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Article: Prognostic significance of Deprivation on Esophago-Gastro-Duodenoscopy (EGD) outcome

Eley, Catherine / Hawkes, Neil D / Barlow, Emma / Egan, Richard John / Lewis, Wyn

2024

Abstract: Introduction: Socio-Economic Deprivation has long been associated with many gastrointestinal diseases yet its influence on esophago-gastro-duodenoscopy (EGD) diagnosis has not been evaluated. The aim of this study was to investigate the influence of ... ...

Abstract	Introduction: Socio-Economic Deprivation has long been associated with many gastrointestinal diseases yet its influence on esophago-gastro-duodenoscopy (EGD) diagnosis has not been evaluated. The aim of this study was to investigate the influence of deprivation on outcomes of EGD irrespective of referral reason. Method: Two-thousand consecutive patients presenting to four Health Boards in Wales from June 2019 were studied retrospectively with deprivation scores calculated using the Wales Indices of Multiple Deprivation (WIMD). Patients were sub-classified into quintiles for analysis (Q1 most, Q5 least Deprived). Results: Inhabitants of the most deprived areas were more likely to be diagnosed with Peptic Ulcer (Q1 7.9%, Q5 4.7%; OR 0.498, p=0.018), Severe Esophagitis (LA4, Q1 2.7% v Q5 0%, OR 0.089, p=0.002), Helicobacter Pylori infection (Q1 5.4%, Q5 1.7%; OR 0.284, p=0.002), but less likely to be diagnosed with Barrett’s Eesophagus (Q1 6.3% v Q5 12.3%, OR 2.146, p=0.004) than those from least deprived areas. New cancer diagnoses numbered 53 and were proportionately higher after Urgent Suspected Cancer (USC, n=35, 4.6%) than routine referral (n=3, 0.6%, p<0.001). Deprivation was associated with more advanced staged cancer (stage III Q1 16.7% v Q5 5.6%, OR 0.997, p=0.006: stage IV Q1 16.7% v Q2 38.9% v Q5 22.2%, OR 0.998, p=0.049). Conclusion: Deprivation was associated with two-fold more peptic ulcer disease, three-fold more Helicobacter Pylori infection, and 12-fold more severe esophagitis, and more advanced cancer stage.
Language	English
Publishing date	2024-04-02
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2761052-4
ISSN	2196-9736 ; 2364-3722 ; 2196-9736
ISSN (online)	2196-9736
ISSN	2364-3722 ; 2196-9736
DOI	10.1055/a-2297-9905
Database	Thieme publisher's database

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Article: The impact of COVID-19 on dynamic hip screw fixation and training.

Barlow, Emma / Larsen, Matthew P / Vijayasurej, Kerrin / Burczy, Michal / Burczy, Jacek / Mullins, Mark

Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego

2021 Volume 49, Issue 292, Page(s) 273–277

Abstract: COVID-19 has had a profound impact on orthopaedic services and surgical training.: Aim: This study aims to identify changes in lag screw position and Tip Apex Distance (TAD) in dynamic hip screw fixation due to changes in practice during the ... ...

Abstract	COVID-19 has had a profound impact on orthopaedic services and surgical training. Aim: This study aims to identify changes in lag screw position and Tip Apex Distance (TAD) in dynamic hip screw fixation due to changes in practice during the coronavirus pandemic and determine whether the changes resulted in improved patient outcomes and enhanced training opportunities. Materials and methods: Retrospective evaluation of two patient cohorts - pre-covid (n=27) and during covid (n=26) - to evaluate the TAD and lag screw position for each patient and record the grade of operating surgeon. A total of 53 patients were included. Results: A mean TAD of 19.78mm and 19.80mm was calculated for cohort 1 and 2 respectively with no significant difference identified. When considering both key risk factors for lag screw cut-out (lag screw position and TAD) the number of patients with both a "satisfactory position" of the screw and a TAD <20mm, were 8/27 (29.6%) and 11/26 (42.3%), respectively. In cohort 1 3/27 cases had a consultant documented as the primary surgeon, while no consultants were documented as being present for the remaining 24 cases. 21/26 cases in cohort 2 had a consultant present some capacity, either as primary surgeon (15/21) or assistant (6/21). Conclusions: Changes in practice due to the pandemic have had some positive effects for both patients and trainees. This study has highlighted the importance of Consultant led trauma lists for improving training and surgical outcomes with a demonstrated improvement when considering both key factors associated with screw cut-out together. Ultimately some of the changes in practice should be continued in the post-covid era.
MeSH term(s)	Bone Screws ; COVID-19 ; Fracture Fixation, Intramedullary ; Hip Fractures ; Humans ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2021-08-31
Publishing country	Poland
Document type	Journal Article
ZDB-ID	1388406-2
ISSN	1426-9686
ISSN	1426-9686
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Article ; Online: Gender divergence: scoping the surgical gap.

