann, C., Mccaughey, P., Mccluney, S. J., Mccullough, J., Mcdonnell, D., Mcdowall, N. A., Mcentee, J. E., Mcglynn, K., Mcgrath, D., Mcgucken, O., Mcilwaine, S., Mcilwrath, A. C., Mckay, S. C., Mckelvie, M. A., Mckenna, M., Mckeon, J., Mckevitt, K. L., Mckinley, N. C., Mclaughlin, D., Mcmahon, S. V., Mcmorran, D., Mcnally, L., Mcquaid, M., Mcwhirter, D. M., Mealy, K., Mears, A., Menzies, D., Merai, H., Mersh, R. J., Miguras, M., Milgrom, D., Miller, K., Milward, J., Mirza, S., Misky, A. T., Mistry, D., Mitchard, M. J., Mitru, R. M., Mohamed, I. M., Mohamed, I., Mohamed, T. M., Mohamed, W. O., Mohd, N., Moore, C., Moradzadeh, J., Morrison, T. E. M., Morrison-Jones, V., Morton, D. G., Mothe, B. S., Motiwala, F., Motter, D., Mowbray, N. G., Mughal, Z., Mulsow, J., Mundkur, N., Muntean, A., Murphy, C., Murphy, R., Murray, M. P., Muzaffar, M., Myatt, A., Nadeem, A., Nagarajan, D., Nagendram, S., Nair, A., Nair, M. K., Nair, M. S., Naismith, K. N., Nambiar, K., Nana, G. R., Nash, Z., Nastro, P., Nazarian, S., Neagle, G., Neale, A., Neary, P. M., Newton, R. C., Ng, M., Ng, S., Niaz, O., Nickson, S., Nicol, D., Nimako, E., Noor Mohamed, M. S., Nyeko-Lacek, M., O'Connor, B. R., O'Neill, E., O'Neill, N., O'Sullivan, D., O'Brien, J., Oakey, M., Obeid, N., Odeh, A., Ogboru, S., Ogbuokiri, C., Okekunle, B., Okorocha, E., Olagbaiye, O., Olivier, J. B., Ooi, R., Orawiec, P., Orizu, M., Orme, N., Ormiston, R., Paget, C., Pal, A., Palani-Velu, L. K., Pan, Y., Panda, N., Pandey, V., Pandya, R., Pandya, D., Paramasevon, K. R., Pardy, C., Parkola, M. J., Pasquali, S., Patel, A. S., Patel, B. Y., Patel, C., Patel, H., Patel, N., Patel, R. T., Patel, S., Patel, Y., Patel, M. M., Patil, S. D., Payne, C. J., Payne, R. E., Pearce, J. C. H., Pearce, L., Pedder, A., Peirce, C. B., Peiris, G. B., Peleki, A., Pellino, G., Pento, V., Peprah, D., Perera, H. S., Perera, M. I., Phelan, L., Photiou, D., Pierre, R., Pilkington, J. P., Pinkney, T. D., Pisavadia, B., Poacher, A., Podda, M., Pollard, H., Popova, D., Poudevigne, M., Prideaux, A., Pullabatla Venkata, U. P., Quddus, A., Quill, S., Rabie, M., Rabie, M. R., Radwan, R. W., Rae, J. F., Rahim, A., Rahmani, L. S., Rajagopal, S., Rajaram, R., Rajaretnam, N., Rajjoub, Y., Rallage, H., Ramcharan, S., Ranathunga, S., Rao, M., Rao, V. S. R., Raofi, A., Rashid, M., Rate, A., Ravindran, R., Raymond, M., Raza, S. S., Reddy, A., Redman, E. P., Redmond, A. E., Rekhraj, S., Renshaw, S., Rex, D., Rezacova, M., Rezvani, S., Ribeiro, B., Rich, J. E., Richardson, T. D., Rigby, S., Rigney, B., Rinkoff, S., Robb, H. D., Robertson, C., Robinson, D., Robinson, A., Rodger, V., Rolph, R., Roomi, S., Roth, N. P. G., Rothnie, K., Roy, C., Rupani, S., Rutherford, D. G., Sacks, R., Saghir, N., Saha, A., Sahay, S. J., Sahnan, K., Salama, Y., Salim, S., Samuel, M., Sana, S., Sandu, L., Sarmah, P., Sarveswaran, J., Saunders, S. M. F., Savill, A., Savioli, F., Schuster Bruce, J. R., Sebastian, J. F., Seddon, T. C., Seneviratne, N., Seth, M., Setshwaelo, T., Sezen, E., Sgardelis, P., Sgro, A., Shah, C., Shah, J., Shah, K., Shah, S. M., Shakoor, Z., Shalaby, M. S., Shanmuganathan, V., Shanmugarajah, K., Sharma, A., Sharma, P., Sharp, O. L., Shepherd, J. A., Sherif, M. A., Shet, S., Shingler, G., Shiwani, M. H., Shreshta, D., Sian, T., Siddiqui, M. N., Siddiqui, Z. A., Siggens, K. L., Sihra, N., Silva, I., Simioni, A., Simmonds, L. F. C., Simpson, D. J., Singh, A., Singh, S., Singhal, T., Sivaloganathan, P., Sloan, K., Smallcombe, N., Smart, C. J., Smart, N. J., Smith, R., Smoker, H., Solinas, L., Souter, J. E. H., Springate, E. L., Stephens, G. F., Stevenson, R., Stewart, D. J., Stoica, I., Strachan, E., Stubbs, B. M., Stupalkowska, W., Suliman, A., Sultana, A., Sunter, H., Suriyakumar, S., Symons, N. R. A., Szentpali, K., Szucs, A., Tabain, V., Tague, L. E., Tailor, K., Tan, C. Y., Tan, S., Tang, A. M., Tarazi, M., Tay, Y. H., Tayeh, S., Taylor, M., Taylor, N. S., Taze, D., Teasdale, E., Thakral, N., Thava, B., Thavanesan, N., Thaventhiran, A. J., Theodoropoulou, K., Thomas, A. T., Thomas, L., Thompson, D. B., Thompson, R., Thoukididou, S. N., Tiboni, S. G., Tiedt, L. A., Ting, N., Tinsley, B. J., Tognarelli, J. M., Torkington, J., Torrance, A., Townsend, D. C., Tozer, P. J., Trail, M., Trew, F., Tudyka, V., Tullie, L., Turnbull, A., Turner, E. J., Twum-Barima, C. S., Tyler, R., Vakis, S., Valle, A. L., Van Boxel, G. I., Vance-Daniel, J., Varcada, M., Varma, N., Vaughan, E. M., Velchuru, V. R., Velho, R., Venkatasubramaniam, A. K., Venn, M. L., Vijay, V., Vinnicombe, Z., Vitish-Sharma, P., Wagener, S., Waite, K., Walters, K. J., Walters, U., Wardle, B. G., Wardle, S. D., Warusavitarne, J., Watfah, J., Watson, N., Wauchope, J., Weatherburn, L. W., Weegenaar, C. R., Welsh, S., Wheatstone, S., Whewell, H. E., Whitehouse, P., Whiteman, E., Whittaker, L., Wijesundera, K., Wilkinson, D., Williams, G. L., Williams, M., Williams, R., Williams, S., Wilson, E. J., Wilson, M. S. J., Winter, D. C., Winter, G., Wolff, J., Wong, A., Wong, C. L. L., Wong, S. Y., Wood, C. S., Woodrow, C., Woodward, A., Woodward, B., Wright, E., Wright, H. L., Wu, F., Yalamarthi, S., Yang, P., Yardimci, E., Yasin, T., Yen, S. K., Yoganathan, S., Yoong, S., Youssef, H., Yow, L. P. S., Zaborowski, A., Zadi, A. Z., Zarka, Z. A., Zarog, M. A., and Zhang, A. Y.
