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Article ; Online: Will children reveal their secret? The coronavirus dilemma.

Porter, George James

2020 Volume 55, Issue 6

MeSH term(s)	Child ; Coronavirus ; Humans
Keywords	covid19
Language	English
Publishing date	2020-06-25
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/13993003.01382-2020
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Article ; Online: Should lockdown be based on age rather than geography?

Porter, George James

Public health

2020 Volume 196, Page(s) e1

MeSH term(s)	COVID-19 ; Geography ; Humans
Language	English
Publishing date	2020-12-29
Publishing country	Netherlands
Document type	Letter ; Comment
ZDB-ID	427333-3
ISSN	1476-5616 ; 0033-3506
ISSN (online)	1476-5616
ISSN	0033-3506
DOI	10.1016/j.puhe.2020.10.033
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Article: Will children reveal their secret? The coronavirus dilemma

Porter, George James

Eur. respir. j

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32398300
Database	COVID19

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Article ; Online: Optimizing the Threshold to Treat Children for Latent Tuberculosis Infection: A North-East England Experience.

Porter, George James / Whyte, Martin / Walters, Elisabetta Ghimenton / Owens, Stephen

The Pediatric infectious disease journal

2022 Volume 42, Issue 3, Page(s) e88–e89

Abstract: We assessed the impact of the updated guidelines on tuberculin skin test interpretation in the North East of England. Data on 241 children screened for latent tuberculosis infection (LTBI) between January 2011 and July 2018 were analyzed; 12.4% of ... ...

Abstract	We assessed the impact of the updated guidelines on tuberculin skin test interpretation in the North East of England. Data on 241 children screened for latent tuberculosis infection (LTBI) between January 2011 and July 2018 were analyzed; 12.4% of children screened under the previous guidelines were treated for LTBI, compared to 33.3% under the new ones ( P < 0.001).
MeSH term(s)	Humans ; Child ; Latent Tuberculosis ; Tuberculin Test ; England ; Interferon-gamma Release Tests
Language	English
Publishing date	2022-11-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	392481-6
ISSN	1532-0987 ; 0891-3668
ISSN (online)	1532-0987
ISSN	0891-3668
DOI	10.1097/INF.0000000000003786
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Article ; Online: A systematic review of qualitative literature on antimicrobial stewardship in Sub-Saharan Africa.

Porter, George James / Owens, Stephen / Breckons, Matthew

Global health research and policy

2021 Volume 6, Issue 1, Page(s) 31

Abstract: Background: Antibiotic resistance is a major problem in every region of the globe and Sub-Saharan Africa (SSA) is no exception. Several systematic reviews have addressed the prevalence of resistant organisms but few have examined the underlying causes ... ...

Abstract	Background: Antibiotic resistance is a major problem in every region of the globe and Sub-Saharan Africa (SSA) is no exception. Several systematic reviews have addressed the prevalence of resistant organisms but few have examined the underlying causes in this region. This systematic review of qualitative literature aims to highlight barriers and facilitators to antimicrobial stewardship in SSA. Methods: A literature search of Embase and MEDLINE(R) was carried out. Studies were included if they were in English, conducted in SSA, and reported qualitative data on the barriers and facilitators of antimicrobial stewardship or on attitudes towards resistance promoting behaviours. Studies were screened with a simple critical appraisal tool. Secondary constructs were extracted and coded into concepts, which were then reviewed and grouped into themes in light of the complete dataset. Results: The literature search yielded 169 results, of which 14 studies from 11 countries were included in the final analysis. No studies were excluded as a result of the critical appraisal. Eight concepts emerged from initial coding, which were consolidated into five major themes: ineffective regulation, health system factors, clinical governance, patient factors and lack of resources. The ineffective regulation theme highlighted the balance between tightening drugstore regulation, reducing over-the-counter sale of antibiotics, and maintaining access to medicines for rural communities. Meanwhile, health system factors explored the tension between antimicrobial stewardship and the need of pharmacy workers to maintain profitable businesses. Additionally, a lack of resources, actions by patients and the day-to-day challenges of providing healthcare were shown to directly impede antimicrobial stewardship and exacerbate other factors which promote resistance. Conclusion: Antibiotic resistance in SSA is a multi-faceted issue and while limited resources contribute to the problem they should be viewed in the context of other factors. We identify several contextual factors that affect resistance and stewardship that should be considered by policy makers when planning interventions. This literature base is also incomplete, with only 11 nations accounted for and many studies being confined to regions within countries, so more research is needed. Specifically, further studies on implementing stewardship interventions, successful or not, would be beneficial to inform future efforts.
MeSH term(s)	Antimicrobial Stewardship ; Delivery of Health Care ; Drug Resistance, Microbial ; Health Facilities ; Humans ; Pharmacies
Language	English
Publishing date	2021-08-20
Publishing country	England
Document type	Journal Article ; Review ; Systematic Review
ISSN	2397-0642
ISSN (online)	2397-0642
DOI	10.1186/s41256-021-00216-0
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Article ; Online: A systematic review of qualitative literature on antimicrobial stewardship in Sub-Saharan Africa

