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  • Online Resource  (103)
  • 1
    Online Resource
    Online Resource
    Home Adaptations: User Perspectives on the Role of Professionals
    SAGE Publications ; 2003
    In:  British Journal of Occupational Therapy Vol. 66, No. 1 ( 2003-01), p. 2-8
    Details
    In: British Journal of Occupational Therapy, SAGE Publications, Vol. 66, No. 1 ( 2003-01), p. 2-8
    Abstract: People with disabilities often carry much of the responsibility for the process of making adaptations to their homes and look to the professionals involved for support. The study described in this article asked people with disabilities whether they believed that they received appropriate professional support, information and practical help when adapting their homes and sought to learn more about their feelings about the adaptation process. A qualitative research method, using three focus groups in different geographical areas, was carried out with a purposive sample of participants who had received adaptations to their homes and had been assisted by their local authorities. The groups comprised participants from urban and rural populations, who had a mix of housing tenure and a variety of professional support. The findings demonstrated that this method was appropriate as a means of both discovering how people felt about the process and identifying what they found to be the most helpful assistance from the professionals involved. The study suggested that when problems arose or delays were experienced during the building process, an occupational therapist was not the only appropriate professional to provide support because this could be given in a variety of ways by different professionals and helping agencies. The study also suggested that, given sufficient information and choice, some people with disabilities preferred to organise their own adaptations, could manage with minimal professional intervention and should be empowered to do so.
    Type of Medium: Online Resource
    ISSN: 0308-0226 , 1477-6006
    URL: Article
    DOI: 10.1177/030802260306600102
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2003
    detail.hit.zdb_id: 2099814-4
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  • 2
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    Therapeutic mammaplasty is a safe and effective alternative to mastectomy with or without immediate breast reconstruction
    Oxford University Press (OUP) ; 2020
    In:  British Journal of Surgery Vol. 107, No. 7 ( 2020-05-28), p. 832-844
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 107, No. 7 ( 2020-05-28), p. 832-844
    Abstract: Therapeutic mammaplasty (TM) may be an alternative to mastectomy, but few well designed studies have evaluated the success of this approach or compared the short-term outcomes of TM with mastectomy with or without immediate breast reconstruction (IBR). Data from the national iBRA-2 and TeaM studies were combined to compare the safety and short-term outcomes of TM and mastectomy with or without IBR. Methods The subgroup of patients in the TeaM study who underwent TM to avoid mastectomy were identified, and data on demographics, complications, oncology and adjuvant treatment were compared with those of patients undergoing mastectomy with or without IBR in the iBRA-2 study. The primary outcome was the percentage of successful breast-conserving procedures in the TM group. Secondary outcomes included postoperative complications and time to adjuvant therapy. Results A total of 2916 patients (TM 376; mastectomy 1532; mastectomy and IBR 1008) were included in the analysis. Patients undergoing TM were more likely to be obese and to have undergone bilateral surgery than those having IBR. However, patients undergoing mastectomy with or without IBR were more likely to experience complications than the TM group (TM: 79, 21·0 per cent; mastectomy: 570, 37·2 per cent; mastectomy and IBR: 359, 35·6 per cent; P & lt; 0·001). Breast conservation was possible in 87·0 per cent of patients who had TM, and TM did not delay adjuvant treatment. Conclusion TM may allow high-risk patients who would not be candidates for IBR to avoid mastectomy safely. Further work is needed to explore the comparative patient-reported and cosmetic outcomes of the different approaches, and to establish long-term oncological safety.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1002/bjs.11468
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2006309-X
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  • 3
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    Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic: outcomes from the B-MaP-C study
    Springer Science and Business Media LLC ; 2023
    In:  Breast Cancer Research and Treatment Vol. 199, No. 2 ( 2023-06), p. 265-279
    Details
    In: Breast Cancer Research and Treatment, Springer Science and Business Media LLC, Vol. 199, No. 2 ( 2023-06), p. 265-279
    Abstract: The B-MaP-C study investigated changes to breast cancer care that were necessitated by the COVID-19 pandemic. Here we present a follow-up analysis of those patients commenced on bridging endocrine therapy (BrET), whilst they were awaiting surgery due to reprioritisation of resources. Methods This multicentre, multinational cohort study recruited 6045 patients from the UK, Spain and Portugal during the peak pandemic period (Feb–July 2020). Patients on BrET were followed up to investigate the duration of, and response to, BrET. This included changes in tumour size to reflect downstaging potential, and changes in cellular proliferation (Ki67), as a marker of prognosis. Results 1094 patients were prescribed BrET, over a median period of 53 days (IQR 32–81 days). The majority of patients (95.6%) had strong ER expression (Allred score 7–8/8). Very few patients required expedited surgery, due to lack of response (1.2%) or due to lack of tolerance/compliance (0.8%). There were small reductions in median tumour size after 3 months’ treatment duration; median of 4 mm [IQR − 20, 4]. In a small subset of patients ( n  = 47), a drop in cellular proliferation (Ki67) occurred in 26 patients (55%), from high (Ki67 ≥ 10%) to low ( 〈  10%), with at least one month’s duration of BrET. Discussion This study describes real-world usage of pre-operative endocrine therapy as necessitated by the pandemic. BrET was found to be tolerable and safe. The data support short-term (≤ 3 months) usage of pre-operative endocrine therapy. Longer-term use should be investigated in future trials.
