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  1. AU="Jonathan Fuld"
  2. AU="López-Caballero, María Guadalupe"
  3. AU="Rawlinson, Jennifer R"
  4. AU="Priti N Mody-Pan"
  5. AU="Yunusov, Marat S"
  6. AU=Peever John
  7. AU="Khosravi, Majid"
  8. AU="Xiang, La"
  9. AU="Sag, Duygu"
  10. AU="Khatiri Yanehsari, M."
  11. AU="Cooke, Georga"
  12. AU="Stefanello, Bianca"
  13. AU="Cummings, Brian J"
  14. AU=Yu Xiongwu
  15. AU=Greenland Sander
  16. AU=Deanfield John
  17. AU="Vu, Hung"
  18. AU="Soucek, Alexander"
  19. AU="Rihui Su"
  20. AU="Campbell, Steve"

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  1. Artikel ; Online: Preterm birth, birth weight, infant weight gain and their associations with childhood asthma and spirometry

    Jennifer K Quint / Jonathan Fuld / Angela Obasi / Sean Semple / Ruaraidh Dobson / Kevin Mortimer / Maia Lesosky / Jeremiah Chakaya / Cindy M Gray / Graham Devereux / Richard Kiplimo / Fred Orina / Helen Meme / Evans Amukoye / Cressida Bowyer / Amos Ndombi / Sarah E West / Lindsey Zurba

    BMJ Open Respiratory Research, Vol 10, Iss

    a cross-sectional observational study in Nairobi, Kenya

    2023  Band 1

    Abstract: Background In sub-Saharan Africa, the origins of asthma and high prevalence of abnormal lung function remain unclear. In high-income countries (HICs), associations between birth measurements and childhood asthma and lung function highlight the importance ...

    Abstract Background In sub-Saharan Africa, the origins of asthma and high prevalence of abnormal lung function remain unclear. In high-income countries (HICs), associations between birth measurements and childhood asthma and lung function highlight the importance of antenatal and early life factors in the aetiology of asthma and abnormal lung function in children. We present here the first study in sub-Saharan Africa to relate birth characteristics to both childhood respiratory symptoms and lung function.Methods Children attending schools in two socioeconomically contrasting but geographically close areas of Nairobi, Kenya, were recruited to a cross-sectional study of childhood asthma and lung function. Questionnaires quantified respiratory symptoms and preterm birth; lung function was measured by spirometry; and parents were invited to bring the child’s immunisation booklet containing records of birth weight and serial weights in the first year.Results 2373 children participated, 52% girls, median age (IQR), 10 years (8–13). Spirometry data were available for 1622. Child immunisation booklets were available for 500 and birth weight and infant weight gain data were available for 323 and 494 children, respectively. In multivariable analyses, preterm birth was associated with the childhood symptoms ‘wheeze in the last 12 months’; OR 1.64, (95% CI 1.03 to 2.62), p=0.038; and ‘trouble breathing’ 3.18 (95% CI 2.27 to 4.45), p<0.001. Birth weight (kg) was associated with forced expiratory volume in 1 s z-score, regression coefficient (β) 0.30 (0.08, 0.52), p=0.008, FVC z-score 0.29 (95% CI 0.08 to 0.51); p=0.008 and restricted spirometry, OR 0.11 (95% CI 0.02 to 0.78), p=0.027.Conclusion These associations are in keeping with those in HICs and highlight antenatal factors in the aetiology of asthma and lung function abnormalities in sub-Saharan Africa.
    Schlagwörter Medicine ; R ; Diseases of the respiratory system ; RC705-779
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2023-12-01T00:00:00Z
    Verlag BMJ Publishing Group
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  2. Artikel ; Online: The use of low-cost Android tablets to train community health workers in Mukono, Uganda, in the recognition, treatment and prevention of pneumonia in children under five

    James O’Donovan / Kenneth Kabali / Celia Taylor / Margarita Chukhina / Jacqueline C. Kading / Jonathan Fuld / Edward O’Neil

    Human Resources for Health, Vol 16, Iss 1, Pp 1-

    a pilot randomised controlled trial

    2018  Band 9

    Abstract: Abstract Background Since 2012, The World Health Organization and UNICEF have advocated for community health workers (CHWs) to be trained in Integrated Community Case Management (iCCM) of common childhood illnesses, such as pneumonia. Despite the ... ...