Mellor, Katie / Barlow, Emma / Barber, Zoe / Walsh, Leona / Egan, Richard J / Lewis, Wyn G / Hemington-Gorse, Sarah

The British journal of surgery

2022 Volume 110, Issue 3, Page(s) 297–298

MeSH term(s)	Humans ; Gender Equity ; General Surgery
Language	English
Publishing date	2022-10-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znac430
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Article ; Online: Enhanced Stress Resilience Training for UK Surgical Trainees; Effect and Evolution Evaluated.

Luton, Oliver W / James, Osian P / Mellor, Katie / Eley, Catherine / Hopkins, Luke / Robinson, David B T / Barlow, Emma / Lebares, Carter C / Lewis, Wyn G / Egan, Richard J

Journal of surgical education

2023 Volume 80, Issue 10, Page(s) 1395–1402

Abstract: Introduction: Core Surgical Training (CST) programs are associated with high burnout. This study aimed to assess the influence of Enhanced Stress Resilience Training (ESRT) over a 2-year period in a single UK Statutory Education Body.: Method: CSTs ... ...

Abstract	Introduction: Core Surgical Training (CST) programs are associated with high burnout. This study aimed to assess the influence of Enhanced Stress Resilience Training (ESRT) over a 2-year period in a single UK Statutory Education Body. Method: CSTs participated in 5-weeks of formal ESRT to address work stressors. The primary outcome measure was career progression related to curriculum metrics and National Training Number (NTN) appointment. Secondary measures related to burnout using validated psychological inventories. Results: Of 42 CSTs, 13 engaged fully with ESRT (31.0%; male 8, female 5, median age 28 year.), 11 engaged partially, and 18 did not. ESRT engagement was associated with better NTN appointment (ESRT 8/13 (61.5%) vs. not 1/18 (5.6%), p = 0.025), less burnout [aMBI; mean 5.14 (SD ± 2.35) vs. 3.14 (±2.25), F 6.637, p = 0.002, η Discussion: ESRT was associated with less stress and burnout, better mindfulness, and most importantly 13-fold better career progression.
Language	English
Publishing date	2023-08-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2277538-9
ISSN	1878-7452 ; 1931-7204
ISSN (online)	1878-7452
ISSN	1931-7204
DOI	10.1016/j.jsurg.2023.07.017
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Article ; Online: PAN's labyrinth: a multidisciplinary delayed diagnosis and patient's perspective.

Barlow, Emma Louise / Seddon, Owen / Healy, Brendan

BMJ case reports

2016 Volume 2016

Abstract: Polyarteritis nodosa (PAN) is a rare, severe form of vasculitis affecting medium-sized vessels. It manifests as a multisystem syndrome, and may be associated with hepatitis B virus-associated PAN (HBV-PAN) although the incidence of this is declining with ...

Abstract	Polyarteritis nodosa (PAN) is a rare, severe form of vasculitis affecting medium-sized vessels. It manifests as a multisystem syndrome, and may be associated with hepatitis B virus-associated PAN (HBV-PAN) although the incidence of this is declining with better vaccination strategies and awareness of bloodborne virus screening. We report a case in which a patient displayed many classical features of the disease, occurring separately over a period of months and leading to contact with various medical specialties. Managing each symptom in isolation led to a number of misdiagnoses (including testicular cancer) and the patient experienced considerable psychological stress and morbidity as a result. The case was complicated by acute pancreatitis developing after an initial treatment response. This may have been iatrogenic (as a consequence of either entecavir or steroids) or secondary to PAN. For our patient, this led to a protracted clinical course but eventual complete resolution of both pathologies.
MeSH term(s)	Angiography ; Delayed Diagnosis ; Diagnosis, Differential ; Hepatitis B/complications ; Hepatitis B virus/isolation & purification ; Humans ; Male ; Middle Aged ; Pain/etiology ; Pancreatitis/etiology ; Polyarteritis Nodosa/diagnosis ; Polyarteritis Nodosa/virology ; Testicular Neoplasms/diagnosis
Language	English
Publishing date	2016-01-05
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2015-213495
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Article ; Online: Childhood Trauma Is Associated With Severity of Hallucinations and Delusions in Psychotic Disorders: A Systematic Review and Meta-Analysis.

