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Article ; Online: Implementation of a simulation free palliative Radiation Therapy pathway: An inter-professional collaborative project.

Clarke, Zoe

Journal of medical imaging and radiation sciences

2024

Abstract: The Western New South Wales Local Health District (WNSWLHD) has a significant footprint within the state of New South Wales (NSW). Due to the significant size of the WNSWLHD, patients residing in the local health district face many barriers to receiving ... ...

Abstract	The Western New South Wales Local Health District (WNSWLHD) has a significant footprint within the state of New South Wales (NSW). Due to the significant size of the WNSWLHD, patients residing in the local health district face many barriers to receiving Radiation Therapy. The inter-professional collaboration behind the successful implementation and evaluation of a simulation free pathway for palliative Radiation Therapy in WNSWLHD will be explored within this narrative. The process known in WNSWLHD as Medical Imaging Simulated Radiation Therapy (MISRT) removes the need for a computed tomography (CT) simulation and allows for palliative Radiation Therapy to be planned on previously acquired diagnostic CT imaging. The implementation of MISRT has required significant inter-professional collaboration. This also extends to inter-centre partnership, intra-district cooperation with Medical Imaging and inter-discipline teamwork amongst Radiation Oncologists, Radiation Oncology Medical Physicists, Radiation Oncology Nursing and Radiation Therapists. The impact and involvement of the inter-disciplinary teamwork will be explored. The methods of implementing MISRT will be outlined covering changes to standard workflow, educational requirements and inclusion criteria. The evaluation of the implementation will also be covered with two evaluation surveys being conducted. Inter-professional communication, education, teamwork and collaboration is highlighted to demonstrate improving access to quality care in a rural and regional healthcare setting whilst reducing known barriers to accessing Radiation Oncology.
Language	English
Publishing date	2024-04-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2426513-5
ISSN	1876-7982 ; 1939-8654
ISSN (online)	1876-7982
ISSN	1939-8654
DOI	10.1016/j.jmir.2024.02.020
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Article ; Online: Contamination of Thames Estuary sediments by retroreflective glass microbeads, road marking paint fragments and anthropogenic microfibres.

West-Clarke, Zaria / Turner, Andrew

The Science of the total environment

2023 Volume 912, Page(s) 169257

Abstract: Surface and subsurface sediment samples (n = 16) from the highly urbanised inner Thames Estuary (UK) have been physically and chemically characterised and analysed for anthropogenic microdebris. Sediments were gravelly sands throughout and were heavily ... ...

Abstract	Surface and subsurface sediment samples (n = 16) from the highly urbanised inner Thames Estuary (UK) have been physically and chemically characterised and analysed for anthropogenic microdebris. Sediments were gravelly sands throughout and were heavily contaminated by lead (Pb, up to 12,500 mg kg
Language	English
Publishing date	2023-12-19
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	121506-1
ISSN	1879-1026 ; 0048-9697
ISSN (online)	1879-1026
ISSN	0048-9697
DOI	10.1016/j.scitotenv.2023.169257
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Article ; Online: The independent and joint risks of alcohol consumption, smoking, and excess weight on morbidity and mortality: a systematic review and meta-analysis exploring synergistic associations.

Burton, R / Fryers, P T / Sharpe, C / Clarke, Z / Henn, C / Hydes, T / Marsden, J / Pearce-Smith, N / Sheron, N

Public health

2023 Volume 226, Page(s) 39–52

Abstract: Objective: Alcohol consumption, smoking, and excess weight independently increase the risk of morbidity/mortality. Less is known about how they interact. This research aims to quantify the independent and joint associations of these exposures across ... ...

