Publications
573 results found
Lawrance E, Thompson R, Roberts L, et al., 2023, Ambient temperature and mental health: a systematic review and meta analysis, The Lancet Planetary Health, Vol: 7, Pages: e580-e589, ISSN: 2542-5196
BackgroundIncreasing evidence indicates that ambient outdoor temperature could affect mental health, which is especially concerning in the context of climate change. We aimed to comprehensively analyse the current evidence regarding the associations between ambient temperature and mental health outcomes.MethodsWe did a systematic review and meta-analysis of the evidence regarding associations between ambient outdoor temperature and changes in mental health outcomes. We searched WebOfScience, Embase, PsychINFO, and PubMed for articles published from database origin up to April 7, 2022. Eligible articles were epidemiological, observational studies in humans of all ages, which evaluated real-world responses to ambient outdoor temperature, and had mental health as a documented outcome; studies of manipulated or controlled temperature or those with only physical health outcomes were excluded. All eligible studies were synthesised qualitatively. If three or more studies reported the same or equivalent effect statistics and if they had equivalent exposure, outcome, and metrics, the studies were pooled in a random-effects meta-analysis. The risk of bias for individual studies was assessed using the Newcastle-Ottawa Scale. The quality of evidence across studies was assessed using the Office of Health Assessment and Translation (OHAT) approach.Findings114 studies were included in the systematic review, of which 19 were suitable for meta-analysis. Three meta-analyses were conducted for suicide outcomes: a 1°C increase in mean monthly temperature was associated with an increase in incidence of 1·5% (95% CI 0·8–2·2, p<0·001; n=1 563 109, seven effects pooled from three studies); a 1°C increase in mean daily temperature was associated with an increase in incidence of 1·7% (0·3–3·0, p=0·014; n=113 523, five effects pooled from five studies); and a 1°C increase in mean monthly temperature was associa
Ravindran S, Matharoo M, Marshall S, et al., 2023, Development, validation, and results of a national endoscopy safety attitudes questionnaire (Endo-SAQ), ENDOSCOPY INTERNATIONAL OPEN, Vol: 11, Pages: E679-E689, ISSN: 2364-3722
Sargsyan N, Das B, Alghazawi L, et al., 2023, Cost and Durability of Various Gastrojejunostomy Closure Techniques, Publisher: SPRINGER, Pages: S61-S61, ISSN: 0960-8923
Sargsyan N, Das B, Alghazawi L, et al., 2023, Economic Cost and Durability of Various Gastrojejunostomy Closure Techniques, Publisher: SPRINGER, Pages: S60-S60, ISSN: 0960-8923
Alghazawi L, Fadel MG, Chen JY, et al., 2023, Educational Values of Laparoscopic Sleeve Gastrectomy Videos; A Quality Review of Both Academic and Commercial Platforms, Publisher: SPRINGER, Pages: S57-S57, ISSN: 0960-8923
Acharya A, Judah G, Ashrafian H, et al., 2023, Investigating the national implementation of SMS and mobile messaging In Population Screening (The SIPS Study), EBioMedicine, Vol: 93, Pages: 1-11, ISSN: 2352-3964
BackgroundThe increasing use of mobile messaging within healthcare, poses challenges for screening programmes, which involve communicating with large, diverse populations. This modified Delphi study aimed to create guidance regarding the use of mobile messaging for screening programmes, to facilitate greater, and equitable screening uptake.MethodsInitial recommendations were derived from a literature review, expert scoping questionnaire, public consultation, and discussion with relevant national organisations. Experts from the fields of public health, screening commissioning, industry and academia voted upon the importance and feasibility of these recommendations