Bailey, Thomas / Alvarez-Jimenez, Mario / Garcia-Sanchez, Ana M / Hulbert, Carol / Barlow, Emma / Bendall, Sarah

Schizophrenia bulletin

2018 Volume 44, Issue 5, Page(s) 1111–1122

Abstract: Introduction: Childhood trauma is a risk factor for the development of psychosis. Furthermore, a number of theories propose specific mechanisms by which childhood trauma may contribute to more severe positive and negative psychotic symptoms, some of ... ...

Abstract	Introduction: Childhood trauma is a risk factor for the development of psychosis. Furthermore, a number of theories propose specific mechanisms by which childhood trauma may contribute to more severe positive and negative psychotic symptoms, some of which are supported empirically. The robustness of this empirical evidence is unclear due to mixed results and methodological limitations of individual studies. A systematic review and meta-analysis of the evidence for associations between childhood trauma and severity of hallucinations, delusions, and negative psychotic symptoms in clinical populations with a diagnosed psychotic disorder is needed. Method: A systematic search was conducted. Reference lists of relevant review articles were hand-searched, and authors contacted for data and additional unpublished studies. Study reporting bias and quality was assessed. Results: In total, 6667 studies were identified and of these 41 studies met inclusion criteria. Of these, 29 studies (4680 participants) were meta-analyzed. Among individuals with psychosis, childhood trauma was significantly correlated with severity of hallucinations (r = .199, P < .001) and delusions (r = .172, P < .001) but contrary to our hypothesis, not correlated with severity of negative symptoms (r = .049, P = .095). Severity of childhood neglect was correlated with negative symptoms (r = .142, P = .005). Conclusion: The results lend support for cognitive and biological theories that traumas in childhood may lead to hallucinations and delusions within psychotic disorders and have important implications for clinical practice.
MeSH term(s)	Adult Survivors of Child Adverse Events ; Delusions/etiology ; Delusions/physiopathology ; Hallucinations/etiology ; Hallucinations/physiopathology ; Humans ; Psychological Trauma/complications ; Psychotic Disorders/etiology ; Psychotic Disorders/physiopathology ; Schizophrenia/etiology ; Schizophrenia/physiopathology ; Severity of Illness Index
Language	English
Publishing date	2018-01-03
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	439173-1
ISSN	1745-1701 ; 0586-7614
ISSN (online)	1745-1701
ISSN	0586-7614
DOI	10.1093/schbul/sbx161
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Article: Acute neurocognitive effects of epigallocatechin gallate (EGCG)

Scholey, Andrew / Downey, Luke A / Ciorciari, Joseph / Pipingas, Andrew / Nolidin, Karen / Finn, Melissa / Wines, Melissa / Catchlove, Sarah / Terrens, Alirra / Barlow, Emma / Gordon, Leanne / Stough, Con

Appetite. 2012 Apr., v. 58, no. 2

2012

Abstract: Green tea is reported to have wide ranging beneficial health outcomes across epidemiological studies, which have been attributed to its flavonoid content. We investigated whether the flavonoid epigallocatechin gallate (EGCG) modulates brain activity and ... ...

Abstract	Green tea is reported to have wide ranging beneficial health outcomes across epidemiological studies, which have been attributed to its flavonoid content. We investigated whether the flavonoid epigallocatechin gallate (EGCG) modulates brain activity and self-reported mood in a double-blind, placebo controlled crossover study. Participants completed baseline assessments of cognitive and cardiovascular functioning, mood and a resting state electroencephalogram (EEG) before and then 120min following administration of 300mg EGCG or matched placebo. EGCG administration was associated with a significant overall increase in alpha, beta and theta activity, also reflected in overall EEG activity, more dominant in midline frontal and central regions, specifically in the frontal gyrus and medial frontal gyrus. In comparison to placebo the EGCG treatment also increased self-rated calmness and reduced self rated stress. This pattern of results suggests that participants in the EGCG condition may have been in a more relaxed and attentive state after consuming EGCG. This is in keeping with the widespread consumption of green tea for its purported relaxing/refreshing properties. The modulation of brain function due to EGCG is deserving of further controlled human studies.
Keywords	acute effects ; brain ; cognition ; electroencephalography ; emotions ; epidemiological studies ; epigallocatechin ; green tea ; placebos
Language	English
Dates of publication	2012-04
Size	p. 767-770.
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	764440-1
ISSN	0195-6663
ISSN	0195-6663
DOI	10.1016/j.appet.2011.11.016
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Article ; Online: The relative contribution of neurocognition and social cognition to 6-month vocational outcomes following Individual Placement and Support in first-episode psychosis.