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Male ,Pediatrics ,medicine.medical_specialty ,Validation study ,Adolescent ,Ultrasound scan ,Pain ,Risk prediction models ,Risk Assessment ,Sensitivity and Specificity ,Cohort Studies ,Ilium ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,030225 pediatrics ,Developmental and Educational Psychology ,medicine ,Appendectomy ,Humans ,Prospective Studies ,030212 general & internal medicine ,Surgical emergency ,Child ,Ultrasonography ,business.industry ,Area under the curve ,Appendicitis ,medicine.disease ,United Kingdom ,Child, Preschool ,Acute Disease ,Pediatrics, Perinatology and Child Health ,Female ,Right iliac fossa pain ,business ,Ireland ,Cohort study - Abstract
BACKGROUND: Acute appendicitis is the most common surgical emergency in children. Differentiation of acute appendicitis from conditions that do not require operative management can be challenging in children. This study aimed to identify the optimum risk prediction model to stratify acute appendicitis risk in children. METHODS: We did a rapid review to identify acute appendicitis risk prediction models. A prospective, multicentre cohort study was then done to evaluate performance of these models. Children (aged 5-15 years) presenting with acute right iliac fossa pain in the UK and Ireland were included. For each model, score cutoff thresholds were systematically varied to identify the best achievable specificity while maintaining a failure rate (ie, proportion of patients identified as low risk who had acute appendicitis) less than 5%. The normal appendicectomy rate was the proportion of resected appendixes found to be normal on histopathological examination. FINDINGS:15 risk prediction models were identified that could be assessed. The cohort study enrolled 1827 children from 139 centres, of whom 630 (34·5%) underwent appendicectomy. The normal appendicectomy rate was 15·9% (100 of 630 patients). The Shera score was the best performing model, with an area under the curve of 0·84 (95% CI 0·82-0·86). Applying score cutoffs of 3 points or lower for children aged 5-10 years and girls aged 11-15 years, and 2 points or lower for boys aged 11-15 years, the failure rate was 3·3% (95% CI 2·0-5·2; 18 of 539 patients), specificity was 44·3% (95% CI 41·4-47·2; 521 of 1176), and positive predictive value was 41·4% (38·5-44·4; 463 of 1118). Positive predictive value for the Shera score with a cutoff of 6 points or lower (72·6%, 67·4-77·4) was similar to that of ultrasound scan (75·0%, 65·3-83·1). INTERPRETATION: The Shera score has the potential to identify a large group of children at low risk of acute appendicitis who could be considered for early discharge. Risk scoring does not identify children who should proceed directly to surgery. Medium-risk and high-risk children should undergo routine preoperative ultrasound imaging by operators trained to assess for acute appendicitis, and MRI or low-dose CT if uncertainty remains. FUNDING: None.
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- 2021
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34. The impact of adopting low-molecular-weight heparin in place of aspirin as routine thromboprophylaxis for patients with hip fracture
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Poacher, Arwel T, primary, Hoskins, Hannah C, additional, Protty, Majd B, additional, Pettit, Rebecca, additional, and Johansen, Antony, additional
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- 2022
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35. Evaluation of appendicitis risk prediction models in adults with suspected appendicitis
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Nepogodiev, D., Matthews, J. H., Morley, G. L., Naumann, D. N., Ball, A., Chauhan, P., Bhanderi, S., Mohamed, I., Glasbey, J. C., Wilkin, R. J. W., Drake, T. M., Clements, J., Blencowe, N. S., Herrod, P. J. J., Pata, F., Frasson, M., Blanco-Colino, R., Soares, A. S., Nepogodiev D, Bhangu A., Matthews, Jh, Morley, Gl, Naumann, Dn, Ball, A, Chauhan, P, Bhanderi, S, Mohamed, I, Glasbey, Jc, Wilkin, R, Drake, Tm, Clements, J, Blencowe, Ns, Herrod, P, Pata, F, Frasson, M, Blanco-Colino, R, Soares, As, Bhangu, A, Nepogodiev, D, Jain, S, Amuthalingam, T, Tyler, R, Griffiths, Ea, Pinkney, Td, Gee, O, Morton, Dg, Beggs, A, Beral, D, Bowley, D, Cruickshank, N, Daniels, I, Griffiths, E, Hornby, St, Lund, Jn, Marriott, P, Singh, P, Smart, Nj, Speake, D, Thompson, C, Torkington, J, Torrance, A, Vohra, R, Warren, O, Winter, Dc, Pellino, G, Sgrò, A, Simioni, A, Farina, V, Podda, M, Di Saverio, S, Birindelli, A, Pasquali, S, Itsurg, Surg, Pt, Bolton, W, Bradshaw, Cj, Chean, Cs, Harris, G, Haddow, Jb, Jamieson, Nb, Mccain, S, Mason, J, Milgrom, D, Nana, Gr, Mohamed, Mn, Brien, Jo, Pearce, J, Rabie, M, Sahnan, K, Sarmah, P, Skerritt, C, Ghazanfar, Ma, Sreedharan, L, Kabwama, S, Gray, Rt, Kamande, Iw, Nazarian, S, Dar, Fa, Misky, At, Arunachalam, S, Twum-Barima, Cs, Mohamed, Im, Connor, Kl, Coe, Po, Kosti, A, Elshaer, M, Colvin, Da, Charalambous, Mp, Yeung, K, Merker, L, Morrison, T, Thaventhiran, Aj, Gilbert, Tm, Clements, Jm, Hicks, G, Afshar, S, Mckinley, Nc, Assaf, N, Hanna, T, Macinnes, E, Thavanesan, N, Dubois, As, Palani-Velu, Lk, Tezas, S, Yow, L, Radwan, Rw, Abdelrahman, M, Lee, Ka, Zarka, Za, Mcdowall, Na, Tan, Cy, Venn, Ml, Ashmore, Dl, Whitehorn, Se, Golder, Am, Reddy, A, Delimpalta, C, Kay, Oh, Shah, Sm, Eiben, I, Doyle, C, Tudyka, V, Issa, E, West, H, Brewer, Hk, Farrow, Ez, Taylor, Ns, Smart, Cj, Griffiths, Np, Halkias, C, Vitish-Sharma, P, Knight, Sr, Mowbray, Ng, Olivier, Jb, Lee, Kj, Clement, Kd, Chrastek, D, Panda, N, Connor, Mj, Fahmy, Se, Bryan, Es, Ngu, Ws, Adegbola, So, Vaughan, Em, Stupalkowska, W, Simmonds, L, Malik, A, Hussein, A, Karim, Mj, Singhal, T, Ormiston, R, Kung, V, Rabie, Ma, Park, Jh, Lal, N, Worku, D, D'Auria, M, Ang, A, Orizu, M, Gammeri, E, Clough, E, Choy, Ch, Lawday, S, Hann, Aj, Robinson, D, Wardle, 