Abstract	Objective: Alcohol consumption, smoking, and excess weight independently increase the risk of morbidity/mortality. Less is known about how they interact. This research aims to quantify the independent and joint associations of these exposures across health outcomes and identify whether these associations are synergistic. Study design: The protocol for this systematic review and meta-analysis was pre-registered (PROSPERO CRD42021231443). Methods: Medline and Embase were searched between 1 January 2010 and 9 February 2022. Eligible peer-reviewed observational studies had to include adult participants from Organisation for Co-Operation and Development countries and report independent and joint associations between at least two eligible exposures (alcohol, smoking, and excess weight) and an ICD-10 outcome (or equivalent). For all estimates, we calculated the synergy index (SI) to identify whether joint associations were synergistic. Meta-analyses were conducted for outcomes with sufficiently homogenous data. Results: The search returned 26,290 studies, of which 98 were included. Based on 138,130 participants, the combined effect (SI) of alcohol and smoking on head and neck cancer death/disease was 3.78 times greater than the additive effect of each exposure (95% confidence interval [CI] = 2.61, 5.48). Based on 2,603,939 participants, the combined effect of alcohol and excess weight on liver disease/death was 1.55 times greater than the additive effect of each exposure (95% CI = 1.33, 1.82). Conclusion: Synergistic associations suggest the true population-level risk may be underestimated. In the absence of bias, individuals with multiple risks would experience a greater absolute risk reduction from an intervention that targets a single exposure than individuals with a single risk.
MeSH term(s)	Adult ; Humans ; Alcohol Drinking/adverse effects ; Alcohol Drinking/epidemiology ; Risk Factors ; Smoking/adverse effects ; Smoking/epidemiology ; Overweight
Language	English
Publishing date	2023-11-23
Publishing country	Netherlands
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	427333-3
ISSN	1476-5616 ; 0033-3506
ISSN (online)	1476-5616
ISSN	0033-3506
DOI	10.1016/j.puhe.2023.10.035
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Article ; Online: Policies and interventions to reduce harmful gambling: an international Delphi consensus and implementation rating study.

Regan, Marguerite / Smolar, Maria / Burton, Robyn / Clarke, Zoe / Sharpe, Casey / Henn, Clive / Marsden, John

The Lancet. Public health

2022 Volume 7, Issue 8, Page(s) e705–e717

Abstract: There is increasing public health concern about harmful gambling, but no consensus on effective policies and interventions to reduce risk and prevent harm has been reached. Focusing on policies and interventions (ie, measures), the aim of this study was ... ...

Abstract	There is increasing public health concern about harmful gambling, but no consensus on effective policies and interventions to reduce risk and prevent harm has been reached. Focusing on policies and interventions (ie, measures), the aim of this study was to determine if expert consensus could be reached on measures perceived to be effective that could be implemented successfully. Our work involved a pre-registered, three-round, independent Delphi panel consensus study and an implementation rating exercise. A starting set of 103 universal and targeted measures, which were sourced from several key resources and inputs from public health stakeholders, were grouped into seven domains: price and taxation; availability; accessibility; marketing, advertising, promotion, and sponsorship; environment and technology; information and education; and treatment and support. Across three rounds, an independent panel of 35 experts individually completed online questionnaires to rank each measure for known or potential effectiveness. A consensus was reached if at least 70% of the panel judged a measure to be either not effective, moderately effective, or highly effective. Then, each measure that reached a consensus for effectiveness was evaluated on four implementation dimensions: practicability, affordability, side-effects, and equity. A summative threshold criterion was used to select a final optimal set of measures for England. The panel reached consensus on 83 (81%) of 103 measures. Two measures were judged as ineffective by the panel. The remaining 81 effective measures were drawn from all domains (14 of 15 measures in the the marketing, advertising, promotion, and sponsorship domain were judged as effective, whereas five of ten measures in the information and education domain were judged as effective). During the evaluation exercise, the 81 measures were assessed for likelihood of implementation success. This assessment considered the practicality, affordability, ability to generate unanticipated side-effects, and ability to decrease differences between advantaged and disadvantaged groups in society of each measure. We identified 40 universal and targeted measures to tackle harmful gambling (three measures from the price and taxation domain; ten from the availability domain; five from the accessibility domain; six from the marketing, advertising, promotion, and sponsorship domain; eight from the environment and technology domain; three from the information and education domain; and five from the treatment and support domain). Implementation of these measures in England could substantially strengthen regulatory controls while providing new resources. The findings of our work offer a blueprint for a public health approach to preventing harms related to gambling.
MeSH term(s)	Consensus ; Delphi Technique ; Exercise ; Gambling/prevention & control ; Humans ; Policy
Language	English
Publishing date	2022-07-18
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ISSN	2468-2667
ISSN (online)	2468-2667
DOI	10.1016/S2468-2667(22)00137-2
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Article ; Online: Involving young people in sexual health research and service improvement: conceptual analysis of patient and public involvement (PPI) in three projects.

