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Veerhuis N, Merizzi A, Papoulias S, Bradbury C, Sheret K, Traynor V. 'It is empowering and gives people dignity in a very difficult process': A multistage, multimethod qualitative study to understand the views of end users in the cultural adaptation of a dementia and driving decision aid. Health Expect 2024; 27:e14006. [PMID: 38497286 PMCID: PMC10945392 DOI: 10.1111/hex.14006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Decisions about driving for individuals living with dementia (ILWD) can be challenging. There are limited evidence-based person-centred interventions in the United Kingdom that support decisions about transitioning to not driving or guidelines for developing decision aids for ILWD. This study aimed to understand the important features of a decision aid through the cultural adaptation of Australian dementia and driving decision aid (DDDA) for ILWD residing in the United Kingdom. METHODS This qualitative study was theoretically underpinned by a person-centred framework and conducted over three stages: (1) Development of a draft UK-specific DDDA; (2) semistructured interviews with ILWD and an online survey with stakeholders to obtain their views on a draft UK DDDA and (3) content analysis and synthesis of qualitative data to inform the final version of the decision aid. RESULTS Eleven ILWD and six of their spouses participated in interviews, and 102 stakeholders responded to an online survey. The four broad features identified as important to include in a decision aid for drivers living with dementia were: a structured and interactive format; positive and supportive messaging and presentation; relevant and concise content and choice-centred. The perceived benefits of the decision aid were identified as supporting conversations, enhancing collaborative decision making and enabling agency with decisions about driving and future mobility options. CONCLUSIONS Decision aids that are underpinned by interactive choice-driven questions enhance a person-centred approach to decisions about driving. Positively framing decision aids through the presentation and content can facilitate engagement with the decision-making process about driving. The findings have implications for the development of decision aids designed for ILWD on other important health and social topics. PATIENT AND PUBLIC INVOLVEMENT Advocating for the development of a UK DDDA were ILWD. Healthcare professionals contributed to the development of a draft UK DDDA. Former and current drivers living with dementia, family members, healthcare professionals and other support networks of ILWD participated in interviews or an online survey which informed the final version of the UK DDDA.
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Affiliation(s)
- Nadine Veerhuis
- Aged, Dementia, Health Education and Research Centre, Faculty of Science Medicine and Health, School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Alessandra Merizzi
- Memory Assessment and Treatment Service, Pennine Care National Health Service Foundation Trust, Oldham, UK
| | - Stephanie Papoulias
- Memory Assessment and Treatment Service, Pennine Care National Health Service Foundation Trust, Oldham, UK
| | - Claire Bradbury
- Memory Assessment Service, Dorset Healthcare University Foundation Trust, Alderney Hospital, Poole, UK
| | - Kathy Sheret
- Memory Assessment Service, Dorset Healthcare University Foundation Trust, Alderney Hospital, Poole, UK
| | - Victoria Traynor
- Aged, Dementia, Health Education and Research Centre, Faculty of Science Medicine and Health, School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
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Britton I, Bradbury C, Srinivas S, Balasubramaniam R, Dale M, Morley-Davies A, Bednall R. CTC service heterogeneity and design of a workforce calculator. Clin Radiol 2023:S0009-9260(23)00144-7. [PMID: 37188552 DOI: 10.1016/j.crad.2023.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 12/14/2022] [Accepted: 03/31/2023] [Indexed: 05/17/2023]
Abstract
AIM To determine the level of heterogeneity in delivery of computed tomography (CT) colonography services and develop a workforce calculator that accommodates the variation identified. MATERIALS AND METHODS A national survey, based on the "WHO workforce indicators of staffing need", established activity standards for essential tasks in delivery of the service. From these data a workforce calculator was designed to guide the required staffing and equipment resource by service size. RESULTS Activity standards were established as mode responses >70%. Service homogeneity was greater in areas where professional standards and guidance were available. The mean service size was 1,101. Did not attend (DNA) rates were lower where direct booking was available (p<0.0001). Service sizes were larger where radiographer reporting was embedded in reporting paradigms (p<0.024). CONCLUSION The survey identified benefits of radiographer-led direct booking and reporting. The workforce calculator derived from the survey provides a framework to guide the resourcing of expansion while maintaining standards.