Allott, Kelly A / Cotton, Susan M / Chinnery, Gina L / Baksheev, Gennady N / Massey, Jessica / Sun, Pamela / Collins, Zoe / Barlow, Emma / Broussard, Christina / Wahid, Tasha / Proffitt, Tina-Marie / Jackson, Henry J / Killackey, Eoin

Schizophrenia research

2013 Volume 150, Issue 1, Page(s) 136–143

Abstract: Aims: To examine whether baseline neurocognition and social cognition predict vocational outcomes over 6 months in patients with first-episode psychosis (FEP) enrolled in a randomised controlled trial of Individual Placement and Support (IPS) versus ... ...

Abstract	Aims: To examine whether baseline neurocognition and social cognition predict vocational outcomes over 6 months in patients with first-episode psychosis (FEP) enrolled in a randomised controlled trial of Individual Placement and Support (IPS) versus treatment as usual (TAU). Methods: 135 FEP participants (IPS n=69; TAU n=66) completed a comprehensive neurocognitive and social cognitive battery. Principal axis factor analysis using PROMAX rotation was used to determine the underlying cognitive structure of the battery. Setwise (hierarchical) logistic and multivariate linear regressions were used to examine predictors of: (a) enrolment in education and employment; and (b) hours of employment over 6 months. Neurocognition and social cognition factors were entered into the models after accounting for premorbid IQ, baseline functioning and treatment group. Results: Six cognitive factors were extracted: (i) social cognition; (ii) information processing speed; (iii) verbal learning and memory; (iv) attention and working memory; (v) visual organisation and memory; and (vi) verbal comprehension. Enrolment in education over 6 months was predicted by enrolment in education at baseline (p=.002) and poorer visual organisation and memory (p=.024). Employment over 6 months was predicted by employment at baseline (p=.041) and receiving IPS (p=.020). Better visual organisation and memory predicted total hours of paid work over 6 months (p<.001). Conclusions: Visual organisation and memory predicted the enrolment in education and duration of employment, after accounting for premorbid IQ, baseline functioning and treatment. Social cognition did not contribute to the prediction of vocational outcomes. Neurocognitive interventions may enhance employment duration in FEP.
MeSH term(s)	Adolescent ; Cognition Disorders/etiology ; Cognition Disorders/rehabilitation ; Employment ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Neuropsychological Tests ; Predictive Value of Tests ; Psychiatric Status Rating Scales ; Psychotic Disorders/complications ; Psychotic Disorders/psychology ; Psychotic Disorders/rehabilitation ; Rehabilitation, Vocational/methods ; Social Behavior ; Young Adult
Language	English
Publishing date	2013-10
Publishing country	Netherlands
Document type	Clinical Trial ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	639422-x
ISSN	1573-2509 ; 0920-9964
ISSN (online)	1573-2509
ISSN	0920-9964
DOI	10.1016/j.schres.2013.07.047
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Article ; Online: Acute neurocognitive effects of epigallocatechin gallate (EGCG).