Lewis, Ruth / Boydell, Nicola / Blake, Carolyn / Clarke, Zoe / Kernaghan, Kirsten / McMellon, Christina

BMJ sexual & reproductive health

2022 Volume 49, Issue 2, Page(s) 76–86

Abstract: Background: Although increasingly recognised as valuable within sexual and reproductive health (SRH) research and service improvement, examples of patient and public involvement (PPI) are underdocumented, including specific issues relating to young ... ...

Abstract	Background: Although increasingly recognised as valuable within sexual and reproductive health (SRH) research and service improvement, examples of patient and public involvement (PPI) are underdocumented, including specific issues relating to young people's involvement. This article aims to contribute to greater transparency about the practical, methodological and ethical considerations of SRH-related PPI with young people, and to offer recommendations for their meaningful involvement. Methods: Guided by a conceptual tool for evaluating youth participation (the '7P' framework), we analysed learning from PPI within three projects (two academic studies and one service improvement project) that worked Analysis: Cross-project analysis of seven interconnected domains (purpose, positioning, perspectives, power relations, protection, place and process) generated productive dialogue about the nuances of meaningfully involving young people in shaping SRH research and services. Key learning includes the importance of: young people's early involvement in agenda-setting for SRH improvement; developing trusting partnerships that can support involvement of diverse groups of young people; creating multiple ways for young people to contribute, including those that do not rely on direct conversation; and formative evaluation of young people's experiences of involvement. Conclusions: Mainstreaming young people's meaningful involvement in shaping SRH research and services requires systems-level change. Resources are required to support SRH researchers and practitioners to share learning and build sustainable multi-sector partnerships, which in turn can increase opportunities for young people from diverse groups to engage with SRH-related PPI activities.
MeSH term(s)	Adolescent ; Humans ; Sexual Health ; Sexual Behavior ; Reproductive Health ; Reproductive Health Services ; Patient Participation
Language	English
Publishing date	2022-10-28
Publishing country	England
Document type	Journal Article
ISSN	2515-2009
ISSN (online)	2515-2009
DOI	10.1136/bmjsrh-2022-201611
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Article ; Online: Reintroducing face-to-face support alongside remote support to form a hybrid stop smoking service in England: a formative mixed methods evaluation.

Woodrow, Nicholas / Gillespie, Duncan / Kitchin, Liz / O'Brien, Mark / Chapman, Scott / Chng, Nai Rui / Passey, Andrew / Aquino, Maria Raisa Jessica / Clarke, Zoe / Goyder, Elizabeth

BMC public health

2024 Volume 24, Issue 1, Page(s) 718

Abstract: Background: During the COVID-19 pandemic, United Kingdom (UK) stop smoking services had to shift to remote delivery models due to social distancing regulations, later reintroducing face-to-face provision. The "Living Well Smokefree" service in North ... ...

