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  1. Article ; Online: Learning Through Chain Event Graphs: The Role of Maternal Factors in Childhood Type 1 Diabetes.

    Keeble, Claire / Thwaites, Peter Adam / Baxter, Paul David / Barber, Stuart / Parslow, Roger Charles / Law, Graham Richard

    American journal of epidemiology

    2017  Volume 186, Issue 10, Page(s) 1204–1208

    Abstract: Chain event graphs (CEGs) are a graphical representation of a statistical model derived from event trees. They have previously been applied to cohort studies but not to case-control studies. In this paper, we apply the CEG framework to a Yorkshire, ... ...

    Abstract Chain event graphs (CEGs) are a graphical representation of a statistical model derived from event trees. They have previously been applied to cohort studies but not to case-control studies. In this paper, we apply the CEG framework to a Yorkshire, United Kingdom, case-control study of childhood type 1 diabetes (1993-1994) in order to examine 4 exposure variables associated with the mother, 3 of which are fully observed (her school-leaving-age, amniocenteses during pregnancy, and delivery type) and 1 with missing values (her rhesus factor), while incorporating previous type 1 diabetes knowledge. We conclude that the unknown rhesus factor values were likely to be missing not at random and were mainly rhesus-positive. The mother's school-leaving-age and rhesus factor were not associated with the diabetes status of the child, whereas having at least 1 amniocentesis procedure and, to a lesser extent, birth by cesarean delivery were associated; the combination of both procedures further increased the probability of diabetes. This application of CEGs to case-control data allows for the inclusion of missing data and prior knowledge, while investigating associations in the data. Communication of the analysis with the clinical expert is more straightforward than with traditional modeling, and this approach can be applied retrospectively or when assumptions for traditional analyses are not held.
    Language English
    Publishing date 2017-11-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2937-3
    ISSN 1476-6256 ; 0002-9262
    ISSN (online) 1476-6256
    ISSN 0002-9262
    DOI 10.1093/aje/kwx171
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Early mobilisation and rehabilitation in the PICU: a UK survey.

    Thompson, Jacqueline Y / Menzies, Julie C / Manning, Joseph C / McAnuff, Jennifer / Brush, Emily Clare / Ryde, Francesca / Rapley, Tim / Pathan, Nazima / Brett, Stephen / Moore, David J / Geary, Michelle / Colville, Gillian A / Morris, Kevin P / Parslow, Roger Charles / Feltbower, Richard G / Lockley, Sophie / Kirkham, Fenella J / Forsyth, Rob J / Scholefield, Barnaby R

    BMJ paediatrics open

    2022  Volume 6, Issue 1

    Abstract: Objective: To understand the context and professional perspectives of delivering early rehabilitation and mobilisation (ERM) within UK paediatric intensive care units (PICUs).: Design: A web-based survey administered from May 2019 to August 2019.: ... ...

    Abstract Objective: To understand the context and professional perspectives of delivering early rehabilitation and mobilisation (ERM) within UK paediatric intensive care units (PICUs).
    Design: A web-based survey administered from May 2019 to August 2019.
    Setting: UK PICUs.
    Participants: A total of 124 staff from 26 PICUs participated, including 22 (18%) doctors, 34 (27%) nurses, 28 (23%) physiotherapists, 19 (15%) occupational therapists and 21 (17%) were other professionals.
    Results: Key components of participants' definitions of ERM included tailored, multidisciplinary rehabilitation packages focused on promoting recovery. Multidisciplinary involvement in initiating ERM was commonly reported. Over half of respondents favoured delivering ERM after achieving physiological stability (n=69, 56%). All age groups were considered for ERM by relevant health professionals. However, responses differed concerning the timing of initiation. Interventions considered for ERM were more likely to be delivered to patients when PICU length of stay exceeded 28 days and among patients with acquired brain injury or severe developmental delay. The most commonly identified barriers were physiological instability (81%), limited staffing (79%), sedation requirement (73%), insufficient resources and equipment (69%), lack of recognition of patient readiness (67%), patient suitability (63%), inadequate training (61%) and inadequate funding (60%). Respondents ranked reduction in PICU length of stay (74%) and improvement in psychological outcomes (73%) as the most important benefits of ERM.
    Conclusion: ERM is gaining familiarity and endorsement in UK PICUs, but significant barriers to implementation due to limited resources and variation in content and delivery of ERM persist. A standardised protocol that sets out defined ERM interventions, along with implementation support to tackle modifiable barriers, is required to ensure the delivery of high-quality ERM.
    MeSH term(s) Child ; Early Ambulation ; Health Personnel ; Humans ; Intensive Care Units, Pediatric ; Surveys and Questionnaires ; United Kingdom
    Language English
    Publishing date 2022-02-15
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2399-9772
    ISSN (online) 2399-9772
    DOI 10.1136/bmjpo-2021-001300
    Database MEDical Literature Analysis and Retrieval System OnLINE

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