across two consensus rounds, using a 5-point Likert scale. Items reaching consensus, defined a priori at 70%, on importance and feasibility formed ‘core’ recommendations. Those reaching this threshold on importance only, were labelled ‘desirable’. All items were subsequently discussed at an expert meeting to confirm suitability. FindingsOf the initial 101 items, 23 reached consensus regarding importance and feasibility. These ‘core’ items were divided across six domains: message content, timing, delivery, evaluation, security, and research considerations. ‘Core’ items such as explicitly specifying the sender and the role of patient involvement in development of screening message research had the highest agreement. A further 17 ‘desirable’ items reached consensus regarding importance, but not feasibility, including the integration into GP services to enable telephone verification.InterpretationThese findings forming national guidance for services, will enable programmes to overcome implementation challenges and facilitate uptake of screening invitations. By providing a list of desirable items, this study provides areas for future consideration, as technological innovation in messaging continues to grow.FundingNIHR Imperial Patient Safety Translation
Danielli S, Ashrafian H, Darzi A, 2023, Population health: transformation will happen at the speed of trust, JOURNAL OF PUBLIC HEALTH, Vol: 45, Pages: 410-413, ISSN: 1741-3842
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- Citations: 1
Bakri NAC, Kwasnicki R, Tenang L, et al., 2023, Upper Limb Recovery Following Mastectomy with and without Breast Reconstruction Measured Using Wearable Activity Monitors, 24th Annual Meeting of The American Society of Breast Surgeons (ASBrS), Publisher: SPRINGER, Pages: S614-S615, ISSN: 1068-9265
Ashrafian H, 2023, Differential diagnosis of tophaceous gout and multiple facial papules in Federico da Montefeltro by Piero della Francesca (c. 1415-1492), RHEUMATOLOGY INTERNATIONAL, Vol: 43, Pages: 1195-1196, ISSN: 0172-8172
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- Citations: 2
Ashrafian H, 2023, Goiter in the paintings by Rogier van der Weyden (1399-1464), JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION, ISSN: 0391-4097
Ashrafian H, 2023, Goiter, thyroid facial involvement and eye disease in the paintings of Jan Gossaert (c. 1478-1532), JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION, ISSN: 0391-4097
Ong ZZ, Sadek Y, Liu X, et al., 2023, Diagnostic performance of deep learning in infectious keratitis: a systematic review and meta-analysis protocol, BMJ OPEN, Vol: 13, ISSN: 2044-6055
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- Citations: 1
Ravindran S, Cavilla R, Ashrafian H, et al., 2023, Development of the "Teamwork in Endoscopy Assessment Module for Endoscopic Non-Technical Skills" (TEAM-ENTS) behavioral marker system, ENDOSCOPY, Vol: 55, Pages: 403-412, ISSN: 0013-726X
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- Citations: 2
Ashrafian H, 2023, Differential diagnosis of a thyroid mass, Gottron's papules, Calcinosis Cutis and Ptosis on the Saint Mary Magdalen and two depictions of a Madonna and Baby by Bartolomeo Vivarini (1432-1499), JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION, Vol: 46, Pages: 1043-1045, ISSN: 0391-4097
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- Citations: 1
Ashrafian H, 2023, Earliest depiction of unilateral gynecomastia in history 300-250 B.C, BREAST CANCER RESEARCH AND TREATMENT, ISSN: 0167-6806
Clarke J, Beaney T, Alboksmaty A, et al., 2023, Factors associated with enrolment into a national COVID-19 pulse oximetry remote monitoring programme in England: a retrospective observational study, The Lancet: Digital Health, Vol: 5, Pages: e194-e205, ISSN: 2589-7500
