Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 8 de 8
Filter
1.
Abdom Radiol (NY) ; 47(10): 3364-3374, 2022 10.
Article in English | MEDLINE | ID: mdl-35881198

ABSTRACT

OBJECTIVE: To review existing structured MRI reports for primary staging of rectal cancer and create a new, freely available structured report based on multidisciplinary expert opinion and literature review. METHODS: Twenty abdominal imaging experts from the Society of Abdominal Radiology (SAR)'s Disease Focused Panel (DFP) on Rectal and Anal Cancer completed a questionnaire and participated in a subsequent consensus meeting based on the RAND-UCLA Appropriateness Method. Twenty-two items were classified via a group survey as "appropriate" or "inappropriate" (defined by ≥ 70% consensus), or "needs group discussion" (defined by < 70% consensus). Certain items were also discussed with multidisciplinary team members from colorectal surgery, oncology and pathology. RESULTS: After completion of the questionnaire, 16 (72%) items required further discussion (< 70% consensus). Following group discussion, consensus was achieved for 21 (95%) of the items. Based on the consensus meeting, a revised structured report was developed. The most significant modifications included (1) Exclusion of the T2/early T3 category; (2) Replacement of the term "circumferential resection margin (CRM)" with "mesorectal fascia (MRF)"; (3) A revised definition of "mucinous content"; (4) Creation of two distinct categories for suspicious lymph nodes (LNs) and tumor deposits; and (5) Classification of suspicious extra-mesorectal LNs by anatomic location. CONCLUSION: The SAR DFP on Rectal and Anal Cancer recommends using this newly updated reporting template for primary MRI staging of rectal cancer.


Subject(s)
Anus Neoplasms , Rectal Neoplasms , Humans , Anus Neoplasms/diagnostic imaging , Anus Neoplasms/pathology , Magnetic Resonance Imaging/methods , Neoplasm Staging , Rectal Neoplasms/diagnostic imaging , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery
2.
J Can Dent Assoc ; 84: j5, 2019 05.
Article in English | MEDLINE | ID: mdl-31199729

ABSTRACT

BACKGROUND: Early childhood dental decay or caries (ECC) is common, often painful and costly to the health care system, yet it is largely preventable. A public health approach is needed, especially as socially vulnerable children most at risk for ECC are less likely to access conventional treatment. Exposure to intimate partner violence (IPV) in the family represents an important social vulnerability for children, yet little is known about ECC in this context. We explored the relation between ECC and exposure to IPV as well as opportunities for community-based early interventions to prevent ECC. METHODS: We searched 5 electronic databases. All primary research and reviews that focused on childhood decay and exposure to IPV or that referred to community settings (specifically women's shelters) for oral health service delivery were included. RESULTS: Of 198 unique documents identified, 12 were included in the analysis. Although limited, our findings suggest a positive relation between exposure to IPV and ECC, the mechanisms of which are not well studied. Women's-shelter-based prevention programs may hold promise in terms of detecting and addressing ECC. Over the time frame of the literature reviewed, we observed a subtle shift in emphasis away from individual behaviours and biological models toward upstream societal structures. CONCLUSIONS: The available literature suggests that the issue of ECC and IPV may be poised to embrace a public health approach to early intervention, characterized by community collaboration, interprofessional cooperation between dentistry and social work and an equitable approach to ECC in a socially vulnerable group.


Subject(s)
Dental Caries , Intimate Partner Violence , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Public Health
3.
Article in English | MEDLINE | ID: mdl-28674055

ABSTRACT

Open-access drug discovery provides a substantial resource for diseases primarily affecting the poor and disadvantaged. The open-access Pathogen Box collection is comprised of compounds with demonstrated biological activity against specific pathogenic organisms. The supply of this resource by the Medicines for Malaria Venture has the potential to provide new chemical starting points for a number of tropical and neglected diseases, through repurposing of these compounds for use in drug discovery campaigns for these additional pathogens. We tested the Pathogen Box against kinetoplastid parasites and malaria life cycle stages in vitro Consequently, chemical starting points for malaria, human African trypanosomiasis, Chagas disease, and leishmaniasis drug discovery efforts have been identified. Inclusive of this in vitro biological evaluation, outcomes from extensive literature reviews and database searches are provided. This information encompasses commercial availability, literature reference citations, other aliases and ChEMBL number with associated biological activity, where available. The release of this new data for the Pathogen Box collection into the public domain will aid the open-source model of drug discovery. Importantly, this will provide novel chemical starting points for drug discovery and target identification in tropical disease research.


