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Ann R Coll Surg Engl ; 102(1): 3-8, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31858833


INTRODUCTION: Achieving a standard of clinical research at the pinnacle of the evidence pyramid is historically expensive and logistically challenging. Research collaboratives have delivered high-impact prospective multicentre audits and clinical trials by using trainee networks with a range of enabling technology. This review outlines such use of technology in the UK and provides a framework of recommended technologies for future studies. METHODS: A review of the literature identified technology used in collaborative projects. Additional technologies were identified through web searches. Technologies were grouped into themes including access (networking and engagement), collaboration and event organisation. The technologies available to support each theme were studied further to outline relative benefits and limitations. FINDINGS: Thirty-three articles from trainee research collaboratives were identified. The most frequently documented technologies were social media applications, website platforms and research databases. The Supportive Technologies in Collaborative Research framework is proposed, providing a structure for using the technologies available to support multicentre collaboration. Such technologies are often overlooked in the literature by established and start-up collaborative project groups. If used correctly, they might help to overcome the physical, logistical and financial barriers of multicentre clinical trials.

Pesquisa Biomédica/métodos , Tecnologia Biomédica/métodos , Comportamento Cooperativo , Relações Interprofissionais , Ensaios Clínicos como Assunto , Comunicação , Cirurgia Geral/educação , Humanos , Internet , Redes Sociais Online , Estudantes de Medicina
Med Mycol ; 57(1): 23-29, 2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29390156


In Northern Ireland there are concerns about candidaemia, with rates higher than those reported in England and Wales. Our aim was to explore the epidemiology of candidaemia during a 10 year period and the clinical management upon suspicion of cases during a one year enhanced investigation in Northern Ireland.Candidaemia reports to the Public Health Agency were validated during 2002-2011 and used to examine incidence and antifungal sensitivity trends (during 2007-2011). A clinical proforma was used to collate information for all patients with candidaemia in 2011.The majority (96%) of isolates were captured through voluntary laboratory reporting. There was a year-on-year increase in candidaemia from 2002-2011, from 80 to 131 episodes (incidence rate ratio 1.09 95% CI 1.05-1.13). Rates were highest in males under 1 year and over 75 years. 83/98 (85%) of case notes were available from candidaemia patients during 2011. The most prevalent risk factors were patients on total parenteral nutrition (26 people, 31.3%), surgery in the two months prior to the candidaemia (25 people, 30.1%), significant steroid use in the previous 3 months (24 people, 28.9%) and active neoplastic disease (23 people, 27.7%),This study confirmed an increase in candidaemia rates over time, with the observed incidence in 2011 higher than England and Wales. We identified areas for improvement around the clinical management of candidaemia. We recommend raising the awareness of guidelines for fundoscopy, echocardiography and central venous catheter removal.

Antifúngicos/uso terapêutico , Candidemia/tratamento farmacológico , Candidemia/epidemiologia , Antifúngicos/farmacologia , Candida/classificação , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candidemia/prevenção & controle , Bases de Dados Factuais , Feminino , Humanos , Incidência , Masculino , Testes de Sensibilidade Microbiana/estatística & dados numéricos , Testes de Sensibilidade Microbiana/tendências , Irlanda do Norte/epidemiologia , Estudos Retrospectivos , Fatores de Risco
Ann Med Surg (Lond) ; 33: 1-6, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30094024


Background: Advances in digital technology hold promise in expanding the clinical and consumer applications of facial electromyography (EMG) through thedevelopment of wireless pervasive systems capable of operating in a nonclinical environment. This systematic review aims to appraise the most commonly reported limitations of the technology in clinical research and practice. Methods: A systematic search for clinical facial EMG literature was performed using MEDLINE, EMBASE, PsychINFO and CINAHL. No language limits were applied. Search results were screened using defined criteria by two authors with disagreements resolved by a third. Practical limitations in the technology, as reported by the authors, were recorded and characterised using recurrent theme analysis. Results: A total of 4,983 records were identified. Of those, 1,061 articles met eligibility criteria and were subsequently reviewed. In the medical domain, the most common area of application was in psychosocial studies (28% of medical studies); in the surgical domain monitoring of facial nerve integrity was the most common application of facial electromyography (27% of surgical studies). Collectively, the three most commonly reported limitations were motion artefact (13.7%), inter-subject variability in response and anatomy (13.1%), and muscle crosstalk (12.0%). Conclusions: This is the first study to evaluate the limitations of facial EMG using a systematic analysis of author reports. Highlighting technology limitations in this non-biased manner raises awareness to users key issues and reliably informs the development of future systems.

Int J Food Sci Nutr ; 67(5): 553-61, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27144647


This study investigated the cross-sectional association between an anti-inflammatory and anti-oxidant dietary pattern and diabetes in the national diet and nutrition survey (NDNS) rolling programme years 1-4. A total of 1531 survey members provided dietary data. Reduced Rank Regression (RRR) was used to derive an anti-inflammatory and anti-oxidant dietary pattern. Serum C-reactive protein (CRP) and plasma carotenoids were selected as response variables and markers of inflammation and antioxidant status, respectively. Overall, 52 survey members had diabetes. The derived anti-inflammatory and anti-oxidant dietary pattern was inversely related to CRP and positively to carotenoids. It was associated with lower odds of diabetes (multivariate adjusted OR for highest compared with lowest quintile: 0.17; 95%CI: 0.04-0.73; p for linear trend = 0.013). In conclusion, an anti-inflammatory and anti-oxidant dietary pattern is inversely related to diabetes. Further research is required to understand the overall framework within which foods and nutrients interact to affect metabolic pathways related to diabetes risk.

Antioxidantes/administração & dosagem , Diabetes Mellitus Tipo 2/prevenção & controle , Dieta , Inquéritos Nutricionais , Adulto , Biomarcadores/sangue , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , Carotenoides/sangue , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Feminino , Humanos , Inflamação/sangue , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Estresse Oxidativo/efeitos dos fármacos , Circunferência da Cintura
J Hosp Infect ; 82(2): 125-8, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22947650


The morbidity and mortality associated with Clostridium difficile ribotype 078 were examined by comparison with other known outbreak strains. A healthcare interaction within eight weeks of a positive specimen significantly increased the likelihood of ribotype 078 compared with ribotype 027. Individuals with ribotype 078 also tended to come from community sources, have a hospital stay post specimen similar to ribotype 027 and a lower 30-day mortality, but these differences were not statistically significant. This study generates several hypotheses and a methodological platform to explore this unique profile.

Infecções por Clostridium/epidemiologia , Infecções por Clostridium/mortalidade , Clostridium difficile/classificação , Clostridium difficile/isolamento & purificação , Ribotipagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Clostridium difficile/genética , Clostridium difficile/patogenicidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Sobrevida , Adulto Jovem