    Abstract Abstract Background Since 2012, The World Health Organization and UNICEF have advocated for community health workers (CHWs) to be trained in Integrated Community Case Management (iCCM) of common childhood illnesses, such as pneumonia. Despite the effectiveness of iCCM, CHWs face many barriers to accessing training. This pilot study compares traditional training with using locally made videos loaded onto low-cost Android tablets to train CHWs on the pneumonia component of iCCM. Methods We conducted a pilot randomised controlled trial with CHWs in the Mukono District of Uganda. The unit of randomisation was the sub-county level, and the unit of analysis was at the level of the individual CHW. Eligible CHWs had completed basic iCCM training but had not received any refresher training on the pneumonia component of iCCM in the preceding 2 years. CHWs in the control group received training in the recognition, treatment, and prevention of pneumonia as it is currently delivered, through a 1-day, in-person workshop. CHWs allocated to the intervention group received training via locally made educational videos hosted on low-cost Android tablets. The primary outcome was change in knowledge acquisition, assessed through a multiple choice questionnaire before and after training, and a post-training clinical assessment. The secondary outcome was a qualitative evaluation of CHW experiences of using the tablet platform. Results In the study, 129 CHWs were enrolled, 66 and 63 in the control and intervention groups respectively. CHWs in both groups demonstrated an improvement in multiple choice question test scores before and after training; however, there was no statistically significant difference in the improvement between groups (t = 1.15, p = 0.254). There was a statistically significant positive correlation (Pearson’s r = 0.26, p = 0.03) linking years of education to improvement in test scores in the control group, which was not present in the intervention group. The majority of CHWs expressed satisfaction with the use of ...
    Schlagwörter Community health worker (CHW) ; Uganda ; Pneumonia ; mHealth ; Mobile technologies ; Integrated Community Case Management (iCCM) ; Medicine (General) ; R5-920 ; Public aspects of medicine ; RA1-1270
    Thema/Rubrik (Code) 796
    Sprache Englisch
    Erscheinungsdatum 2018-09-01T00:00:00Z
    Verlag BMC
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  3. Artikel ; Online: Risk assessment for hospital admission in patients with COPD; a multi-centre UK prospective observational study.

    Jilles M Fermont / Charlotte E Bolton / Marie Fisk / Divya Mohan / William Macnee / John R Cockcroft / Carmel McEniery / Jonathan Fuld / Joseph Cheriyan / Ruth Tal-Singer / Ian B Wilkinson / Angela M Wood / Michael I Polkey / Hana Müllerova

    PLoS ONE, Vol 15, Iss 2, p e

    2020  Band 0228940

    Abstract: In chronic obstructive pulmonary disease (COPD), acute exacerbation of COPD requiring hospital admission is associated with mortality and healthcare costs. The ERICA study assessed multiple clinical measures in people with COPD, including the short ... ...