George James Porter / Stephen Owens / Matthew Breckons

Global Health Research and Policy, Vol 6, Iss 1, Pp 1-

2021 Volume 11

Abstract: Abstract Background Antibiotic resistance is a major problem in every region of the globe and Sub-Saharan Africa (SSA) is no exception. Several systematic reviews have addressed the prevalence of resistant organisms but few have examined the underlying ... ...

Abstract	Abstract Background Antibiotic resistance is a major problem in every region of the globe and Sub-Saharan Africa (SSA) is no exception. Several systematic reviews have addressed the prevalence of resistant organisms but few have examined the underlying causes in this region. This systematic review of qualitative literature aims to highlight barriers and facilitators to antimicrobial stewardship in SSA. Methods A literature search of Embase and MEDLINE(R) was carried out. Studies were included if they were in English, conducted in SSA, and reported qualitative data on the barriers and facilitators of antimicrobial stewardship or on attitudes towards resistance promoting behaviours. Studies were screened with a simple critical appraisal tool. Secondary constructs were extracted and coded into concepts, which were then reviewed and grouped into themes in light of the complete dataset. Results The literature search yielded 169 results, of which 14 studies from 11 countries were included in the final analysis. No studies were excluded as a result of the critical appraisal. Eight concepts emerged from initial coding, which were consolidated into five major themes: ineffective regulation, health system factors, clinical governance, patient factors and lack of resources. The ineffective regulation theme highlighted the balance between tightening drugstore regulation, reducing over-the-counter sale of antibiotics, and maintaining access to medicines for rural communities. Meanwhile, health system factors explored the tension between antimicrobial stewardship and the need of pharmacy workers to maintain profitable businesses. Additionally, a lack of resources, actions by patients and the day-to-day challenges of providing healthcare were shown to directly impede antimicrobial stewardship and exacerbate other factors which promote resistance. Conclusion Antibiotic resistance in SSA is a multi-faceted issue and while limited resources contribute to the problem they should be viewed in the context of other factors. We ...
Keywords	Sub-Saharan Africa ; Antibiotic resistance ; Antibiotic stewardship ; Public health ; Global health ; Qualitative synthesis ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Reporting quality of surgical randomised controlled trials in head and neck cancer: a systematic review.

Canagarajah, Netanya Aarabi / Porter, George James / Mitra, Kurchi / Chu, Timothy Shun Man

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

2021 Volume 278, Issue 11, Page(s) 4125–4133

Abstract: Purpose: Randomised controlled trials (RCTs) are considered the gold standard for evaluating the efficacy of an intervention. However, previous research has shown that RCTs in several surgical specialities are poorly reported, making it difficult to ... ...