    Type of Medium: Online Resource
    ISSN: 0167-6806 , 1573-7217
    URL: Article
    DOI: 10.1007/s10549-023-06893-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2004077-5
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  • 4
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    65. Development of a multi-disciplinary service for children and young people with Behçet’s syndrome: within the Liverpool National Centre of Excellence for Behçet’s syndrome
    Oxford University Press (OUP) ; 2017
    In:  Rheumatology Vol. 56, No. suppl_7 ( 2017-12-01)
    Details
    In: Rheumatology, Oxford University Press (OUP), Vol. 56, No. suppl_7 ( 2017-12-01)
    Type of Medium: Online Resource
    ISSN: 1462-0324 , 1462-0332
    URL: Article
    DOI: 10.1093/rheumatology/kex390.065
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 1474143-X
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  • 5
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    Behçet’s syndrome in children and young people in the United Kingdom and the Republic of Ireland: a prospective epidemiological study
    Oxford University Press (OUP) ; 2021
    In:  Rheumatology Vol. 60, No. 10 ( 2021-10-02), p. 4728-4736
    Details
    In: Rheumatology, Oxford University Press (OUP), Vol. 60, No. 10 ( 2021-10-02), p. 4728-4736
    Abstract: To define the incidence and prevalence of Behçet’s syndrome (BS) in children and young people (CYP) up to the age of 16 years in the United Kingdom (UK) and Republic of Ireland (ROI). Methods A prospective epidemiological study was undertaken with the support of the British Paediatric Surveillance Unit (BPSU) and the British Society of Paediatric Dermatologists (BSPD). Consultants reported anonymised cases of BS seen. A follow-up study at one year examined progression of disease and treatment. Results Over a two-year period, 56 cases met the International Criteria for Behçet’s Disease. For children under 16 years of age, the two-year period prevalence estimate was 4.2 per million (95% CI: 3.2, 5.4) and the incidence was 0.96 per million person years (95% CI: 0.66, 1.41). Mucocutaneous disease was the most common phenotype (56/100%), with ocular (10/56; 17.9%), neurological (2/56; 3.6%) and vascular involvement (3/56; 5.4%) being less common. Median age at onset was 6.34 years and at diagnosis was 11.72 years. There were slightly more female than male children reported (32/56; 55.6%). The majority of cases (85.7%) were white Caucasian. Apart from genital ulcers, which were more common in females, there were no significant differences in frequency of manifestations between male or females, nor between ethnicities. Over 83% of cases had three or more non-primary care healthcare professionals involved in their care. Conclusion BS is extremely rare in CYP in the UK and ROI and most have mucocutaneous disease. Healthcare needs are complex, and coordinated care is key.
    Type of Medium: Online Resource
    ISSN: 1462-0324 , 1462-0332
    URL: Article
    DOI: 10.1093/rheumatology/keab084
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 6
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    Tocilizumab as a potential therapeutic option for children with severe, refractory juvenile localized scleroderma
    Oxford University Press (OUP) ; 2018
    In:  Rheumatology Vol. 57, No. 2 ( 2018-02-01), p. 398-401
    Details
    In: Rheumatology, Oxford University Press (OUP), Vol. 57, No. 2 ( 2018-02-01), p. 398-401
    Type of Medium: Online Resource
    ISSN: 1462-0324 , 1462-0332
    URL: Article
    DOI: 10.1093/rheumatology/kex382
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
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  • 7
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    OA32 UK Paediatric Rheumatology Clinical Studies Group research priorities - results of a multidisciplinary consultation and consensus exercise
    Oxford University Press (OUP) ; 2022
    In:  Rheumatology Vol. 61, No. Supplement_1 ( 2022-04-23)
    Details
    In: Rheumatology, Oxford University Press (OUP), Vol. 61, No. Supplement_1 ( 2022-04-23)
    Abstract: The evidence base underlying the management of children and young people (CYP) with paediatric rheumatic diseases (PRDs) is inadequate, with many critical outstanding questions warranting investigation. The aim of this study was to elicit multidisciplinary PRDs research priorities, through consultation with patients, carers and healthcare professionals. Methods This study was led by the UK NIHR CRN Children/Versus Arthritis Paediatric Rheumatology CSG (referred to as ‘the CSG’) and its Topic Specific Groups (TSGs). The CSG is a multidisciplinary group with strong patient/parent representation, supporting the development of clinical studies in the UK. Research priority ideas were sought from paediatric rheumatologists, trainees, allied healthcare professional (AHP), nurses, patients, parents and charities, through online surveys and face-to-face meetings. Research ideas were categorised as disease-specific or broad/general. They were grouped into sub-themes, duplicates/questions that had already been answered were removed, and similar submissions combined. A modified Delphi process was undertaken, including online research priority ranking, and an online consensus workshop to derive top PRD research priorities. Results The initial consultation yielded 304 research priority ideas; 25% from patients/parents, 22% from the CSG, 18% from TSGs, 13% from AHPs, 11% from trainees, 11% from Nurses. 55 disease-specific and 37 broad/general research priorities were voted upon in the first online survey, yielding a top 11 general broad research priorities. The top 10 disease specific priorities were discussed at the online Delphi priority setting workshop, and two online surveys were held during the workshop to determine their final ranking. Two of the disease-specific priorities were combined, leading to a top 9 (see Table). Disease specific proprieties related to clinical trials in JIA (n = 3) / Juvenile Dermatomyositis (n = 1) / Chronic Recurrent Multifocal Osteomyelitis (n = 1) / Juvenile Systemic Lupus Erythematosus (n = 1) Scleroderma (n = 1), management of JIA in adulthood (n = 1) and chronic pain (n = 1). Conclusion UK consensus-based PRD research priorities have been derived, underpinned by collaboration with patients/carers and healthcare professionals, helping to guide funding bodies to improve the evidence base in PRD’s. Disclosure E.M.D. Smith: None. N. Egbivwie: None. K. Cowan: None. A.V. Ramanan: None. C.E. Pain: None.