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Affiliation(s)
- I Britton
- Imaging Department, University Hospital of North Midlands, Stoke-on-Trent, UK.
| | - C Bradbury
- Imaging Department, University Hospital of North Midlands, Stoke-on-Trent, UK
| | - S Srinivas
- Imaging Department, University Hospital of North Midlands, Stoke-on-Trent, UK
| | - R Balasubramaniam
- Imaging Department, University Hospital of North Midlands, Stoke-on-Trent, UK
| | - M Dale
- Imaging Department, University Hospital of North Midlands, Stoke-on-Trent, UK
| | - A Morley-Davies
- Cardiology Department, University Hospital of North Midlands, Stoke-on-Trent, UK
| | - R Bednall
- Quality Improvement Academy, University Hospital of North Midlands, Stoke-on-Trent, UK
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Alder L, Trapani D, Bradbury C, Van Swearingen AED, Tolaney SM, Khasraw M, Anders CK, Lascola CD, Hsu L, Lin NU, Sammons S. Durable responses in patients with HER2+ breast cancer and leptomeningeal metastases treated with trastuzumab deruxtecan. NPJ Breast Cancer 2023; 9:19. [PMID: 36997605 PMCID: PMC10063529 DOI: 10.1038/s41523-023-00519-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 03/01/2023] [Indexed: 04/01/2023] Open
Abstract
Leptomeningeal metastases (LM) are a devastating complication of HER2 + metastatic breast cancer (MBC), with no effective treatments. In a case series of 8 patients with heavily pretreated HER2 + MBC and progressing LM, all 8 patients (100%) derived clinical benefit from Trastuzumab deruxtecan (TDXd), and 4 patients (50%) had an objective partial response based on formal neuroradiology MRI reads using the EORTC/RANO-LM Revised-Scorecard. T-DXd warrants further study in LM in HER2 + MBC and solid tumors where T-DXd may be active.
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Affiliation(s)
- Laura Alder
- Division of Medical Oncology, Department of Medicine, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Dario Trapani
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Claire Bradbury
- Department of Biostatistics, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Amanda E D Van Swearingen
- Division of Medical Oncology, Department of Medicine, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Sara M Tolaney
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Mustafa Khasraw
- Division of Medical Oncology, Department of Medicine, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Carey K Anders
- Division of Medical Oncology, Department of Medicine, Duke Cancer Institute, Duke University, Durham, NC, USA
| | | | - Liangge Hsu
- Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Nancy U Lin
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sarah Sammons
- Division of Medical Oncology, Department of Medicine, Duke Cancer Institute, Duke University, Durham, NC, USA.
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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Affronti ML, Patel M, Severance E, Loughlin C, Bradbury C, Herndon JE, Boyd K, Lipp ES, Friedman HS, Desjardins A, Johnson M, Peters KB. QOL-08. PHASE II RANDOMIZED STUDY TO EVALUATE EFFICACY AND SATISFACTION OF ROLAPITANT PLUS ONDANSETRON VS. ONDANSETRON MONOTHERAPY IN PREVENTING NAUSEA/VOMITING FOR GLIOMAS RECEIVING RADIATION/TEMOZOLOMIDE. Neuro Oncol 2022. [PMCID: PMC9661050 DOI: 10.1093/neuonc/noac209.935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
BACKGROUND
Nausea and vomiting remain the most feared cancer treatment-related side effects. Trials establishing antiemetic guidelines exclude malignant glioma (MG) patients. In MG patients receiving radiation with concurrent temozolomide, chemoradiation-induced nausea and vomiting (cRINV) rates are 35 and 26%, respectively, which reduce quality of life, treatment adherence, and potentially cancer control.OBJECTIVES: In a randomized phase II open label trial, we compared patient satisfaction and efficacy of ondansetron monotherapy (short-acting 5HT3-RA; 3h half-life) vs. rolapitant (long-acting NK1-RA; 180h half-life) plus ondansetron in preventing cRINV during 6-weeks of daily temozolomide (75 mg/m2/dX42d) with radiation.