BACKGROUND: Hypoxaemia is an important predictor of severity in individuals with COVID-19 and can present without symptoms. The COVID Oximetry @home (CO@h) programme was implemented across England in November, 2020, providing pulse oximeters to higher-risk people with COVID-19 to enable early detection of deterioration and the need for escalation of care. We aimed to describe the clinical and demographic characteristics of individuals enrolled onto the programme and to assess whether there were any inequalities in enrolment. METHODS: This retrospective observational study was based on data from a cohort of people resident in England recorded as having a positive COVID-19 test between Oct 1, 2020, and May 3, 2021. The proportion of participants enrolled onto the CO@h programmes in the 7 days before and 28 days after a positive COVID-19 test was calculated for each clinical commissioning group (CCG) in England. Two-level hierarchical multivariable logistic regression with random intercepts for each CCG was run to identify factors predictive of being enrolled onto the CO@h programme. FINDINGS: CO@h programme sites were reported by NHS England as becoming operational between Nov 21 and Dec 31, 2020. 1 227 405 people resident in 72 CCGs had a positive COVID-19 test between the date of programme implementation and May 3, 2021, of whom 19 932 (1·6%) were enrolled onto the CO@h programme. Of those enrolled, 14 441 (72·5%) were aged 50 years or older or were identified as clinically extremely vulnerable (ie, having a high-risk medical condition). Higher odds of enrolment onto the CO@h programme were found in older individuals (adjusted odds ratio 2·21 [95% CI 2·19-2·23], p<0·001, for those aged 50-64 years; 3·48 [3·33-3·63], p<0·001, for those aged 65-79 years; and 2·50 [2·34-2·68], p<0·001, for those aged ≥80 years), in individuals of non-White ethnicity (1·3
Che Bakri NA, Kwasnicki R, Khan N, et al., 2023, Impact of axillary lymph node dissection and sentinel lymph node biopsy on upper limb morbidity in breast cancer patients: a systematic review and meta-analysis, Annals of Surgery, Vol: 277, Pages: 572-580, ISSN: 0003-4932
Objective: To evaluate the impact of ALND and SLNB on upper limb (UL) morbidity in breastcancer patients.Summary Background: Axillary de-escalation is motivated by a desire to reduce harm ofALND. Understanding the impact of axillary surgery and disparities in operative procedureson post-operative arm morbidity would better direct resources to the point of need and cementthe need for de-escalation strategies.Methods: Embase, Medline, CINAHL and PsychINFO were searched from 1990 until March2020. Included studies were randomized-controlled and observational studies focusing on ULmorbidities, in breast surgery patients. The study followed the Preferred Reporting Items forSystematic Reviews and Meta-Analyses (PRISMA) guidelines. The prevalence of upper limbmorbidity comparing SLNB and ALND at less than 12 months, 12-24 months and beyond 24months were analyzed.Results: Sixty-seven studies were included. All studies reported a higher rate of lymphedemaand pain after ALND compared to SLNB. The difference in lymphedema and pain prevalencebetween SLNB and ALND was 13.7% (95% CI 10.5-16.8, p<0.005) and 24.2% (95% CI 12.1-36.3, p<0.005) respectively. Pooled estimates for prevalence of reduced strength and rangeof motion after SLNB and ALND were 15.2% vs 30.9% and 17.1% vs 29.8% respectively.Type of axillary surgery, greater BMI, and radiotherapy were some of the predictors for ULmorbidities.Conclusions: Prevalence of lymphedema after ALND was higher than previously estimated.ALND patients experienced greater rates of lymphedema, pain, reduced strength, and ROMcompared to SLNB. The findings support the continued drive to de-escalate axillary surgery.