Abstract	Background: During the COVID-19 pandemic, United Kingdom (UK) stop smoking services had to shift to remote delivery models due to social distancing regulations, later reintroducing face-to-face provision. The "Living Well Smokefree" service in North Yorkshire County Council adopted a hybrid model offering face-to-face, remote, or a mix of both. This evaluation aimed to assess the hybrid approach's strengths and weaknesses and explore potential improvements. Methods: Conducted from September 2022 to February 2023, the evaluation consisted of three components. First, qualitative interviews involved 11 staff and 16 service users, analysed thematically. Second, quantitative data from the QuitManager system that monitored the numbers and proportions of individuals selecting and successfully completing a 4-week quit via each service option. Third, face-to-face service expenses data was used to estimate the value for money of additional face-to-face provision. The qualitative findings were used to give context to the quantitative data via an "expansion" approach and complementary analysis. Results: Overall, a hybrid model was seen to provide convenience and flexible options for support. In the evaluation, 733 individuals accessed the service, with 91.3% selecting remote support, 6.1% face-to-face, and 2.6% mixed provision. Remote support was valued by service users and staff for promoting openness, privacy, and reducing stigma, and was noted as removing access barriers and improving service availability. However, the absence of carbon monoxide monitoring in remote support raised accountability concerns. The trade-off in "quantity vs. quality" of quits was debated, as remote support reached more users but produced fewer carbon monoxide-validated quits. Primarily offering remote support could lead to substantial workloads, as staff often extend their roles to include social/mental health support, which was sometimes emotionally challenging. Offering service users a choice of support options was considered more important than the "cost-per-quit". Improved dissemination of information to support service users in understanding their options for support was suggested. Conclusions: The hybrid approach allows smoking cessation services to evaluate which groups benefit from remote, face-to-face, or mixed options and allocate resources accordingly. Providing choice, flexible provision, non-judgmental support, and clear information about available options could improve engagement and match support to individual needs, enhancing outcomes.
MeSH term(s)	Humans ; Carbon Monoxide ; Pandemics ; Smoking ; Tobacco Smoking ; England
Chemical Substances	Carbon Monoxide (7U1EE4V452)
Language	English
Publishing date	2024-03-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-024-18235-0
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Article ; Online: The Importance of a Standardized Screening Tool to Identify Thromboembolic Risk Factors in Pediatric Lower Extremity Arthroscopy Patients.

Ellis, Henry Bone / Sabatino, Meagan J / Clarke, Zachary / Dennis, Garrett / Fletcher, Amanda L / Wyatt, Charles W / Zia, Ayesha / Wilson, Philip L

The Journal of the American Academy of Orthopaedic Surgeons

2019 Volume 27, Issue 9, Page(s) 335–343

Abstract: Introduction: Deep vein thrombosis and pulmonary embolism are major complications that can occur in common orthopaedic procedures such as knee arthroscopy. The purpose of this study is to determine the incidence of venous thromboembolism (VTE) risk ... ...

Abstract	Introduction: Deep vein thrombosis and pulmonary embolism are major complications that can occur in common orthopaedic procedures such as knee arthroscopy. The purpose of this study is to determine the incidence of venous thromboembolism (VTE) risk factors in adolescent patients undergoing elective lower extremity arthroscopy. A second objective is to determine whether a targeted, standardized screening tool is both cost- and clinically effective in the identification of VTE risk factors in adolescents. Methods: A standardized VTE screening tool was prospectively administered to all elective arthroscopic procedures in a pediatric sports medicine practice. A comparison cohort that did not complete the screening tool was isolated through a retrospective chart review identifying VTE risk factors. The incidence and cost between the two cohorts were compared. Results: Of 332 subjects who did not receive a targeted screening (TS) tool, 103 risk factors were noted. One pulmonary embolism case was identified with a total incidence of 0.15% over 3 years. With TS, we identified 325 subjects with 134 identifiable risk factors. Six patients (1.8%) were noted to be very high risk, requiring consultation with hematology. No VTEs were reported. When compared with the retrospective review, TS identified 30% more risk factors. A significant increase in the identification of family history of blood clots (P < 0.001), history of previous blood clot (P = 0.059), recurrent miscarriages in the family (P = 0.010), and smoking exposure (P = 0.062) was found. Additionally, the total cost of screening was less than the cost of prophylaxis treatment with no screening ($20.98 versus $23.51 per person, respectively). Discussion: Risk factors for VTE may be present in 32.5% of elective adolescent arthroscopic patients. A TS model for VTE identified 30% more risk factors, especially a significant family history, and was shown to be a cost-effective way to safely implement a VTE prevention program. Level of evidence: Level II.
MeSH term(s)	Abortion, Habitual ; Adolescent ; Adult ; Arthroscopy ; Child ; Cohort Studies ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Diagnostic Screening Programs ; Elective Surgical Procedures ; Female ; Humans ; Incidence ; Male ; Mass Screening/methods ; Postoperative Complications/diagnosis ; Postoperative Complications/economics ; Postoperative Complications/epidemiology ; Postoperative Complications/prevention & control ; Risk Factors ; Smoking ; Thrombosis ; Venous Thromboembolism/diagnosis ; Venous Thromboembolism/economics ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/prevention & control ; Young Adult
Language	English
Publishing date	2019-01-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200524-1
ISSN	1940-5480 ; 1067-151X
ISSN (online)	1940-5480
ISSN	1067-151X
DOI	10.5435/JAAOS-D-18-00390
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Article: The crystal structures of 3-