Subject(s)
Antimalarials/pharmacology , Malaria/drug therapy , Cell Line , Chagas Disease/drug therapy , Drug Discovery/methods , HEK293 Cells , Humans , Leishmaniasis/drug therapy , Neglected Diseases/drug therapy , Trypanosomiasis, African/drug therapy
4.
Trials ; 14: 81, 2013 Mar 20.
Article in English | MEDLINE | ID: mdl-23514100

ABSTRACT

BACKGROUND: Effective programs to help children manage their weight are required. Families for Health focuses on a parenting approach, designed to help parents develop their parenting skills to support lifestyle change within the family. Families for Health V1 showed sustained reductions in overweight after 2 years in a pilot evaluation, but lacks a randomized controlled trial (RCT) evidence base. METHODS/DESIGN: This is a multi-center, investigator-blind RCT, with parallel economic evaluation, with a 12-month follow-up. The trial will recruit 120 families with at least one child aged 6 to 11 years who is overweight (≥91st centile BMI) or obese (≥98th centile BMI) from three localities and assigned randomly to Families for Health V2 (60 families) or the usual care control (60 families) groups. Randomization will be stratified by locality (Coventry, Warwickshire, Wolverhampton).Families for Health V2 is a family-based intervention run in a community venue. Parents/carers and children attend parallel groups for 2.5 hours weekly for 10 weeks. The usual care arm will be the usual support provided within each NHS locality.A mixed-methods evaluation will be carried out. Child and parent participants will be assessed at home visits at baseline, 3-month (post-treatment) and 12-month follow-up. The primary outcome measure is the change in the children's BMI z-scores at 12 months from the baseline. Secondary outcome measures include changes in the children's waist circumference, percentage body fat, physical activity, fruit/vegetable consumption and quality of life. The parents' BMI and mental well-being, family eating/activity, parent-child relationships and parenting style will also be assessed.Economic components will encompass the measurement and valuation of service utilization, including the costs of running Families for Health and usual care, and the EuroQol EQ-5D health outcomes. Cost-effectiveness will be expressed in terms of incremental cost per quality-adjusted life year gained. A de novo decision-analytic model will estimate the lifetime cost-effectiveness of the Families for Health program.Process evaluation will document recruitment, attendance and drop-out rates, and the fidelity of Families for Health delivery. Interviews with up to 24 parents and children from each arm will investigate perceptions and changes made. DISCUSSION: This paper describes our protocol to assess the effectiveness and cost-effectiveness of a parenting approach for managing childhood obesity and presents challenges to implementation. TRIAL REGISTRATION: Current Controlled Trials http://ISRCTN45032201.


Subject(s)
Child Health Services/economics , Health Care Costs , Obesity/therapy , Parenting , Research Design , Risk Reduction Behavior , Age Factors , Body Mass Index , Child , Clinical Protocols , Cost-Benefit Analysis , Diet/adverse effects , England , Exercise , Feeding Behavior , House Calls , Humans , Mental Health , Obesity/diagnosis , Obesity/economics , Obesity/physiopathology , Obesity/psychology , Parent-Child Relations , Quality of Life , Quality-Adjusted Life Years , Time Factors , Treatment Outcome , Weight Loss
5.
Best Pract Res Clin Endocrinol Metab ; 19(3): 441-54, 2005 Sep.
Article in English | MEDLINE | ID: mdl-16150385

ABSTRACT

Childhood obesity is a complex disease with different genetic, metabolic, environmental and behavioural components that are interrelated and potentially confounding, thus making causal pathways difficult to define. Given the tracking of obesity and the associated risk factors, childhood is an important period for prevention. To date, evidence would support preventative interventions that encourage physical activity and a healthy diet, restrict sedentary activities and offer behavioural support. However, these interventions should involve not only the child but the whole family, school and community. If the current global obesity epidemic is to be halted, further large-scale, well-designed prevention studies are required, particularly within settings outside of the USA, in order to expand the currently limited evidence base upon which clinical recommendations and public health approaches can be formulated. This must be accompanied by enhanced monitoring of paediatric obesity prevalence and continued support from all stakeholders at global, national, regional and local levels.