Abstract	Purpose: Randomised controlled trials (RCTs) are considered the gold standard for evaluating the efficacy of an intervention. However, previous research has shown that RCTs in several surgical specialities are poorly reported, making it difficult to ascertain if various biases have been appropriately minimised. This systematic review assesses the reporting quality of surgical head and neck cancer RCTs. Methods: A literature search of PubMed and Embase was performed. Papers were included if they reported RCTs which assessed a surgical technique used to treat or diagnose head and neck cancer published during or after 2011. The CONSORT 2010 checklist was used to evaluate the reporting quality of these trials. Results: 41 papers were included. The mean CONSORT score was 16.5/25 (66% adherence) and the scores ranged from 7.5 (30%) to 25. The most common omissions were full trial protocol (found in 14.6%), participant recruitment method (22%) and effect size with a precision estimate for all outcome measures (29.3%). The full design and implementation of the randomisation methods were reported in 6 (14.6%). Papers published in journals which endorsed CONSORT had significantly higher scores (p = 0.02) and the journal impact factor was significantly correlated with CONSORT score (p = 0.01). Conclusion: We have identified several pieces of information that are underreported in surgical head and neck cancer RCTs. These omissions make understanding and comparing the methodologies and conclusions of RCTs more difficult. The endorsement of CONSORT by journals improved adherence, suggesting that wider adoption of the checklist may improve reporting.
MeSH term(s)	Checklist ; Head and Neck Neoplasms/surgery ; Humans ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2021-02-19
Publishing country	Germany
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	1017359-6
ISSN	1434-4726 ; 0937-4477
ISSN (online)	1434-4726
ISSN	0937-4477
DOI	10.1007/s00405-021-06694-9
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Article: Evaluating the Current State of Epilepsy Care in the Province of Ontario.

Van Winssen, Christine / Andrade, Andrea V / Andrade, Danielle M / Burneo, Jorge G / de Ribaupierre, Sandrine / Donner, Elizabeth / Hassan, Ayman / Ibrahim, George / Jones, Kevin C / Lomax, Lysa Boissé / Muir, Katherine / Nouri, Maryam N / Porter, Nikki / Ramachandrannair, Rajesh / Raymond, Paul / Rutka, James / Shapiro, Michelle J / Steven, David A / Swain, Darryl /

Valiante, Taufik / Whiting, Sharon / Whitney, Robyn / Yau, Ivanna / Fantaneanu, Tadeu A

The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques

2024 , Page(s) 1–3

Abstract: There are numerous challenges pertaining to epilepsy care across Ontario, including Epilepsy Monitoring Unit (EMU) bed pressures, surgical access and community supports. We sampled the current clinical, community and operational state of Ontario epilepsy ...

Abstract	There are numerous challenges pertaining to epilepsy care across Ontario, including Epilepsy Monitoring Unit (EMU) bed pressures, surgical access and community supports. We sampled the current clinical, community and operational state of Ontario epilepsy centres and community epilepsy agencies post COVID-19 pandemic. A 44-item survey was distributed to all 11 district and regional adult and paediatric Ontario epilepsy centres. Qualitative responses were collected from community epilepsy agencies. Results revealed ongoing gaps in epilepsy care across Ontario, with EMU bed pressures and labour shortages being limiting factors. A clinical network advising the Ontario Ministry of Health will improve access to epilepsy care.
Language	English
Publishing date	2024-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	197622-9
ISSN	0317-1671
ISSN	0317-1671
DOI	10.1017/cjn.2024.30
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Article ; Online: Health and socioeconomic resource provision for older people in South Asian countries

Natasha Roya Matthews / George James Porter / Mathew Varghese / Nidesh Sapkota / Murad Moosa Khan / Ammu Lukose / Stella-Maria Paddick / Malathie Dissanayake / Naila Zaman Khan / Richard Walker

Global Health Action, Vol 16, Iss

Bangladesh, India, Nepal, Pakistan and Sri Lanka evidence from NEESAMA

2023 Volume 1

Abstract: Background The global population is ageing rapidly, with low- and middle-income countries (LMICs) undergoing a fast demographic transition. As the number of older adults in LMICs increases, services able to effectively address their physical and mental ... ...