Clarke, Zane / Barnes, Evan / Prichard, Kate L / Mares, Laura J / Clegg, Jack K / McCluskey, Adam / Houston, Todd A / Simone, Michela I

Acta crystallographica. Section E, Crystallographic communications

2018 Volume 74, Issue Pt 6, Page(s) 862–867

Abstract: The effect of different leaving groups on the ... ...

Abstract	The effect of different leaving groups on the substitution
Language	English
Publishing date	2018-05-31
Publishing country	England
Document type	Journal Article
ZDB-ID	2041947-8
ISSN	2056-9890 ; 1600-5368
ISSN	2056-9890 ; 1600-5368
DOI	10.1107/S205698901800765X
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Article: Master plan.

Clarke, Zada / Hill, Angela M

Journal of AHIMA

2006 Volume 77, Issue 8, Page(s) 40–1, 44

MeSH term(s)	Humans ; Information Management/education ; Medical Informatics ; Planning Techniques ; Staff Development/organization & administration ; United States
Language	English
Publishing date	2006-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	1093944-1
ISSN	1060-5487 ; 0273-9976
ISSN	1060-5487 ; 0273-9976
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Article ; Online: Morphological optimization for access to dual oxidants in biofilms.

Kempes, Christopher P / Okegbe, Chinweike / Mears-Clarke, Zwoisaint / Follows, Michael J / Dietrich, Lars E P

Proceedings of the National Academy of Sciences of the United States of America

2013 Volume 111, Issue 1, Page(s) 208–213

Abstract: A major theme driving research in biology is the relationship between form and function. In particular, a longstanding goal has been to understand how the evolution of multicellularity conferred fitness advantages. Here we show that biofilms of the ... ...

Abstract	A major theme driving research in biology is the relationship between form and function. In particular, a longstanding goal has been to understand how the evolution of multicellularity conferred fitness advantages. Here we show that biofilms of the bacterium Pseudomonas aeruginosa produce structures that maximize cellular reproduction. Specifically, we develop a mathematical model of resource availability and metabolic response within colony features. This analysis accurately predicts the measured distribution of two types of electron acceptors: oxygen, which is available from the atmosphere, and phenazines, redox-active antibiotics produced by the bacterium. Using this model, we demonstrate that the geometry of colony structures is optimal with respect to growth efficiency. Because our model is based on resource dynamics, we also can anticipate shifts in feature geometry based on changes to the availability of electron acceptors, including variations in the external availability of oxygen and genetic manipulation that renders the cells incapable of phenazine production.
MeSH term(s)	Bacterial Physiological Phenomena ; Biofilms ; Calibration ; Electrodes ; Kinetics ; Models, Theoretical ; Mutation ; Oxidants/chemistry ; Oxidation-Reduction ; Oxygen/chemistry ; Phenazines/chemistry ; Pseudomonas aeruginosa/metabolism ; Signal Transduction ; Temperature
Chemical Substances	Oxidants ; Phenazines ; Oxygen (S88TT14065)
Language	English
Publishing date	2013-12-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	209104-5
ISSN	1091-6490 ; 0027-8424
ISSN (online)	1091-6490
ISSN	0027-8424
DOI	10.1073/pnas.1315521110
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