Subject(s)
Child Nutritional Physiological Phenomena , Health Promotion , Obesity/prevention & control , Child , Child, Preschool , Family Health , Feeding Behavior , Health Policy , Humans , Motor Activity , Obesity/epidemiology , United Kingdom , United States
6.
Proc Nutr Soc ; 62(3): 577-81, 2003 Aug.
Article in English | MEDLINE | ID: mdl-14692592

ABSTRACT

Obesity is a serious health issue. In the UK the prevalence of obesity has trebled in the last 20 years and today one in five adults is clinically obese. Research shows that obesity is a predictable response to an environment that favours the consumption of energy-dense foods and allows minimal physical activity. This finding implies that the efficacy of public health messages to individuals to inform their lifestyle choices will be enhanced by environmental changes that support and facilitate healthy options. The present paper focuses on the importance of communicating scientific knowledge to the stakeholders with a responsibility for tackling obesity and addresses some of the barriers that are encountered.


Subject(s)
Communication , Energy Intake , Health Promotion/methods , Obesity/epidemiology , Obesity/prevention & control , Adult , Environment , Exercise , Female , Humans , Life Style , Male , Prevalence , Public Health , Risk Factors , United Kingdom/epidemiology
7.
Proc Nutr Soc ; 62(1): 123-7, 2003 Feb.
Article in English | MEDLINE | ID: mdl-14631985

ABSTRACT

Regular consumption of whole grain foods has been associated with a reduction in the incidence of cardiovascular disease and diabetes, reductions in cancer mortality at certain sites and an overall reduction in premature death. Although benefits are observed at relatively low levels of intake (between two and three servings per d), the consumption of whole grain foods in some Western countries is less than one serving per d. The main sources of whole grain are wholemeal and rye breads and whole grain breakfast cereals. Typical consumers of wholegrain foods tend to be older, from a high socio-economic group, are less likely to smoke and are more likely to exercise than non-consumers. Some of these attributes may contribute to the observed health benefits. However whole grain foods are an important source of a range of nutrients as part of a healthy eating plan. There is considerable scope for strategies to promote increased consumption of whole grain foods to reduce the risk of a variety of chronic diseases.


Subject(s)
Dietary Fiber/administration & dosage , Edible Grain , Food Preferences , Adolescent , Adult , Age Factors , Aged , Female , Health Promotion , Humans , Male , Middle Aged , Sex Factors , United Kingdom
8.
Public Health Nutr ; 6(5): 479-84, 2003 Aug.
Article in English | MEDLINE | ID: mdl-12943564

ABSTRACT

OBJECTIVE: To assess the consumption of whole-grain foods in different age and sociodemographic groups in Great Britain, using data from two national surveys. DESIGN: Cross-sectional analysis of the consumption of whole-grain foods. SETTING: The 1986-87 Dietary and Nutritional Survey of British Adults and the 1994-95 National Diet and Nutrition Survey of people aged 65 years and over. SUBJECTS: In 1986-87, 2086 British adults aged 16-64 years; 1189 British adults aged 65 years and over in 1994-95. RESULTS: In the 1986-87 survey population, consumption of whole-grain foods increased with age. Median consumption of whole-grain foods was 1 serving per week in 16-24-year-olds and 3 servings per week in the 35-64-year-olds In 1994-95, median consumption was 5 servings per week in adults aged 65 years and over. Overall, one-third of British adults ate no whole-grain foods on a daily basis, and less than 5% ate 3 or more servings per day. Manual occupation and smoking were consistently associated with a higher proportion of non-consumers and fewer servings per week of whole-grain foods, independent of age, sex, region and season (each ). The main sources of whole-grain foods were wholemeal bread and breakfast cereals, which accounted for more than three-quarters of all servings. CONCLUSIONS: Consumption of whole-grain foods in the adult UK populations is more prevalent in the non-smoking, higher socio-economic groups. Amongst consumers of whole-grain foods, the frequency is similar to that reported in the USA and Norway.


Subject(s)
Edible Grain , Feeding Behavior , Adolescent , Adult , Age Distribution , Aged , Cross-Sectional Studies , Diet , Diet Surveys , Female , Humans , Male , Middle Aged , Nutrition Surveys , Smoking , Socioeconomic Factors , United Kingdom
SELECTION OF CITATIONS
SEARCH DETAIL
...