Abstract	Background The global population is ageing rapidly, with low- and middle-income countries (LMICs) undergoing a fast demographic transition. As the number of older adults in LMICs increases, services able to effectively address their physical and mental health needs will be increasingly important. Objective We review the health and socioeconomic resources currently available for older people in South Asian countries, Bangladesh, India, Nepal, Pakistan and Sri Lanka, to identify gaps in available resources and assess areas for improvement. Methods We conducted a search of grey and published literature via Google Search, Compendex, EBSCO, JSTOR, Medline, Ovid, ProQuest databases, Scopus and Web of Science. Data on population demographics, human resources, health funding and social protection for older people were extracted. Local informants were consulted to supplement and verify the data. Results In the study countries, the number of health professionals with expertise in elderly care was largely unknown, with minimal postgraduate training programmes available in elderly medicine or psychiatry. Older adults are therefore cared for by general physicians, nurses and community health workers, all of whom are present in insufficient numbers per capita. Total average healthcare expenditure was 2.5–5.5% of GDP, with 48.1–72.0% of healthcare costs covered by out-of-pocket payments. Pakistan did not have a social pension; only India and Nepal offered financial assistance to people with dementia; and all countries had disproportionately low numbers of care elderly homes. Conclusions Inadequate healthcare funding, a shortage of healthcare professionals and insufficient government pension and social security schemes are significant barriers to achieving universal health coverage in LMICs. Governing bodies must expand training programmes for healthcare providers for older adults, alongside increasing social protection to improve access to those in need and to prevent catastrophic health expenditure.
Keywords	ageing ; elderly health ; mental health ; social care ; south asia ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Health and socioeconomic resource provision for older people in South Asian countries: Bangladesh, India, Nepal, Pakistan and Sri Lanka evidence from NEESAMA.

Matthews, Natasha Roya / Porter, George James / Varghese, Mathew / Sapkota, Nidesh / Khan, Murad Moosa / Lukose, Ammu / Paddick, Stella-Maria / Dissanayake, Malathie / Khan, Naila Zaman / Walker, Richard

Global health action

2022 Volume 16, Issue 1, Page(s) 2110198

Abstract: Background: The global population is ageing rapidly, with low- and middle-income countries (LMICs) undergoing a fast demographic transition. As the number of older adults in LMICs increases, services able to effectively address their physical and mental ...

Abstract	Background: The global population is ageing rapidly, with low- and middle-income countries (LMICs) undergoing a fast demographic transition. As the number of older adults in LMICs increases, services able to effectively address their physical and mental health needs will be increasingly important. Objective: We review the health and socioeconomic resources currently available for older people in South Asian countries, Bangladesh, India, Nepal, Pakistan and Sri Lanka, to identify gaps in available resources and assess areas for improvement. Methods: We conducted a search of grey and published literature via Google Search, Compendex, EBSCO, JSTOR, Medline, Ovid, ProQuest databases, Scopus and Web of Science. Data on population demographics, human resources, health funding and social protection for older people were extracted. Local informants were consulted to supplement and verify the data. Results: In the study countries, the number of health professionals with expertise in elderly care was largely unknown, with minimal postgraduate training programmes available in elderly medicine or psychiatry. Older adults are therefore cared for by general physicians, nurses and community health workers, all of whom are present in insufficient numbers per capita. Total average healthcare expenditure was 2.5-5.5% of GDP, with 48.1-72.0% of healthcare costs covered by out-of-pocket payments. Pakistan did not have a social pension; only India and Nepal offered financial assistance to people with dementia; and all countries had disproportionately low numbers of care elderly homes. Conclusions: Inadequate healthcare funding, a shortage of healthcare professionals and insufficient government pension and social security schemes are significant barriers to achieving universal health coverage in LMICs. Governing bodies must expand training programmes for healthcare providers for older adults, alongside increasing social protection to improve access to those in need and to prevent catastrophic health expenditure.
MeSH term(s)	Humans ; Aged ; Pakistan ; Bangladesh ; Sri Lanka ; Nepal ; South Asian People ; India ; Socioeconomic Factors
Language	English
Publishing date	2022-12-20
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2540569-X
ISSN	1654-9880 ; 1654-9880
ISSN (online)	1654-9880
ISSN	1654-9880
DOI	10.1080/16549716.2022.2110198
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