    Abstract In chronic obstructive pulmonary disease (COPD), acute exacerbation of COPD requiring hospital admission is associated with mortality and healthcare costs. The ERICA study assessed multiple clinical measures in people with COPD, including the short physical performance battery (SPPB), a simple test of physical function with 3 components (gait speed, balance and sit-to-stand). We tested the hypothesis that SPPB score would relate to risk of hospital admissions and length of hospital stay. Data were analysed from 714 of the total 729 participants (434 men and 280 women) with COPD. Data from this prospective observational longitudinal study were obtained from 4 secondary and 1 tertiary centres from England, Scotland, and Wales. The main outcome measures were to estimate the risk of hospitalisation with acute exacerbation of COPD (AECOPD and length of hospital stay derived from hospital episode statistics (HES). In total, 291 of 714 individuals experienced 762 hospitalised AECOPD during five-year follow up. Poorer performance of SPPB was associated with both higher rate (IRR 1.08 per 1 point decrease, 95% CI 1.01 to 1.14) and increased length of stay (IRR 1.18 per 1 point decrease, 95% CI 1.10 to 1.27) for hospitalised AECOPD. For the individual sit-to-stand component of the SPPB, the association was even stronger (IRR 1.14, 95% CI 1.02 to 1.26 for rate and IRR 1.32, 95% CI 1.16 to 1.49 for length of stay for hospitalised AECOPD). The SPPB, and in particular the sit-to-stand component can both evaluate the risk of H-AECOPD and length of hospital stay in COPD. The SPPB can aid in clinical decision making and when prioritising healthcare resources.
    Schlagwörter Medicine ; R ; Science ; Q
    Thema/Rubrik (Code) 360
    Sprache Englisch
    Erscheinungsdatum 2020-01-01T00:00:00Z
    Verlag Public Library of Science (PLoS)
    Dokumenttyp Artikel ; Online
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  4. Artikel ; Online: Physiological effects and subjective tolerability of prone positioning in COVID-19 and healthy hypoxic challenge

    Akhilesh Jha / Fangyue Chen / Sam Mann / Ravi Shah / Randa Abu-Youssef / Holly Pavey / Helen Lin-Jia-Qi / Josh Cara / Daniel Cunningham / Kate Fitzpatrick / Celine Goh / Renee Ma / Souradip Mookerjee / Vaitehi Nageshwaran / Timothy Old / Catherine Oxley / Louise Jordon / Mayurun Selvan / Anna Wood /
    Andrew Ying / Chen Zhang / Dariusz Wozniak / Iain Goodhart / Frances Early / Marie Fisk / Jonathan Fuld

    ERJ Open Research, Vol 8, Iss

    2021  Band 1

    Abstract: Background Prone positioning has a beneficial role in coronavirus disease 2019 (COVID-19) patients receiving ventilation but lacks evidence in awake non-ventilated patients, with most studies being retrospective, lacking control populations and ... ...

    Abstract Background Prone positioning has a beneficial role in coronavirus disease 2019 (COVID-19) patients receiving ventilation but lacks evidence in awake non-ventilated patients, with most studies being retrospective, lacking control populations and information on subjective tolerability. Methods We conducted a prospective, single-centre study of prone positioning in awake non-ventilated patients with COVID-19 and non-COVID-19 pneumonia. The primary outcome was change in peripheral oxygenation in prone versus supine position. Secondary outcomes assessed effects on end-tidal CO2, respiratory rate, heart rate and subjective symptoms. We also recruited healthy volunteers to undergo proning during hypoxic challenge. Results 238 hospitalised patients with pneumonia were screened; 55 were eligible with 25 COVID-19 patients and three non-COVID-19 patients agreeing to undergo proning – the latter insufficient for further analysis. 10 healthy control volunteers underwent hypoxic challenge. Patients with COVID-19 had a median age of 64 years (interquartile range 53–75). Proning led to an increase in oxygen saturation measured by pulse oximetry (SpO2) compared to supine position (difference +1.62%; p=0.003) and occurred within 10 min of proning. There were no effects on end-tidal CO2, respiratory rate or heart rate. There was an increase in subjective discomfort (p=0.003), with no difference in breathlessness. Among healthy controls undergoing hypoxic challenge, proning did not lead to a change in SpO2 or subjective symptom scores. Conclusion Identification of suitable patients with COVID-19 requiring oxygen supplementation from general ward environments for awake proning is challenging. Prone positioning leads to a small increase in SpO2 within 10 min of proning though is associated with increased discomfort.
    Schlagwörter Medicine ; R
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2021-02-01T00:00:00Z
    Verlag European Respiratory Society
    Dokumenttyp Artikel ; Online
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  5. Artikel ; Online: Quantitative 18F-fluorodeoxyglucose positron emission tomography/computed tomography to assess pulmonary inflammation in COPD