    Type of Medium: Online Resource
    ISSN: 1462-0324 , 1462-0332
    URL: Article
    DOI: 10.1093/rheumatology/keac132.032
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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  • 8
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    Non-invasive imaging and clinical skin scores in juvenile localized scleroderma
    Oxford University Press (OUP) ; 2023
    In:  Rheumatology ( 2023-08-02)
    Details
    In: Rheumatology, Oxford University Press (OUP), ( 2023-08-02)
    Abstract: To evaluate whether in juvenile localized scleroderma (JLS), non-invasive imaging can differentiate affected from non-affected skin and whether imaging correlates with a validated skin score [Localised Scleroderma Cutaneous Assessment Tool (LoSCAT)]. Methods A total of 25 children with JLS were recruited into a prospective study and a single ‘target’ lesion was selected. High-frequency ultrasound (HFUS, measuring skin thickness), infrared thermography (IRT, skin temperature), laser Doppler imaging (LDI, skin blood flow) and multispectral imaging (MSI, oxygenation) were performed at four sites: two of affected skin (centre and inner edge of lesion) and two of non-affected skin (1 cm from the edge of the lesion ‘outer’ and contralateral non-affected side) at four visits at 3 month intervals. Results Differences between affected and non-affected skin were detected with all four techniques. Compared with non-affected skin, affected skin was thinner (P  & lt; 0.001), with higher temperature (P  & lt; 0.001–0.006), perfusion (P  & lt; 0.001–0.039) and oxygenation (P  & lt; 0.001–0.028). Lesion skin activity (LoSCAT) was positively correlated with centre HFUS [r = 0.32 (95% CI 0.02, 0.61), P = 0.036] and negatively correlated with centre LDI [r = −0.26 (95% CI −0.49, −0.04), P = 0.022] . Lesion skin damage was positively correlated with centre and inner IRT [r = 0.43 (95% CI 0.19, 0.67), P  & lt; 0.001 and r = 0.36 (95% CI 0.12, 0.59), P = 0.003, respectively] and with centre and inner LDI [r = 0.37 (95% CI 0.05, 0.69), P = 0.024 and r = 0.41 (95% CI 0.08, 0.74), P = 0.015, respectively] . Conclusion Non-invasive imaging can detect differences between affected and non-affected skin in JLS and may help to differentiate between activity (thicker, less well-perfused skin) and damage (thinner, highly perfused skin).
    Type of Medium: Online Resource
    ISSN: 1462-0324 , 1462-0332
    URL: Article
    DOI: 10.1093/rheumatology/kead380
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 9
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    COVID-19, remote working and paediatric training: what can we learn?
    BMJ ; 2021
    In:  Archives of disease in childhood - Education & practice edition Vol. 106, No. 3 ( 2021-06), p. 188-189
    Details
    In: Archives of disease in childhood - Education & practice edition, BMJ, Vol. 106, No. 3 ( 2021-06), p. 188-189
    Type of Medium: Online Resource
    ISSN: 1743-0585 , 1743-0593
    URL: Article
    DOI: 10.1136/archdischild-2020-320180
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2188492-4
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  • 10
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    A Sensorimotor Approach to the Treatment of Trauma and Dissociation
    Elsevier BV ; 2006
    In:  Psychiatric Clinics of North America Vol. 29, No. 1 ( 2006-3), p. 263-279
    Details
    In: Psychiatric Clinics of North America, Elsevier BV, Vol. 29, No. 1 ( 2006-3), p. 263-279
    Type of Medium: Online Resource
    ISSN: 0193-953X
    URL: Article
    DOI: 10.1016/j.psc.2005.10.012
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2006
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