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Shurlock J., Siddique K., Forouzanfar A., Brews R., Acharya A., Jain A., Tozer P.J., Warusavitarne J., Emslie K.M., Collier-Wakefield O., Sivaloganathan P., Dobson C., Elseedawy M., McNally L., Williams M., Motiwala F.H., Choi S., Asmadi A.A., Burnside D., Everden A., Suriyakumar S., Sandu L., Kent D.A., Bowen J., Long P., Khair A., Shah K., Phelan L., Pierre R., Dhari A.A., Hoff M., Nickson S., Setshwaelo T., Chalk A., Parkola M.J., Harlinska A., Chan T., Dudek J.G., Rolph R., Allen M., Pollard H., Gormely R., Finlayson H., Ljungqvist G., Peponis C., Rahman M., Dhesi S., Arshad F., Faris A.R., Sooriyamoorthy T., Springate E.L., Barnieh W., Patel A.S., Siddiqui Z.A., Chishti I.A., Ayube-Brown J., Rabie M.R., Blake L., Yardimci E., Nagendram S., Neophytou G.I., Henderson L., Farhan-Alanie M., Kong C.Y., Ghazala R., Evans J., Hussain N., Kabir M., Hraishawi I., Cox M., Bailey J.A., Muhibullah N., Yanni F., Stevenson R., Nair A., Murphy C., Mcgucken O., Pandya R., Bowerman H., Lafaurie G., Van Boxel G.I., Shanmugarajah K., Maragouthakis D., Hanif Z., Evans J.D., Yoganathan S., Richardson T.D., Cook V., Clark G.L., Rigney B., O'Neill E., Guliani J., Chan D., Harper F., Sian T., Boereboom C., Blackwell J., Hardy E., Boyd-Carson H., Couch D.G., Barter C.A., Thoukididou S.N., Hatt J.R., Jones C.S., Dean S., Rajaretnam N., Masood M., Thakral N., Griffith D., Doherty C., Longshaw A., Peprah D., Mathew G., Hook A., Vance-Daniel J., Ibrahim Y., Walters K.J., Whewell H.E., Sherif M.A., Mckenna M., O'Sullivan D., Woodrow C., Gill S., Johnstone A., Gentry R., Irwin R., Forgie A., Welsh S., Ivey P., Bullivant J.K., English W.J., Osterberg A., Morowala A., Al-Faham Z., Islam S., Tan E., Sadek S., Sihra N., Shrestha D., Chong B., Nadeem A., Fasuyi J.A., Patel M.M., Daureeawoo R., Okekunle B., Cheruvu M., Mazumdar E., Hussain A., Patel C., Mcquaid M., Banks A., Robinson A., Khan M.S., Riaz W., Verroiotou M., Cohen J.A., Kouroumpas E., Ghaffari I., Moradzadeh J., Kamal M., Gulamhussein M., Gaines E., Ghatorae S., Clark S., Savill A., Hutchinson B., Chapman J., Wu F., Creasy W., Raymond M., Grosvenor S., Odeh A., Malik Y., Bansal H., Grant C., Raofi A., Ahmed B., Mai D., Souter J., Hamelmann R.N., Ikram S., Durbacz M., Gilliland N., Salem A., Chudek D., Ladwa N., Storey R., Fontaine C., Toomey D., Miller B., Oakey M., Smoker H., Chapman S.J., O'Hagan S.C., Tahir W., Wilcox G., Ahmad A., Akram F., Baddams T.S., Boshier P.R., Fehervari M., Easdon S., Ilozue T., Adam M.E., Jokhan S., Foster A., Nambiar K., Bohra P., Janardanan S., Shanmuganathan V., Maqboul F., Ettles C., Wardle S.D., Martinou E., Khasria A., Bagga R., Motter D., Mundkur N., Pan Y., Akbari K., Farrell S.M., Rahim A., Gummaraju A., Mahmoud A., Akinsola O., Smallcombe N., Tarazi M., Hanley C., Campbell U.M., Franklin D., Davidson J.R., Raza S.S., Krishnamoorthy A., Rajjoub Y., Ali M., Seddon T.C., Payne R.E., Das A., Martin L.M., Naismith K.N., Venkata U.P., Manda V.M., Burns K.M., Huang J., Samuel M., Docherty J.A., Cheah W.L., Ooi R., Nyeko-Lacek M., Marsh L., Prideaux A., Li C.H., Poacher A., Lee M., Muzaffar M., Kara A., Walsh E., Sunter H., Roth N., Roy C., Mcmorran D., Turnbull A., Layton G.R., Archer J.E., Yang P., Douka E., Amin V., Borghol K., Blackford O.D., Bond S., Baker B., Mohamed W.O., Williams R., Garnham J., Robb H.D., Allington J., Cloney L., Tamborska A., Kalia K., Fung E., Johnston Z., Lynch L., Christides A., Tan H.L., Cynthia G., Tsang B., Rossi C., Kaubrys M., Al-Khafaji N., Jenkins M., Peiris G.B., Gunning S., Nimako E., Pandya D., Hever P., Amayo A., Bull C., Clements C., Al-Sheikh M., Savioli F., Long M., Horsfield E., Robertson C., Ogboru S., Mcilwrath A.C., Bell J., Limb C., Obeid N., Rich J.E., Balasubramaniam A., Mashar R., Taylor M., Bruce J.S., Dennison G., Curtis N.J., Ezerska E., Ellis B., Wiggill S., Tee A., Ng S., Carder C., Abdelwahed A., Chandler S.B., Tinsley B.J., Finotti E., Occhioni G., Cossu F., Vulcano I., Viscosi F., Michelini M., Compagnoni B., Sepe C., Isolani S.M., Regina G., Alagna V., Martorelli G., Gabbianelli C., Moroni P., Zuin M., Conci S., Lazzari G., Costamagna D., Zurleni T.Z., Altomare M.A., Desiderio J., Di Cintio A., Gemini A., Trastulli S., Viviani E., Tomasoni M., Montori G., Harder G., Argenti F., Malabarba S., Checcacci P., Montanelli P., Guerra F., Skalamera I., Staderini F., Grandi S., Nelli T., Coratti F., Sorrentino L., Maffioli A., Cavallo D., Bondurri A., Groppo G., Curti R., Solaini L., Xidas A., Manias T., Delogu D., Vacca A., Solinas L., Corbellini C., Fiore L., Nigro A., Santurro L., Angrisani M., Sparta C., Lorettu A., Mura F.A., Ruggiu G.V., Pirari P.F., Pau R., Melis M., Piu F., Patti S., Deserra A., Angelieri D., Del Basso C., Rossi D., Iannone I., De Padua C., Giubilo C., Falaschi F., Cirillo B., Gordini L., Podda F., Sanna S., Saba A., Poillucci G., Pinna E., Messina A., Sena G., Cardona R., De Luca E., Sacco R., Vescio G., Ammendola M., Romano R., Bianco A., Bonfante P., D'Ambra L., Feleppa C., Gennai A., Lizzi V., Moggia E., Imperatore M., Bolzon S., Belvedere A., Amaducci E., Ripoli M.C., Segalini E., Cervellera M., Vaccari S., Eretta C.O., O'Neill R., Llewelyn O., Jones N., Clerici F., Ballabio M., Andolfi E., Angelini M., Fontani A., Miranda E., Scricciolo M., Provenza G., Pellicano G.A., Pulighe F., Argenio G., Melis A., Balestra F., Anania M., Cruccu A., Massaiu C., Murru M.L., Martino A., Luzzi A.P., La Valle G., Chillitupa C.Z., Bartoli