    Laurence Vass / Marie Fisk / Joseph Cheriyan / Divya Mohan / Julia Forman / Adelola Oseni / Anand Devaraj / Kaisa M. Mäki-Petäjä / Carmel M. McEniery / Jonathan Fuld / Nicholas S. Hopkinson / David A. Lomas / John R. Cockcroft / Ruth Tal-Singer / Michael I. Polkey / Ian B. Wilkinson

    ERJ Open Research, Vol 7, Iss

    2021  Band 3

    Abstract: Rationale COPD and smoking are characterised by pulmonary inflammation. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging may improve knowledge of pulmonary inflammation in COPD patients and aid early ... ...

    Abstract Rationale COPD and smoking are characterised by pulmonary inflammation. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging may improve knowledge of pulmonary inflammation in COPD patients and aid early development of novel therapies as an imaging biomarker. Objectives To evaluate pulmonary inflammation, assessed by FDG uptake, in whole and regional lung in “usual” (smoking-related) COPD patients, alpha-1 antitrypsin deficiency (α1ATD) COPD patients, smokers without COPD and never-smokers using FDG PET/CT. Secondly, to explore cross-sectional associations between FDG PET/CT and systemic inflammatory markers in COPD patients and repeatability of the technique in COPD patients. Methods Data from two imaging studies were evaluated. Pulmonary FDG uptake (normalised Ki; nKi) was measured by Patlak graphical analysis in four subject groups: 84 COPD patients, 11 α1ATD-COPD patients, 12 smokers and 10 never-smokers. Within the COPD group, associations between nKi and systemic markers of inflammation were assessed. Repeatability was evaluated in 32 COPD patients comparing nKi values at baseline and at 4-month follow-up. Results COPD patients, α1ATD-COPD patients and smokers had increased whole lung FDG uptake (nKi) compared with never-smokers (0.0037±0.001, 0.0040±0.001, 0.0040±0.001 versus 0.0028±0.001 mL·cm−3·min−1, respectively, p<0.05 for all). Similar results were observed in upper and middle lung regions. In COPD participants, plasma fibrinogen was associated with whole lung nKi (β=0.30, p=0.02) in multivariate analysis adjusted for current smoking, forced expiratory volume in 1 s % predicted, systemic neutrophils and C-reactive protein levels. Mean percentage difference in nKi between the baseline and follow-up was 3.2%, and the within subject coefficient of variability was 7.7%. Conclusions FDG PET/CT has potential as a noninvasive tool to enable whole lung and regional quantification of FDG uptake to assess smoking- and COPD-related pulmonary inflammation.
    Schlagwörter Medicine ; R
    Thema/Rubrik (Code) 610 ; 616
    Sprache Englisch
    Erscheinungsdatum 2021-08-01T00:00:00Z
    Verlag European Respiratory Society
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    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  6. Artikel ; Online: Validity of Reporting Oxygen Uptake Efficiency Slope from Submaximal Exercise Using Respiratory Exchange Ratio as Secondary Criterion

    Wilby Williamson / Jonathan Fuld / Kate Westgate / Karl Sylvester / Ulf Ekelund / Soren Brage

    Pulmonary Medicine, Vol

    2012  Band 2012

    Schlagwörter Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Internal medicine ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Sprache Englisch
    Erscheinungsdatum 2012-01-01T00:00:00Z
    Verlag Hindawi Publishing Corporation
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    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  7. Artikel ; Online: Organisational interventions to reduce length of stay in hospital

    Céline Miani / Sarah Ball / Emma Pitchforth / Josephine Exley / Sarah King / Martin Roland / Jonathan Fuld / Ellen Nolte

    Health Services and Delivery Research, Vol 2, Iss

    a rapid evidence assessment

    2014  Band 52

    Abstract: Background: Available evidence on effective interventions to reduce length of stay in hospital is wide-ranging and complex, with underlying factors including those acting at the health system, organisational and patient levels, and the interface between ... ...