Ashrafian H, 2023, Presentations of bubonic plague in the Renaissance by Carlo Crivelli (c. 1430-1495)., Clin Microbiol Infect, Vol: 29
Che Bakri NA, Kwasnicki RM, Khan N, et al., 2023, Impact of Axillary Lymph Node Dissection and Sentinel Lymph Node Biopsy on Upper Limb Morbidity in Breast Cancer Patients A Systematic Review and Meta-Analysis, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 572-580, ISSN: 0003-4932
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- Citations: 11
Fehervari M, Banh S, Varma P, et al., 2023, Weight loss specific to indication, remission of diabetes, and short-term complications after sleeve gastrectomy conversion to Roux-en-Y gastric bypass: a systematic review and meta-analysis, SURGERY FOR OBESITY AND RELATED DISEASES, Vol: 19, Pages: 384-395, ISSN: 1550-7289
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- Citations: 3
Das B, Ledesma F, Ashrafian H, et al., 2023, Gastrojejunostomy Closure Technique and Risk of Leak: an Evaluation in Ex Vivo Porcine Models, OBESITY SURGERY, Vol: 33, Pages: 978-981, ISSN: 0960-8923
Ashrafian H, 2023, Goiters in the Renaissance era: Multiple cases of thyroid autoimmunity and iodine deficiency, BEST PRACTICE & RESEARCH CLINICAL ENDOCRINOLOGY & METABOLISM, Vol: 37, ISSN: 1521-690X
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- Citations: 2
Marecos J, Shattock E, Bartlett O, et al., 2023, Health misinformation and freedom of expression: considerations for policymakers, HEALTH ECONOMICS POLICY AND LAW, ISSN: 1744-1331
Schaarup JFR, Aggarwal R, Dalsgaard EM, et al., 2023, Perception of artificial intelligence-based solutions in healthcare among people with and without diabetes: A cross-sectional survey from the health in Central Denmark cohort, Diabetes Epidemiology and Management, Vol: 9
Background: Patients’ acceptance of artificial intelligence (AI) based health-related technologies depend strongly on their perception and trust of AI. This research field has not been studied extensively, especially among people living with diabetes. A large proportion of them frequently use health technologies in their everyday lives to manage their condition, which may make them more prepared to adopt AI-based solutions. Our study aimed to investigate the perception of AI-based solutions in healthcare, and characteristics associated with positive attitudes towards AI among people with and without diabetes. Methods: An online survey was sent to 12,755 participants in the Health in Central Denmark cohort, including 10 questions and six scenarios related to current technology use, data sharing, and AI. The question on benefits and risks of AI, and the responses to the scenarios were used as outcomes. Multinomial logistic regression was used to examine which characteristics were associated with seeing the benefit of AI over the risks, including diabetes status, age, sex, education, health literacy, the use of wearable devices, and views on data sharing. A similar analysis was conducted on the acceptance of AI-based solutions in healthcare-related scenarios. Findings: 8,420 participants responded to the survey. Most participants (88%) had previously heard about AI. 46% of participants agreed with the statement that the benefits of AI outweigh the risks, while only 2% agreed with the opposite statement, and 30% were unsure. We did not find evidence for a differential opinion by diabetes status. Having diabetes was associated with less openness to replace healthcare professionals by AI-based technologies, although most people were still open to AI if controlled by humans. Interpretation: Despite the generally positive perception of AI and its benefits to healthcare, human interaction seemed to play an important role in defining positive attitudes to AI across diff
Danielli S, Radyte E, Donnelly P, et al., 2023, Improving health in London: reflections from three mini case studies (HIV, mental health, healthcare estate), Cities and Health, Vol: 7, Pages: 312-317, ISSN: 2374-8834
Global health will increasingly be determined by cities and therefore city-wide transformation of health and care is crucially important. Reflections from our experiences in London suggest some critical ingredients for city-wide transformation, including: having a shared aim; robust engagement with the citizens, service users and providers of services; setting aside organisational priorities and effective incentives to do so; a focus on enablers; strong city-wide leadership. Rather than working ‘together but separately’, health and care partners must work ‘together, together’ if cities are to meet the health and care challenges of the next decade.