A., Conti D., Spaziani A., Bellochi R., Listorti C., Salandini M.C., Carlucci M., Tenconi S.M., Cannavo M., Marano A., Giuffrida M.C., Cannata G., Pellegrino L., Giraudo G., Baraghini M., Garzi A., Giudicissi R., Zalla T., Romoli L., Vannucchi A., Giani I., Feroci F., Calussi M., Ribaudo M., Fiorot A., Stecca T., Nistri C., Fornasier C., Valiani S.V., Brunelli D.B., Evoli L.E., Giuliani N.G., Contine A.C., Renzi C.R., Feo C.V., Anania G., Carcoforo P., Aisoni F., Licari L., Tutino R., Cocorullo G., Silvestri V., De Marco P., Fontana T., Orlando G., Falco N., Baseggio M., Napetti S., Mella A., Rossi G.M., Chimetto A., Cosci M., Bonomo M., Scialandrone G., Chetta N., Carvalho L.C., Magalhaes J.S., Pereira A.M., Fernandes C., Fareleira A., Goncalves D., Pais M., Pereira A., Resende F.M., Correia D., Cardoso D., Tojal A., Santos S.C., Barbosa L., Louro H.C., Bairos F., Martins F.M., Messias F.M., Ferreira M.S., Borges F.C., Botelho P., Lima M., Valente P.M., Joao A.A., Guimaraes J.M., Rocha R., Nogueira S.T., Kabir U., Wong C., Rahmani L.S., Tan S., Chng S., Jasinski B., Cheng S.A., Mardhiah S., McGlynn K., Hannan E., Burke J., Haveliwala Z., O'Neill M., Boland M., Hayes C., Fox A., Zaborowski A., Mitru R.M., Mc-Dermott A., Coyle D., Stoica I., McMahon S.V., Laughlin D.M., Kannegieser-Bailey M., Murphy R., Muntean A., Shet S., Thomas L., De Freitas S., Quill S., Aljorfi A., Soh B., Law J.J., Hartnett J., Jansen T., Gilgan J., Jung J., Scanlon K., Szucs A., Ahern D.P., Redmond A.E., Edwards S.E., Manoharan P., Brennan S., Abdelgadir A.M., Mckevitt K.L., Zarog M.A., Ahmed G., Bukhari W., Ahad A., Paniagua M., Samartin C., Primo J.C., Garrido L., Lopez M., Rufo E., Trostchansky I., Rodriguez L., Infante H., Acosta A., Cremades P., Cidoncha A., Olmos V., Oliva I., Santamaria C., Cavero A., Calvo H., Suero C.A., Maderuelo V.M., Galvez P., Hernando A., Eguaras I., Recreo A.C., Garcia-Carrero M., Moreda R., De Andres U., Del Pozo E., Calvo M., Moratalla C.N., Ronda R.N., Contreras R.G., De Burgos C.B., Cortes G.V., Martinez C.C., Agudo A.R., Soriano J.T., Ramos X.H., Echazarreta E., Elia M., Hernaez A., Sanchez L., Vallejo-Bernad C., Oliver J.R., Sanchez-Rubio M., Kalviainen H.K., Genzor S., Gonzalez-Nicolas T., Puerta E., Laviano E., Gimenez T., Ferminan A., Muriel-Alvarez P., Sierra-Granon J.E., Escoll-Rufino J., Cuello-Guzman E., Mestres-Petit N., Merichal-Resina M., Pinillos-Somalo A., Gomez-Carmona Z., Vazquez-Fernandez A.P., Trujillo-Diaz J.J., Couso J.R., Fernandez M.D., Riera E., Espinosa J., Carral-Freire M., Martinez-Almeida R., Santarrufina-Martinez S., Sebastian-Tomas J.C., Gonzalvez-Guardiola P., Fernandez E.C., Mozo A.S., Stoyanov T.I., Santamaria P.C., Grimaldo E.G., Fernandez-Candela A., Curtis-Martinez C., Del-Valle-Ruiz S.R., Sanchez-Cifuentes A., Ramirez-Faraco M., Lopez A.F., Leon C., Kumar S., Fornell-Ariza M., Ayllon-Gamez S., Pena-Barturen C., Ojea-Ruiz-Yherla L., Saavedra-Chacon M., Perez-Calvo J., Gomez-Facundo H., Riba-Combatti L., Manas O.C., De-Soto-Cardenal B., De-La-Herranz-Guerrero P., Dominguez-Sanchez C., Gamero-Huaman J.C., Suarez-Cabrera A., Ramirez-Redondo A.A., Lara-Fernandez Y., Bascuas-Rodrigo B., Lopez-Duran B.L., Pigem A., Gil J., Salvador H., Planellas P., Farres R., Caballero A., Arnau M., Tapiolas I., Ridaura N., Roncero L.S., Collado-Roura F., Fijo L.M., Cormenzana O.B., Vinas N.L., Grifell M.S., Prats M.A., Torrado A.A., Sanz-Navarro S., Contreras-Saiz E., Solar-Garcia L., Moreno-Gijon M., Suarez-Sanchez A., Diaz-Vico T., Rodicio-Miravalles J.L., Garcia-Gutierrez C., Pila U., Melone S., Martin-Prieto L., Rojo J.A., Gonzalez M., Zorrilla L., Garcia-Marin J.A., Baeza-Murcia M., Pellicer-Franco E., Jimenez-Ballester M.A., Asensio-Gomez L., Gortazar-De-Las-Casas S., Guevara-Martinez J., Ramirez L., Verea S., Anguita F., Navarro G., Criado ADC., Lara M.C., Martinez E.T., Sanchez-Martinez A., Hernandez-Gimenez L., Galofre-Recasens M., Ferrer-Vilela I., Perez-Sanchez L.E., Esteves M.B., Menendez-Moreno A., Baz-Figueroa C., Rosat A., Hontoria M.S., Garcia N.A., Gracia-Roman R., Pascua-Sole M., Pino-Perez O., Garcia-Perez J.M., Pineno-Flores C., Ambrona-Zafra D., Sancho-Muriel J., Alvarez E., Jimenez-Rosellon R., Daga O., Alberca-Paramo A., Sanchez-Garcia S., Garcia-Santos E., Pareja-Ciuro F., Olivares-Oliver C., Navarro-Morales L., Tamayo-Lopez M.J., Tinoco-Gonzalez J., Garcia-Rivera C.O., Agua I.A., Moreno-Suero F., Pereira-Mosquera E., Zerpa C., Llacer E., Diaz A., Caro A., Feliu F., Franco M., Escuder J., Abellan M., Padilla E., Mambrilla-Herrero S., Plua-Muniz K.T., Bailon-Cuadrado M., Tejero-Pintor F.J., Choolani-Bhojwani E., Vila-Zarate C., Delgado-Plasencia L.J., Ponchietti L., Cousins L., Busuttil A., Baird C., Drye N., Brown O.D., Mansour S., Anderson O., Mahapatra R., Clements J.A., D'Souza N., Littlehales D.J., Tang A.M., Byrne B.E., Cunha P., Ogbuokiri C., Eiben P., Gravante G., Kho H., Dobbs S., Doulias T., Ng J., Wilson M., Venugopal R., Wolff J., Akhtar K., Walji H.D., Tognarelli J.M., Knight K.A., Ansari A., Hussaini S.A., Wright E., Brewer H., Rinkoff S., Harries R.L., Fairfield C.J., Abbott T., Jackson A., Wright H.L., Walters U., Carney K., Logan P.C., Mughal Z., Strachan E., Chasty B., Ma J., Mazzeo C., Badii B., Armellini A., Grassia M., Perin A., Ruzzenente A., Magnoli M., Depalma N., Longheu A., Papandrea M., Dova L., De Prizio M., Gusai G.P., Di Zitti L., Geretto P., Azabdaftari A., Chianese G., Elbetti C., Ruffolo C., Giaccari S., Devezas V., Ferreira J.S., Peixoto R., Alshafei A., Simo V., Jose H.S., Ugarte-Sierra B., Salva A.B., Gomez N., Marinello F., Medina-Arana V., Vega L., Ballester M.M., Espina B., Prieto-Nieto M.I., Rodriguez E.C., Padilla-Valverde D., and Duran-Munoz-Cruzado V.M.