    Abstract Background: Available evidence on effective interventions to reduce length of stay in hospital is wide-ranging and complex, with underlying factors including those acting at the health system, organisational and patient levels, and the interface between these. There is a need to better understand the diverse literature on reducing the length of hospital stay. Objectives: This study sought to (i) describe the nature of interventions that have been used to reduce length of stay in acute care hospitals; (ii) identify the factors that are known to influence length of stay; and (iii) assess the impact of interventions on patient outcomes, service outcomes and costs. Data sources: We searched MEDLINE (Ovid), EMBASE, the Health Management Information Consortium and System for Information on Grey Literature in Europe for the period January 1995 to January 2013 with no limitation of publication type. Methods: We conducted a rapid evidence synthesis of the peer-reviewed literature on organisational interventions set in or initiated from acute hospitals. We considered evidence published between 2003 and 2013. Data were analysed drawing on the principles of narrative synthesis. We also carried out interviews with eight NHS managers and clinical leads in four sites in England. Results: A total of 53 studies met our inclusion criteria, including 19 systematic reviews and 34 primary studies. Although the overall evidence base was varied and frequently lacked a robust study design, we identified a range of interventions that showed potential to reduce length of stay. These were multidisciplinary team working, for example some forms of organised stroke care; improved discharge planning; early supported discharge programmes; and care pathways. Nursing-led inpatient units were associated with improved outcomes but, if anything, increased length of stay. Factors influencing the impact of interventions on length of stay included contextual factors and the population targeted. The evidence was mixed with regard to the extent to which ...
    Schlagwörter organisational interventions ; length of hospital stay ; multidisciplinary care ; discharge planning ; early supported discharge ; clinical care pathway ; rapid evidence assessment ; transferable learning ; Public aspects of medicine ; RA1-1270 ; Medicine (General) ; R5-920
    Thema/Rubrik (Code) 360
    Sprache Englisch
    Erscheinungsdatum 2014-12-01T00:00:00Z
    Verlag National Institute for Health Research
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  8. Artikel ; Online: Cardiovascular risk prediction using physical performance measures in COPD

    Divya Mohan / Carmel M McEniery / John R Cockcroft / William MacNee / Jonathan Fuld / Marie Fisk / Joseph Cheriyan / Ruth Tal-Singer / Ian B Wilkinson / Jilles M Fermont / Hana Müllerova / Angela M Wood / Charlotte E Bolton / Kaisa M Mäki-Petäjä / Ali B Al-Hadithi

    BMJ Open, Vol 10, Iss

    results from a multicentre observational study

    2020  Band 12

    Abstract: Objectives Although cardiovascular disease (CVD) is a common comorbidity associated with chronic obstructive pulmonary disease (COPD), it is unknown how to improve prediction of cardiovascular (CV) risk in individuals with COPD. Traditional CV risk ... ...

    Abstract Objectives Although cardiovascular disease (CVD) is a common comorbidity associated with chronic obstructive pulmonary disease (COPD), it is unknown how to improve prediction of cardiovascular (CV) risk in individuals with COPD. Traditional CV risk scores have been tested in different populations but not uniquely in COPD. The potential of alternative markers to improve CV risk prediction in individuals with COPD is unknown. We aimed to determine the predictive value of conventional CVD risk factors in COPD and to determine if additional markers improve prediction beyond conventional factors.Design Data from the Evaluation of the Role of Inflammation in Chronic Airways disease cohort, which enrolled 729 individuals with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II–IV COPD were used. Linked hospital episode statistics and survival data were prospectively collected for a median 4.6 years of follow-up.Setting Five UK centres interested in COPD.Participants Population-based sample including 714 individuals with spirometry-defined COPD, smoked at least 10 pack years and who were clinically stable for >4 weeks.Interventions Baseline measurements included aortic pulse wave velocity (aPWV), carotid intima–media thickness (CIMT), C reactive protein (CRP), fibrinogen, spirometry and Body mass index, airflow Obstruction, Dyspnoea and Exercise capacity (BODE) Index, 6 min walk test (6MWT) and 4 m gait speed (4MGS) test.Primary and secondary outcome measures New occurrence (first event) of fatal or non-fatal hospitalised CVD, and all-cause and cause-specific mortality.Results Out of 714 participants, 192 (27%) had CV hospitalisation and 6 died due to CVD. The overall CV risk model C-statistic was 0.689 (95% CI 0.688 to 0.691). aPWV and CIMT neither had an association with study outcome nor improved model prediction. CRP, fibrinogen, GOLD stage, BODE Index, 4MGS and 6MWT were associated with the outcome, independently of conventional risk factors (p<0.05 for all). However, only 6MWT improved model discrimination (C=0.727, 95% CI 0.726 to 0.728).Conclusion Poor physical performance defined by the 6MWT improves prediction of CV hospitalisation in individuals with COPD.Trial registration number ID 11101.
    Schlagwörter Medicine ; R
    Thema/Rubrik (Code) 310
    Sprache Englisch
    Erscheinungsdatum 2020-12-01T00:00:00Z
    Verlag BMJ Publishing Group
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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  9. Artikel ; Online: The p38 mitogen activated protein kinase inhibitor losmapimod in chronic obstructive pulmonary disease patients with systemic inflammation, stratified by fibrinogen

