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81.
Subodh Verma MD PhD FRCSC Bobby Yanagawa Sameer KalraMarc Ruel MD PhD FRCSC Mark D. Peterson Michael H. Yamashita Andrew Fagan Maria E. Currie Christopher W. White Stephane Leung Wai Sang Cristian Rosu Steve Singh Holly Mewhort Nandini Gupta Paul W.M. Fedak 《The Journal of thoracic and cardiovascular surgery》2013
82.
NCE Smith GP Findlay D Weyman H Freeth 《Annals of the Royal College of Surgeons of England》2013,95(2):101-106
Introduction
In 2006 the National Confidential Enquiry into Patient Outcome and Death undertook a large prospective study of trauma care, which revealed several findings pertaining to the management of head injuries in a sample of 493 patients.Methods
Case note data were collected for all trauma patients admitted to all hospitals accepting emergencies in England, Wales, Northern Ireland and the Channel Islands over a three-month period. Severely injured patients with an injury severity score (ISS) of ≥16 were included in the study. The case notes for these patients were peer reviewed by a multidisciplinary group of clinicians, who rated the overall level of care the patient received.Results
Of the 795 patients who met the inclusion criteria for the study, 493 were admitted with a head injury. Room for improvement in the level of care was found in a substantial number of patients (265/493). Good practice was found to be highest in high volume centres. The overall head injury management was found to be satisfactory in 84% of cases (319/381).Conclusions
This study has shown that care for trauma patients with head injury is frequently rated as less than good and suggests potential long-term remedies for the problem, including a reconfiguration of trauma services and better provision of neurocritical care facilities. 相似文献83.
Nagelhout GE Levy DT Blackman K Currie L Clancy L Willemsen MC 《Addiction (Abingdon, England)》2012,107(2):407-416
Aim To develop a simulation model projecting the effect of tobacco control policies in the Netherlands on smoking prevalence and smoking‐attributable deaths. Design, setting and participants Netherlands SimSmoke—an adapted version of the SimSmoke simulation model of tobacco control policy—uses population, smoking rates and tobacco control policy data for the Netherlands to predict the effect of seven types of policies: taxes, smoke‐free legislation, mass media, advertising bans, health warnings, cessation treatment and youth access policies. Measurements Outcome measures were smoking prevalence and smoking‐attributable deaths. Findings With a comprehensive set of policies, as recommended by MPOWER, smoking prevalence can be decreased by as much as 21% in the first year, increasing to a 35% reduction in the next 20 years and almost 40% by 30 years. By 2040, 7706 deaths can be averted in that year alone with the stronger set of policies. Without effective tobacco control policies, almost a million lives will be lost to tobacco‐related diseases between 2011 and 2040. Of those, 145 000 can be saved with a comprehensive tobacco control package. Conclusions Smoking prevalence and smoking‐attributable deaths in the Netherlands can be reduced substantially through tax increases, smoke‐free legislation, high‐intensity media campaigns, stronger advertising bans and health warnings, comprehensive cessation treatment and youth access laws. The implementation of these FCTC/MPOWER recommended policies could be expected to show similar or even larger relative reductions in smoking prevalence in other countries which currently have weak policies. 相似文献
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Catecholamines (epinephrine and norepinephrine) are synthesised and produced by the adrenal medulla and postganglionic nerve
fibres of the sympathetic nervous system. It is known that essential hypertension has a significant neurogenic component,
with the rise in blood pressure mediated at least in part by overactivity of the sympathetic nervous system. Moreover, novel
therapeutic strategies aimed at reducing sympathetic activity show promise in the treatment of hypertension. This article
reviews recent advances within this rapidly changing field, particularly focusing on the role of genetic polymorphisms within
key catecholamine biosynthetic enzymes, cofactors, and storage molecules. In addition, mechanisms linking the sympathetic
nervous system and other adverse cardiovascular states (obesity, insulin resistance, dyslipidaemia) are discussed, along with
speculation as to how recent scientific advances may lead to the emergence of novel antihypertensive treatments. 相似文献
88.
A. M. Aiken J. B. Haddow N. R. A. Symons S. Kaptanis A. C. Katz-Summercorn D. Debnath H. Dent S. Tayeh V. Kung S. Clark J. Gahir S. Dindyal S. Farag A. Lazaridis C. P. Bretherton S. Williams A. Currie H. West J. Davies S. Arora A. Kheraj B. M. Stubbs N. Yassin S. Mallappa G. Garrett S. Hislop A. Bhangu Y. Abbey I. Al-Shoek U. Ahmad G. Sharp A. Memarzadeh A. Patel F. Ali H. Kaderbhai C. H. Knowles 《Hernia》2013,17(5):657-664
Purpose
Evidence regarding whether or not antibiotic prophylaxis is beneficial in preventing post-operative surgical site infection in adult inguinal hernia repair is conflicting. A recent Cochrane review based on 17 randomised trials did not reach a conclusion on this subject. This study aimed to describe the current practice and determine whether clinical equipoise is prevalent.Methods
Surgeons in training were recruited to administer the Survey of Hernia Antibiotic Prophylaxis usE survey to consultant-level general surgeons in London and the south-east of England on their practices and beliefs regarding antibiotic prophylaxis in adult elective inguinal hernia repair. Local prophylaxis guidelines for the participating hospital sites were also determined.Results
The study was conducted at 34 different sites and received completed surveys from 229 out of a possible 245 surgeons, a 93 % response rate. Overall, a large majority of hospital guidelines (22/28) and surgeons’ personal beliefs (192/229, 84 %) supported the use of single-dose pre-operative intravenous antibiotic prophylaxis in inguinal hernia repair, although there was considerable variation in the regimens in use. The most widely used regimen was intravenous co-amoxiclav (1.2 g). Less than half of surgeons were adherent to their own hospital antibiotic guidelines for this procedure, although many incorrectly believed that they were following these.Conclusion
In the south-east of England, there is a strong majority of surgical opinion in favour of the use of antibiotic prophylaxis in this procedure. It is therefore likely to be extremely difficult to conduct further randomised studies in the UK to support or refute the effectiveness of prophylaxis in this commonly performed procedure. 相似文献89.
Ferran Marsa-Sambola Janine Muldoon Joanne Williams Alistair Lawrence Melanie Connor Candace Currie 《Child indicators research》2016,9(1):111-131
This study describes the development of the SAPS and investigates its reliability and validity within the context of the Health Behaviour in School-Aged Children Survey (HBSC) which gathered data on representative samples of school pupils aged 11, 13 and 15 in Scotland and England. In the development of SAPS, following a comprehensive review of the literature, two small-scale empirical studies were carried out (one qualitative and one quantitative). Regarding the validation process, the reliability and validity of the SAPS was assessed in a sub-sample (n?=?7159) of pupils who completed the HBSC survey and were identified as owning pets. Factor analysis resulted in a one-factor solution (explaining 67.78 % of the variance); Cronbach’s alpha for the scale was 0.894. The item-total correlation ranged from 0.368 to 0.784. A linear model showed that attachment to pets was associated with age (being 11 or 13 years old), being a girl, white ethnicity, and considering a pet as one’s own. SAPS scores were also positively associated with quality of life. The total variance in SAPS explained by these variables was 15.7 %. Effect sizes of associations were medium (age, considering a pet as one’s own) and small (ethnicity, age, gender, quality of life). The study concludes that SAPS is a coherent and psychometrically sound measure. It is associated with a range of demographic variables and quality of life, which confirms its utility as a new succinct measure of children’s and young people’s attachment to pets for use in health and social science research. 相似文献
90.