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Adult ,humanos ,Decision Making ,Risk Assessment ,NO ,apendicectomía ,apendicitis ,evaluación de riesgos ,Appendectomy ,Humans ,hospital ,General ,collaborative ,LS7_4 ,right iliac fossa ,appendicitis ,emergency service ,Original Articles ,adulto ,Appendicitis ,adult ,appendectomy ,humans ,risk assessment ,decision making ,Lower GI ,Original Article ,appendicitis, prediction models, right iliac fossa pain ,Emergency Service, Hospital ,toma de decisión - Abstract
Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P, Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making were identified by identifying UK adults at low risk of appendicitis. An online calculator is available (http://appy-risk.org). WCC, white cell count; CRP, C‐reactive protein; AIRS, Appendicitis Inflammatory Response Score; AAS, Adult Appendicitis Score. Important differences between men and women
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- 2019
36. The drowned world of Kenneth Slessor
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Poacher, Jeffrey
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- 2001
37. 500 The Four Year Clinical and Economic Impact of an Extended Screening Program for Developmental Dysplasia of the Hip in Cardiff and Vale University Health Board
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C Carpenter, A Poacher, J. Froud, and L Marsh
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medicine.medical_specialty ,Developmental dysplasia ,business.industry ,Family medicine ,medicine ,Surgery ,Economic impact analysis ,Health board ,business - Abstract
Aim Early detection of DDH is associated with the increased success of non-surgical treatment. Therefore, Cardiff and Vale Health Board (CAVUHB) implemented an extended screening program for Developmental dysplasia of the Hip (DDH) to improve neonatal public health within the population. Method A 4-year prospective case-control study of all patients born between 01/01/2016-31/12/2019 (n = 21843) who underwent ultrasonographic screening for DDH in CAVUHB. Ultrasounds were graded using Graf’s classification, with treatment outcomes determined by patient’s records and costings based on NHS tariffs. Results Screening of those with risk factors diagnosed 49% of treated DDH cases. Screening for risk factors cost CAVUHB £175,000 per annum, with a cost per favourable outcome of £12351. The mean cost of DDH treatment of a late presenting patient was £23,782, incurring a cost reduction of 48%. Cost-effectiveness and positive predictive value (PPV) of calcaneovalgus malformations, oligohydramnios, and plagiocephaly demonstrating PPV similar to that of primary risk factors. Calcaneovalgus malformations demonstrated significantly higher PPV than primary risk factors for DDH (p Conclusions CAVUHB cost-effectively reduced morbidity and surgical mortality within the neonatal population, as a result of its extended screening program for DDH. The novel findings of prevalence and predictive value of secondary risk factors as a marker of treatable DDH are significant, as currently they are not included in the national new-born and infant physical examination (NIPE) guidance. High predictive value with low population prevalence indicates that these are cost reducing and clinically valuable markers of disease that could provide value if within a national screening program.
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- 2021
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38. John Foulcher's democracy
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Poacher, Jeffrey
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- 1999
39. 500 The Four Year Clinical and Economic Impact of an Extended Screening Program for Developmental Dysplasia of the Hip in Cardiff and Vale University Health Board
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Poacher, A, primary, Froud, J, additional, Marsh, L, additional, and Carpenter, C, additional
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- 2021
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40. Lack of improvement in sepsis care on the wards: results of four consecutive yearly point-prevalence studies in Wales
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Maja Kopczynska, Harry Unwin, Richard Pugh, Ben Sharif, Thomas Chandy, Daniel Davies, Matthew Shield, David Purchase, Samuel Tilley, Arwel Poacher, Lewis Oliva, Sam Willis, Isabelle Ray, John Hui, Bethan Payne, Eilis Wardle, Fi Andrew, Hei Priscilla Chan, Jack Barrington, Jay Hale, Joanna Hawkins, Jess Nicholas, Lara Wirt, Lowri Thomas, Megan Walker, Myat Pan, Tallulah Ray, Umair Asim, Victoria Maidman, Zeid Atiyah, Zain Nasser, Zhao Tan, Laura Tan, Tamas Szakmany, and Welsh Digital Data Collection Platform Collaborators
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Sepsis ,medicine.medical_specialty ,business.industry ,Emergency medicine ,Prevalence ,Medicine ,business ,medicine.disease - Abstract
Background: The ‘Sepsis Six’ bundle was promoted as a more deliverable tool outside of the critical care settings, but there is very little data available on the progress and change of sepsis care outside the critical care environment in the UK. Our aim was to compare the yearly prevalence, outcome and the Sepsis Six bundle compliance in patients at risk of mortality from sepsis in non-intensive care environments. Methods: Patients with a National Early Warning Score (NEWS) of 3 or above and suspected or proven infection were enrolled into four yearly 24-hour point prevalence studies, carried out in fourteen hospitals across Wales from 2016-2019. Results: Out of the 26,947 patients screened 1,651 fulfilled inclusion criteria and were recruited. The full ‘Sepsis Six’ care bundle was completed on 223 (14.0%) occasions, with no significant difference between the years. On 190 (11.5%) occasions none of the bundle elements were completed. There was no significant correlation between bundle element compliance, NEWS or year of study. One hundred and seventy (10.7%) patients were seen by critical care outreach; the ‘Sepsis Six’ bundle was completed significantly more often in this group (54/170, 32.0%) than for patients who were not reviewed by critical care outreach (168/1385, 11.6%; pConclusions: Our data suggests that despite efforts to increase sepsis awareness within the NHS, there is poor compliance with the sepsis care bundles and no change in the high mortality over the study period. Further research is needed to determine which time-sensitive ward-based interventions can reduce mortality in patients with sepsis and how can these results be embedded to routine clinical practice.Trial registration: Defining Sepsis on the Wards ISRCTN 86502304 https://doi.org/10.1186/ISRCTN86502304 prospectively registered 09/05/2016
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- 2021
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41. Response: Impact and outcomes of postoperative anaemia in colorectal cancer patients: a systematic review
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Froud, Joseph L. J., primary, Poacher, Arwel T., additional, Whittaker, Thomas M., additional, Williamson, Jeremy S., additional, and Williams, Gethin L., additional
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- 2021
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42. Slessor's culture : contexts and institutions of Australian poetry, 1919-39
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Jeffrey Poacher
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Power (social and political) ,Macabre ,Poetry ,Literariness ,Aesthetics ,Media studies ,Historicism ,Popular culture ,Modernism (music) ,Context (language use) ,Sociology - Abstract
Seen from the distance of over half a century, Kenneth Slessor appears as the most important Australian poet of the period between the world wars; his work is widely praised by other poets and remains popular with the reading public. But this is the view from the present. A different picture emerges if Slessor's poetry is considered against the cultural background in which it was first published. This thesis examines some of the contemporaneous contexts for Slessor's writing. The institutions of Australian literature during the 1920s and 1930s - from the commercial strategies of its publishers to the preferences of its readers - were important factors in the circulation of Slessor's work. Chapter one of this thesis will consider the ways in which Slessor responded to these material circumstances and to his culture's prevailing literary tastes; it will also consider his response to what might be thought of as a current of irrationalism in the popular culture of his day. The remaining two chapters will traverse other contexts for his poetry: the writing of some of his friends and associates; forms of power and ideas of community; and, finally, his relationship to the physical world around him, the city and its objects.Recent commentary has tended to emphasise Slessor's social and political conservatism, especially by pointing to the later phases of his career as a journalist and newspaper editor. This study seeks to qualify and, on occasion, challenge that view. Opinions that Slessor expressed decades after he stopped writing poetry are not always a reliable guide to his work from the twenties and thirties. Seen in context, Slessor's poems and prose from the inter-war period often adopted positions that should properly be regarded as liberal, even transgressive, by the standards of their day. In this respect, the present study proceeds from an illocutionary assumption - that it is possible to examine a poem, like any other form of utterance, as an event of its time in order to recover something of its original sense. Criticism of Slessor's poetry has often concentrated on questions of its supposed modernism. The approach here, archival rather than theoretical, will not attempt to rehearse those debates. Instead, the emphasis will be on the material and institutional factors that influenced the development of his work, especially in its existence as a commodity of a special kind, circulating within a larger cultural economy. Seen in this light, Slessor appears less an aspiring member of a supposed "artist-aristocracy" (as he has been called by some critics) and more a struggling vendor of a marginalised literary product - much like the pedlar who exhorts citizens to buy his macabre wares in "Cannibal Street", the last poem of the Five Bells collection. Yet the historicist approach of this thesis does not seek to reconstitute poems merely as documents of their era, nor to disregard their status as works of the imagination. As well as surveying cultural contexts, the present study is intended as a form of attention to the literariness of Slessor's writing.