Ashrafian H, Harling L, 2023, Earliest depiction of lymphedema in history 1700 to 1500 BC, JOURNAL OF VASCULAR SURGERY-VENOUS AND LYMPHATIC DISORDERS, Vol: 11, Pages: 229-230, ISSN: 2213-333X
Breda J, Darzi A, Ashrafian H, et al., 2023, Editorial: Innovations in quality of care., Front Health Serv, Vol: 3
Bolous NS, Graetz DE, Ashrafian H, et al., 2022, Harnessing a clinician-led governance model to overcome healthcare tribalism and drive innovation: a case study of Northumbria NHS Foundation Trust, Journal of Health, Organization and Management, Vol: 37, Pages: 1-16, ISSN: 0268-9235
PurposeHealthcare tribalism refers to the phenomenon through which different groups in a healthcare setting strictly adhere to their profession-based silo, within which they exhibit stereotypical behaviours. In turn, this can lead to deleterious downstream effects upon productivity and care delivered to patients. This study highlights a clinician-led governance model, implemented at a National Health Service (NHS) trust, to investigate whether it successfully overcame tribalism and helped drive innovation.Design/methodology/approachThis was a convergent mixed-methods study including qualitative and quantitative data collected in parallel. Qualitative data included 27 semi-structured interviews with representatives from four professional groups. Quantitative data were collected through a verbally administered survey and scored on a 10-point scale.FindingsThe trust arranged its services under five autonomous business units, with a clinician and a manager sharing the leadership role at each unit. According to interviewees replies, this equivalent authority was cascaded down and enabled breaking down professional siloes, which in turn aided in the adoption of an innovative clinical model restructure.Practical implicationsThis study contributes to the literature by characterizing a real-world example in which healthcare tribalism was mitigated while reflecting on the advantages yielded as a result.Originality/valuePrevious studies from all over the world identified major differences in the perspectives of different healthcare professional groups. In the United Kingdom, clinicians largely felt cut off from decision-making and dissatisfied with their managerial role. The study findings explain a governance model that allowed harmony and inclusion of different professions. Given the long-standing strains on healthcare systems worldwide, stakeholders can leverage the study findings for guidance in developing and implementing innovative managerial approaches.
Fadel MG, Fehervari M, Lairy A, et al., 2022, Clinical outcomes of single-stage versus two-stage laparoscopic Roux-en-y gastric bypass in the management of obesity (BMI ≥50 kg/m2): a retrospective cohort study, Langenbecks Archives of Surgery, Vol: 407, Pages: 3349-3356, ISSN: 1435-2443
BackgroundLaparoscopic Roux-en-Y gastric bypass (LRYGB) in patients with obesity, BMI ≥ 50 kg/m2, can be a challenging operation. Weight loss with intra-gastric balloon (IGB) insertion prior to LRYGB may improve operative outcomes.MethodsBetween June 2000 and June 2020, patients with a BMI ≥ 50 kg/m2 underwent either IGB insertion followed by LRYGB (two-stage group), or LRYGB as the definitive bariatric procedure (single-stage group) in our institution. The two-stage procedure was adopted for high risk individuals. Primary outcome measures were percentage total weight loss (%TWL) at 24 months, length of stay and postoperative morbidity. Propensity score analysis was used to account for differences between groups.ResultsA total of 155 (mean age 42.9 years ± 10.60; mean BMI 54.6 kg/m2 ± 4.53) underwent either the two-stage (n = 30) or single-stage procedure (n = 125) depending on preoperative fitness. At 6 months following LRYGB, there was a significant difference in %TWL between the groups in a matched analysis (11.9% vs 23.7%, p < 0.001). At 24 months, there was no difference in %TWL (32.0% vs 34.7%, p = 0.13). Median hospital stay following LRYGB was 2.0 (1-4) days with the two-stage vs 2.0 (0-14) days for the single-stage approach (p = 0.75). There was also no significant difference in complication rates (p = 0.058) between the two groups.ConclusionsThere was no difference in weight loss after one or two-stage procedures in the treatment of patients with a BMI ≥ 50 kg/m2 super obesity in a propensity score weighted analysis at 24 months. Length of stay and perioperative complications were similar for high risk patients; however, the two-stage approach was associated with delayed weight loss. Single-stage management is recommended for moderate risk patients, particularly with significant metabolic disorders, whilst
Nabeel A, Al-Sabah SK, Ashrafian H, 2022, Digital Contact Tracing Applications against COVID-19: A Systematic Review, MEDICAL PRINCIPLES AND PRACTICE, Vol: 31, Pages: 424-432, ISSN: 1011-7571
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- Citations: 2
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