    Marie Fisk / Joseph Cheriyan / Divya Mohan / Julia Forman / Kaisa M Mäki-Petäjä / Carmel M McEniery / Jonathan Fuld / James H F Rudd / Nicholas S Hopkinson / David A Lomas / John R Cockcroft / Ruth Tal-Singer / Michael I Polkey / Ian B Wilkinson

    PLoS ONE, Vol 13, Iss 3, p e

    A randomised double-blind placebo-controlled trial.

    2018  Band 0194197

    Abstract: Background Cardiovascular disease is a major cause of morbidity and mortality in COPD patients. Systemic inflammation associated with COPD, is often hypothesised as a causal factor. p38 mitogen-activated protein kinases play a key role in the ... ...

    Abstract Background Cardiovascular disease is a major cause of morbidity and mortality in COPD patients. Systemic inflammation associated with COPD, is often hypothesised as a causal factor. p38 mitogen-activated protein kinases play a key role in the inflammatory pathogenesis of COPD and atherosclerosis. Objectives This study sought to evaluate the effects of losmapimod, a p38 mitogen-activated protein kinase (MAPK) inhibitor, on vascular inflammation and endothelial function in chronic obstructive pulmonary disease (COPD) patients with systemic inflammation (defined by plasma fibrinogen >2·8g/l). Methods This was a randomised, double-blind, placebo-controlled, Phase II trial that recruited COPD patients with plasma fibrinogen >2.8g/l. Participants were randomly assigned by an online program to losmapimod 7·5mg or placebo tablets twice daily for 16 weeks. Pre- and post-dose 18F-Fluorodeoxyglucose positron emission tomography co-registered with computed tomography (FDG PET/CT) imaging of the aorta and carotid arteries was performed to quantify arterial inflammation, defined by the tissue-to-blood ratio (TBR) from scan images. Endothelial function was assessed by brachial artery flow-mediated dilatation (FMD). Results We screened 160 patients, of whom, 36 and 37 were randomised to losmapimod or placebo. The treatment effect of losmapimod compared to placebo was not significant, at -0·05 for TBR (95% CI: -0·17, 0·07), p = 0·42, and +0·40% for FMD (95% CI: -1·66, 2·47), p = 0·70. The frequency of adverse events reported was similar in both treatment groups. Conclusions In this plasma fibrinogen-enriched study, losmapimod had no effect on arterial inflammation and endothelial function at 16 weeks of treatment, although it was well tolerated with no significant safety concerns. These findings do not support the concept that losmapimod is an effective treatment for the adverse cardiovascular manifestations of COPD.
    Schlagwörter Medicine ; R ; Science ; Q
    Thema/Rubrik (Code) 610
    Sprache Englisch
    Erscheinungsdatum 2018-01-01T00:00:00Z
    Verlag Public Library of Science (PLoS)
    Dokumenttyp Artikel ; Online
    Datenquelle BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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