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- 2020
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43. Lack of improvement in sepsis care on the wards: results of four consecutive yearly point-prevalence studies in Wales
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Kopczynska, Maja, primary, Unwin, Harry, additional, Pugh, Richard, additional, Sharif, Ben, additional, Chandy, Thomas, additional, Davies, Daniel, additional, Shield, Matthew, additional, Purchase, David, additional, Tilley, Samuel, additional, Poacher, Arwel, additional, Oliva, Lewis, additional, Willis, Sam, additional, Ray, Isabelle, additional, Hui, John, additional, Payne, Bethan, additional, Wardle, Eilis, additional, Andrew, Fi, additional, Chan, Hei Priscilla, additional, Barrington, Jack, additional, Hale, Jay, additional, Hawkins, Joanna, additional, Nicholas, Jess, additional, Wirt, Lara, additional, Thomas, Lowri, additional, Walker, Megan, additional, Pan, Myat, additional, Ray, Tallulah, additional, Asim, Umair, additional, Maidman, Victoria, additional, Atiyah, Zeid, additional, Nasser, Zain, additional, Tan, Zhao, additional, Tan, Laura, additional, Szakmany, Tamas, additional, and Collaborators, Welsh Digital Data Collection Platform, additional
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- 2021
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44. Appendicitis risk prediction models in children presenting with right iliac fossa pain (RIFT study): a prospective, multicentre validation study
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Nepogodiev, Dmitri, primary, Wilkin, Richard JW, additional, Bradshaw, Catherine J, additional, Skerritt, Clare, additional, Ball, Alasdair, additional, Moni-Nwinia, Waaka, additional, Blanco-Colino, Ruth, additional, Chauhan, Priyesh, additional, Drake, Thomas M, additional, Frasson, Matteo, additional, Gee, Oliver, additional, Glasbey, James C, additional, Matthews, Jacob H, additional, Morley, Gabriella L, additional, Naumann, David N, additional, Pata, Francesco, additional, Soares, Antonio S, additional, Bhangu, Aneel, additional, Abbas, SH, additional, Abdelgadir, AM, additional, Abdelrahman, A, additional, Abdelrahman, M, additional, Abdelwahed, A, additional, Abou El Ella, Y, additional, Abulafi, M, additional, Acharya, A, additional, Adam, ME, additional, Adams, RE, additional, Adegbola, SO, additional, Adimonye, A, additional, Adnan, M, additional, Afshar, S, additional, Ahad, A, additional, Ahel, J, additional, Ahern, DP, additional, Ahmad Asmadi, A, additional, Ahmed, B, additional, Ahmed, G, additional, Ahmed, OS, additional, Ahmed, S, additional, Akbari, K, additional, Akinsola, O, additional, Al-Khyatt, W, additional, Al-Sarireh, B, additional, Al-Sheikh, M, additional, Alani, M, additional, Alexander, R, additional, Alhammali, T, additional, Ali, M, additional, Aljorfi, A, additional, Allen, M, additional, Allington, J, additional, Alshafei, A, additional, Amarasinghe, R, additional, Amayo, A, additional, Amin, V, additional, Amuthalingam, Thuva, additional, Anandan, L, additional, Anderson, O, additional, Andreani, SM, additional, Andrews, B, additional, Ang, A, additional, Aravind, B, additional, Archer, JE, additional, Aremu, MA, additional, Arunachalam, S, additional, Aruparayil, N, additional, Ashmore, DL, additional, Ashour, O, additional, Ashraf, N, additional, Assaf, N, additional, Avalapati, H, additional, Awokoya, OO, additional, Ayube-Brown, J, additional, Badenoch, T, additional, Bagga, R, additional, Baginski, A, additional, Bailey, S, 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additional, Jain, Sarus, additional, Jama, GM, additional, Jamieson, NB, additional, Janardanan, S, additional, Jasinski, B, additional, Jenner, D, additional, Jerome, E, additional, Johnson, B, additional, Johnstone, A, additional, Jokhan, S, additional, Jones, A, additional, Jones, CE, additional, Jones, CS, additional, Jones, E, additional, Jones, L, additional, Kabir, U, additional, Kabwama, S, additional, Kamal, M, additional, Kamande, IW, additional, Kanakala, V, additional, Kannegieser-Bailey, M, additional, Kaptanis, S, additional, Karim, MJ, additional, Karwal, RS, additional, Kaur, G, additional, Keegan, R, additional, Kelay, A, additional, Kennedy, ND, additional, Kent, DA, additional, Khair, A, additional, Khan, K, additional, Khan, S, additional, Khasria, A, additional, Kho, H, additional, Kilkenny, J, additional, King, R, additional, Kinross, J, additional, Kirkham, EN, additional, Knight, B, additional, Kochupapy, R, additional, Koh, C, additional, Kouli, O, additional, Krishnamoorthy, A, additional, Krivan, S, additional, Kumar, K, additional, Kumar, S, additional, Kung, VWS, additional, Kuo, R, additional, Lafaurie, G, additional, Lai, CW, additional, Lal, N, additional, Lawday, S, additional, Layman, S, additional, Layton, GR, additional, Lazzaro, A, additional, Lecky-Thompson, L, additional, Lee, KA, additional, Lee, KJ, additional, Lee, M, additional, Lee, SL, additional, Leighton, PA, additional, Leitch, RP, additional, Lennox-Warburton, HC, additional, Leung, EL, additional, Li, CH, additional, Lim, JM, additional, Limb, C, additional, Ljungqvist, G, additional, Lloyd, G, additional, Lodhia, S, additional, Logan, PC, additional, Long, M, additional, Long, P, additional, Long, RH, additional, Longshaw, A, additional, Louw, C, additional, Lund, JN, additional, Ly, C, additional, Lynch Wong, MJ, additional, Ma, JKY, additional, Macdonald, A, additional, Macinnes, EGE, additional, Magro, T, additional, Mahapatra, R, additional, Mahendran, B, additional, Mahmood, F, additional, Mahmoud, A, additional, Mahon, D, additional, Mai, D, additional, Maina, A, additional, Major, CP, additional, Makhija, R, additional, Malam, Y, additional, Malik, A, additional, Malik, K, additional, Malik, SN, additional, Manda, VM, additional, Manektella, KM, additional, Mann, C, additional, Manoharan, P, additional, Manson, R, additional, Mansoor, S, additional, Mansour, MM, additional, Mansour, S, additional, Maqboul, F, additional, Maragouthakis, D, additional, Marangoni, G, additional, Mardhiah, S, additional, Maripi, H, additional, Marriott, P, additional, Marsh, L, additional, Marshall, G, additional, Martin, A, additional, Martin, LM, additional, Martinou, E, additional, Mashar, R, additional, Mason, John, additional, Masood, M, additional, Mathew, G, additional, Maude, K, additional, Mazumdar, E, additional, Mc-Dermott, A, additional, Mcarthur, D, additional, Mccain, RS, additional, McCain, S, additional, Mccann, C, additional, Mccaughey, P, additional, Mccluney, SJ, additional, Mccullough, J, additional, Mcdonnell, D, additional, Mcdowall, NA, additional, McEntee, JE, additional, McGlynn, K, additional, Mcgrath, D, additional, Mcgucken, O, additional, Mcilwaine, S, additional, Mcilwrath, AC, additional, Mckay, SC, additional, McKelvie, MA, additional, Mckenna, M, additional, Mckeon, J, additional, Mckevitt, KL, additional, Mckinley, NC, additional, McLaughlin, D, additional, McMahon, SV, additional, Mcmorran, D, additional, McNally, L, additional, Mcquaid, M, additional, Mcwhirter, DM, additional, Mealy, K, additional, Mears, A, additional, Menzies, D, additional, Merai, H, additional, Mersh, RJ, additional, Miguras, M, additional, Milgrom, D, additional, Miller, K, additional, Milward, J, additional, Mirza, S, additional, Misky, AT, additional, Mistry, D, additional, Mitchard, MJ, additional, Mitru, RM, additional, Mohamed, IM, additional, Mohamed, Imran, additional, Mohamed, TM, additional, Mohamed, WO, additional, Mohd, N, additional, Moore, C, additional, Moradzadeh, J, additional, Morrison, TEM, additional, Morrison-Jones, V, additional, Morton, Dion