Appetite

2012 Volume 58, Issue 2, Page(s) 767–770

Abstract	Green tea is reported to have wide ranging beneficial health outcomes across epidemiological studies, which have been attributed to its flavonoid content. We investigated whether the flavonoid epigallocatechin gallate (EGCG) modulates brain activity and self-reported mood in a double-blind, placebo controlled crossover study. Participants completed baseline assessments of cognitive and cardiovascular functioning, mood and a resting state electroencephalogram (EEG) before and then 120 min following administration of 300 mg EGCG or matched placebo. EGCG administration was associated with a significant overall increase in alpha, beta and theta activity, also reflected in overall EEG activity, more dominant in midline frontal and central regions, specifically in the frontal gyrus and medial frontal gyrus. In comparison to placebo the EGCG treatment also increased self-rated calmness and reduced self rated stress. This pattern of results suggests that participants in the EGCG condition may have been in a more relaxed and attentive state after consuming EGCG. This is in keeping with the widespread consumption of green tea for its purported relaxing/refreshing properties. The modulation of brain function due to EGCG is deserving of further controlled human studies.
MeSH term(s)	Affect/drug effects ; Aged ; Aged, 80 and over ; Brain/drug effects ; Brain/physiology ; Camellia sinensis/chemistry ; Catechin/administration & dosage ; Catechin/analogs & derivatives ; Cognition/drug effects ; Cross-Over Studies ; Double-Blind Method ; Electroencephalography ; Female ; Humans ; Male ; Middle Aged ; Placebos ; Plant Extracts/administration & dosage ; Tea
Chemical Substances	Placebos ; Plant Extracts ; Tea ; Catechin (8R1V1STN48) ; epigallocatechin gallate (BQM438CTEL)
Language	English
Publishing date	2012-04
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ISSN	1095-8304
ISSN (online)	1095-8304
DOI	10.1016/j.appet.2011.11.016
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Article ; Online: Moderated online social therapy for depression relapse prevention in young people: pilot study of a 'next generation' online intervention.

Rice, Simon / Gleeson, John / Davey, Christopher / Hetrick, Sarah / Parker, Alexandra / Lederman, Reeva / Wadley, Greg / Murray, Greg / Herrman, Helen / Chambers, Richard / Russon, Penni / Miles, Christopher / D'Alfonso, Simon / Thurley, Melissa / Chinnery, Gina / Gilbertson, Tamsyn / Eleftheriadis, Dina / Barlow, Emma / Cagliarini, Daniella /

Toh, Jia-Wern / McAlpine, Stuart / Koval, Peter / Bendall, Sarah / Jansen, Jens Einar / Hamilton, Matthew / McGorry, Patrick / Alvarez-Jimenez, Mario

Early intervention in psychiatry

2016 Volume 12, Issue 4, Page(s) 613–625

Abstract: Aim: Implementation of targeted e-mental health interventions offers a promising solution to reducing the burden of disease associated with youth depression. A single-group pilot study was conducted to evaluate the acceptability, feasibility, usability ... ...

Abstract	Aim: Implementation of targeted e-mental health interventions offers a promising solution to reducing the burden of disease associated with youth depression. A single-group pilot study was conducted to evaluate the acceptability, feasibility, usability and safety of a novel, moderated online social therapy intervention (entitled Rebound) for depression relapse prevention in young people. Methods: Participants were 42 young people (15-25 years) (50% men; mean age = 18.5 years) in partial or full remission. Participants had access to the Rebound platform for at least 12 weeks, including the social networking, peer and clinical moderator and therapy components. Results: Follow-up data were available for 39 (92.9%) participants. There was high system usage, with 3034 user logins (mean = 72.2 per user) and 2146 posts (mean = 51.1). Almost 70% of users had ≥10 logins over the 12 weeks, with 78.5% logging in over at least 2 months of the pilot. A total of 32 (84%) participants rated the intervention as helpful. There was significant improvement between the number of participants in full remission at baseline (n = 5; none of whom relapsed) relative to n = 19 at 12-week follow-up (P < 0.001). Six (14.3%) participants relapsed to full threshold symptoms at 12 weeks. There was a significant improvement to interviewer-rated depression scores (Montgomery-Asberg Depression Rating Scale (MADRS); P = 0.014, d = 0.45) and a trend for improved strength use (P = 0.088, d = 0.29). The single-group design and 12-week treatment phase preclude a full understanding of the clinical benefits of the Rebound intervention. Conclusions: The Rebound intervention was shown to be acceptable, feasible, highly usable and safe in young people with major depression.
MeSH term(s)	Adolescent ; Adult ; Depression/therapy ; Female ; Humans ; Male ; Peer Group ; Pilot Projects ; Recurrence ; Remission Induction ; Secondary Prevention/methods ; Social Networking ; Telemedicine/methods ; Young Adult
Language	English
Publishing date	2016-06-17
Publishing country	Australia
Document type	Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2272425-4
ISSN	1751-7893 ; 1751-7885
ISSN (online)	1751-7893
ISSN	1751-7885
DOI	10.1111/eip.12354
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