G, additional, Mothe, BS, additional, Motiwala, Fh, additional, Motter, D, additional, Mowbray, NG, additional, Mughal, Z, additional, Mulsow, J, additional, Mundkur, N, additional, Muntean, A, additional, Murphy, C, additional, Murphy, R, additional, Murray, MP, additional, Muzaffar, M, additional, Myatt, A, additional, Nadeem, A, additional, Nagarajan, D, additional, Nagendram, S, additional, Nair, A, additional, Nair, MK, additional, Nair, MS, additional, Naismith, KN, additional, Nambiar, K, additional, Nana, GR, additional, Nash, Z, additional, Nastro, P, additional, Nazarian, S, additional, Neagle, G, additional, Neale, A, additional, Neary, PM, additional, Newton, RC, additional, Ng, M, additional, Ng, S, additional, Niaz, O, additional, Nickson, S, additional, Nicol, D, additional, Nimako, E, additional, Noor Mohamed, MS, additional, Nyeko-Lacek, M, additional, O'Connor, BR, additional, O'Neill, E, additional, O'Neill, N, additional, O'Sullivan, D, additional, O'Brien, J, additional, Oakey, M, additional, Obeid, N, additional, Odeh, A, additional, Ogboru, S, additional, Ogbuokiri, C, additional, Okekunle, B, additional, Okorocha, E, additional, Olagbaiye, O, additional, Olivier, JB, additional, Ooi, R, additional, Orawiec, P, additional, Orizu, M, additional, Orme, N, additional, Ormiston, R, additional, Paget, C, additional, Pal, A, additional, Palani-Velu, LK, additional, Pan, Y, additional, Panda, N, additional, Pandey, V, additional, Pandya, R, additional, Pandya, D, additional, Paramasevon, KR, additional, Pardy, C, additional, Parkola, MJ, additional, Pasquali, Sandro, additional, Patel, AS, additional, Patel, BY, additional, Patel, C, additional, Patel, H, additional, Patel, N, additional, Patel, RT, additional, Patel, S, additional, Patel, Y, additional, Patel, MM, additional, Patil, SD, additional, Payne, CJ, additional, Payne, RE, additional, Pearce, JCH, additional, Pearce, L, additional, Pedder, A, additional, Peirce, CB, additional, Peiris, GB, additional, Peleki, A, additional, Pellino, Gianluca, additional, Pento, V, additional, Peprah, D, additional, Perera, HS, additional, Perera, MI, additional, Phelan, L, additional, Photiou, D, additional, Pierre, R, additional, Pilkington, JP, additional, Pinkney, Thomas D, additional, Pisavadia, B, additional, Poacher, A, additional, Podda, M, additional, Pollard, H, additional, Popova, D, additional, Poudevigne, M, additional, Prideaux, A, additional, Pullabatla Venkata, UP, additional, Quddus, A, additional, Quill, S, additional, Rabie, M, additional, Rabie, MR, additional, Radwan, RW, additional, Rae, JF, additional, Rahim, A, additional, Rahmani, LS, additional, Rajagopal, S, additional, Rajaram, R, additional, Rajaretnam, N, additional, Rajjoub, Y, additional, Rallage, H, additional, Ramcharan, S, additional, Ranathunga, S, additional, Rao, M, additional, Rao, VSR, additional, Raofi, A, additional, Rashid, M, additional, Rate, A, additional, Ravindran, R, additional, Raymond, M, additional, Raza, SS, additional, Reddy, A, additional, Redman, EP, additional, Redmond, AE, additional, Rekhraj, S, additional, Renshaw, S, additional, Rex, D, additional, Rezacova, M, additional, Rezvani, S, additional, Ribeiro, B, additional, Rich, JE, additional, Richardson, TD, additional, Rigby, S, additional, Rigney, B, additional, Rinkoff, S, additional, Robb, HD, additional, Robertson, C, additional, Robinson, D, additional, Robinson, A, additional, Rodger, V, additional, Rolph, R, additional, Roomi, S, additional, Roth, NPG, additional, Rothnie, K, additional, Roy, C, additional, Rupani, S, additional, Rutherford, DG, additional, Sacks, R, additional, Saghir, N, additional, Saha, A, additional, Sahay, SJ, additional, Sahnan, K, additional, Salama, Y, additional, Salim, S, additional, Samuel, M, additional, Sana, S, additional, Sandu, L, additional, Sarmah, P, additional, Sarveswaran, J, additional, Saunders, SMF, additional, Savill, A, additional, Savioli, F, additional, Schuster Bruce, JR, additional, Sebastian, JF, additional, Seddon, TC, additional, Seneviratne, N, additional, Seth, M, additional, Setshwaelo, T, additional, Sezen, E, additional, Sgardelis, P, additional, Sgrò, A, additional, Shah, C, additional, Shah, J, additional, Shah, K, additional, Shah, SM, additional, Shakoor, Z, additional, Shalaby, MS, additional, Shanmuganathan, V, additional, Shanmugarajah, K, additional, Sharma, A, additional, Sharma, P, additional, Sharp, OL, additional, Shepherd, JA, additional, Sherif, MA, additional, Shet, S, additional, Shingler, G, additional, Shiwani, MH, additional, Shreshta, D, additional, Sian, T, additional, Siddiqui, MN, additional, Siddiqui, ZA, additional, Siggens, KL, additional, Sihra, N, additional, Silva, I, additional, Simioni, A, additional, Simmonds, LFC, additional, Simpson, DJ, 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additional, Yardimci, E, additional, Yasin, T, additional, Yen, SK, additional, Yoganathan, S, additional, Yoong, S, additional, Youssef, H, additional, Yow, LPS, additional, Zaborowski, A, additional, Zadi, AZ, additional, Zarka, ZA, additional, Zarog, MA, additional, and Zhang, AY, additional
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- 2020
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45. Response: Impact and outcomes of postoperative anaemia in colorectal cancer patients: a systematic review
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Thomas M. Whittaker, J. Froud, Arwel T. Poacher, Gethin Williams, and Jeremy S. Williamson
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medicine.medical_specialty ,High prevalence ,Colorectal cancer ,business.industry ,Gastroenterology ,MEDLINE ,Anemia ,medicine.disease ,medicine ,Humans ,Postoperative Period ,Colorectal Neoplasms ,Intensive care medicine ,business ,Academic rigor - Abstract
We read with great interest Moncur and colleagues'1 recent systematic review investigating the impact and outcomes of postoperative anaemia in colorectal cancer patients. We congratulate the authors on an interesting review of the current literature that clearly establishes a clinical and academic need to ascertain the true effect of postoperative anaemia, given its high prevalence and potential negative effects on patient outcomes. However, we feel that the novel bias tool, utilised to add improved academic rigor to reviews of this kind, was performed incorrectly in this case.
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- 2021
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46. THE DROVER'S WIVES: 101 retellings of a classic short story
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Poacher, Jeffrey
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The Drover's Wife: 101 Retellings of a Classic Short Story (Collection) -- O'Neill, Ryan ,Literature/writing - Abstract
THE DROVER'S WIVES 101 retellings of a classic short story RYAN O'NEILL 264pp. Lightning Books. 9.99 [pounds sterling]. Henry Lawson's story 'The Drover's Wife' is one of the landmarks of [...]
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- 2020
47. Developing a minimum common dataset for hip fracture audit to help countries set up national audits that can support international comparisons
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Johansen, Antony, Ojeda-Thies, Cristina, Poacher, Arwel T., Hall, Andrew J., Brent, Louise, Ahern, Emer C., and Costa, Matt L.
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AimsThe aim of this study was to explore current use of the Global Fragility Fracture Network (FFN) Minimum Common Dataset (MCD) within established national hip fracture registries, and to propose a revised MCD to enable international benchmarking for hip fracture care.MethodsWe compared all ten established national hip fracture registries: England, Wales, and Northern Ireland; Scotland; Australia and New Zealand; Republic of Ireland; Germany; the Netherlands; Sweden; Norway; Denmark; and Spain. We tabulated all questions included in each registry, and cross-referenced them against the 32 questions of the MCD dataset. Having identified those questions consistently used in the majority of national audits, and which additional fields were used less commonly, we then used consensus methods to establish a revised MCD.ResultsA total of 215 unique questions were used across the ten registries. Only 72 (34%) were used in more than one national audit, and only 32 (15%) by more than half of audits. Only one registry used all 32 questions from the 2014 MCD, and five questions were only collected by a single registry. Only 21 of the 32 questions in the MCD were used in the majority of national audits. Only three fields (anaesthetic grade, operation, and date/time of surgery) were used by all ten established audits. We presented these findings at the Asia-Pacific FFN meeting, and used an online questionnaire to capture feedback from expert clinicians from different countries. A draft revision of the MCD was then presented to all 95 nations represented at the Global FFN conference in September 2021, with online feedback again used to finalize the revised MCD.ConclusionThe revised MCD will help aspirant nations establish new registry programmes, facilitate the integration of novel analytic techniques and greater multinational collaboration, and serve as an internationally-accepted standard for monitoring and improving hip fracture services.Cite this article: Bone Joint J2022;104-B(6):721–728.
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- 2022
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48. Four consecutive yearly point-prevalence studies in Wales indicate lack of improvement in sepsis care on the wards.
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Kopczynska, Maja, Unwin, Harry, Pugh, Richard J., Sharif, Ben, Chandy, Thomas, Davies, Daniel J., Shield, Matthew E., Purchase, David E., Tilley, Samuel C., Poacher, Arwel, Oliva, Lewis, Willis, Sam, Ray, Isabelle E., Hui, John Ng C., Payne, Bethany C., Wardle, Eilis F., Andrew, Fiona, Chan, Hei Man Priscilla, Barrington, Jack, and Hale, Jay
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SEPSIS ,CRITICAL care medicine ,DISEASE prevalence ,CANCER chemotherapy ,CARDIOPULMONARY resuscitation - Abstract
The 'Sepsis Six' bundle was promoted as a deliverable tool outside of the critical care settings, but there is very little data available on the progress and change of sepsis care outside the critical care environment in the UK. Our aim was to compare the yearly prevalence, outcome and the Sepsis Six bundle compliance in patients at risk of mortality from sepsis in non-intensive care environments. Patients with a National Early Warning Score (NEWS) of 3 or above and suspected or proven infection were enrolled into four yearly 24-h point prevalence studies, carried out in fourteen hospitals across Wales from 2016 to 2019. We followed up patients to 30 days between 2016–2019 and to 90 days between 2017 and 2019. Out of the 26,947 patients screened 1651 fulfilled inclusion criteria and were recruited. The full 'Sepsis Six' care bundle was completed on 223 (14.0%) occasions, with no significant difference between the years. On 190 (11.5%) occasions none of the bundle elements were completed. There was no significant correlation between bundle element compliance, NEWS or year of study. One hundred and seventy (10.7%) patients were seen by critical care outreach; the 'Sepsis Six' bundle was completed significantly more often in this group (54/170, 32.0%) than for patients who were not reviewed by critical care outreach (168/1385, 11.6%; p < 0.0001). Overall survival to 30 days was 81.7% (1349/1651), with a mean survival time of 26.5 days (95% CI 26.1–26.9) with no difference between each year of study. 90-day survival for years 2017–2019 was 74.7% (949/1271), with no difference between the years. In multivariate regression we identified older age, heart failure, recent chemotherapy, higher frailty score and do not attempt cardiopulmonary resuscitation orders as significantly associated with increased 30-day mortality. Our data suggests that despite efforts to increase sepsis awareness within the NHS, there is poor compliance with the sepsis care bundles and no change in the high mortality over the study period. Further research is needed to determine which time-sensitive ward-based interventions can reduce mortality in patients with sepsis and how can these results be embedded to routine clinical practice. Trial registration Defining Sepsis on the Wards ISRCTN 86502304 https://doi.org/10.1186/ISRCTN86502304 prospectively registered 09/05/2016. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
49. How Can Undergraduate Surgical Societies Meet the Learning Needs of Their Members? A Multicentre Study
- Author
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Ahmed, W, Hakim, M, Poacher, A, Kennett, J, and Jones, C
- Published
- 2019
- Full Text
- View/download PDF
50. The Impact of the Implementation of a New Selective Screening Program for Neonatal Hip Ultrasound in Cardiff and Vale University Health Board
- Author
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Poacher A and Carpenter C
- Subjects
Pediatrics ,medicine.medical_specialty ,education.field_of_study ,business.industry ,Cost effectiveness ,Population ,Surgical mortality ,Retrospective cohort study ,University hospital ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Orthopedic surgery ,Medicine ,Effective treatment ,030212 general & internal medicine ,Health board ,business ,education - Abstract
Objective: Developmental dysplasia of the hip (DDH) is a common and preventable cause of disability. Early detection of DDH (
- Published
- 2018
- Full Text
- View/download PDF
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