METHODS
Fifty-three eligible patients receiving chemoradiation were randomized to Arm-A (ondansetron 8mg Days 1-42, rolapitant 180mg on Day 21) or Arm-B (rolapitant on Day 1 plus daily ondansetron). Primary endpoint included the percentage achieving cRINV-complete response (CR; no vomiting or antiemetic rescue) during the first 2-weeks of radiation. Secondary endpoints included cRIN/cRIV rates, preference for rolapitant plus ondansetron, and toxicity.
RESULTS
Forty-eight initiated protocol treatment. Mean age=53, 58% male, median KPS 90%, 71% low alcohol N/V risk factor, 73% glioblastoma. During the first 2-weeks of radiation, cRINV-CR was 60% for 25 evaluable patients receiving ondansetron monotherapy and 65% for 23 receiving rolapitant/ondansetron (p< 0.71). Patient-reported cRINV-CR was 61% and 74%, respectively (p< 0.41); cRIN rates (44% Arm-A; 53% Arm-B) were more than cRIV rates (28% Arm-A; 11% Arm-B). More patients receiving ondansetron alone vomited the first 2-weeks (22%) than with rolapitant/ondansetron (0%); p< 0.05. Among 32 patients who completed the study, patients preferred ondansetron (63%) over rolapitant/ondansetron (19%); p< 0.0039; 19% had no preference. Adverse events attributable to antiemetic treatment (fatigue/constipation) were all grade 1-2.
CONCLUSIONS
While patients prefer ondansetron monotherapy, there was no difference in cRINV-CR between the first 2-week treatments and some had less vomiting with rolapitant plus ondansetron. We will present overall N/V results.
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Affiliation(s)
- Mary Lou Affronti
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center , Durhame, NC , USA
| | - Mallika Patel
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center , Durham, NC , USA
| | - Erin Severance
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center , Durham, NC , USA
| | - Charles Loughlin
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center , Durham, NC , USA
| | - Claire Bradbury
- Duke Cancer Institute Biostatistics, Duke University Medical Center , Durham, NC , USA
| | - James E Herndon
- Duke Cancer Institute Biostatistics, Duke University Medical Center , Durham, NC , USA
| | - Kendra Boyd
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center , Durham, NC , USA
| | - Eric S Lipp
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center , Durham, NC , USA
| | - Henry S Friedman
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center , Durham, NC , USA
| | - Annick Desjardins
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center , Durham, NC , USA
| | - Margaret Johnson
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center , Durham , USA
| | - Katherine B Peters
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center , Durham, NC , USA
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Bradbury C, Britton I, Morley-Davies A, Balasubramaniam R. What is the impact of CT colonography interpretation by advanced practitioner radiographers on delivery of the 28 day colorectal cancer target? Radiography (Lond) 2021; 27:1130-1134. [PMID: 34176721 DOI: 10.1016/j.radi.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION CT Colonography (CTC) is an indicated test to assess the colon and rectum for evidence of polyps and neoplasms. The advanced practitioner radiographer (APR) is increasingly involved with the entirety of the radiology pathway including procedural modification, preliminary clinical evaluation (PCE) and multi-disciplinary team (MDT) meeting notification of high risk colonic pathologies. METHODS A retrospective audit of the Radiology Information System (RIS) was undertaken at a large secondary care centre, 12 months of data of 119 consecutive patients who had undergone CTC with summary coded reports of high risk pathology were included for analysis. Analysis of accuracy of procedural modification, PCE and impact of hypothesised earlier full radiological staging data being available for MDT discussions were measured and evaluated. RESULTS For high risk C4b studies, just 16.67% of colonic pathology was observed during the CTC study, rising to 79% during radiographer PCE. For likely colonic neoplasm C5a studies 86% of colonic pathology was observed during the CTC study, rising to 93% during radiographer PCE. Where subsequent CT chest staging was deemed necessary following CTC by the referring team, patients had a median wait of 34 days for completion CT chest scan staging. CONCLUSION This study supports the integration of the advanced practitioner radiographer into the entire radiological processes of a CTC, with time advantages apparent for both diagnostics, but also the decision to treat. IMPLICATIONS FOR PRACTICE Appropriately trained radiographers are able to support CTC services to ensure delivery of an effective two-week wait diagnostic service with direct MDT liaison.
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Affiliation(s)
- C Bradbury
- Imaging Department, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom.
| | - I Britton
- Imaging Department, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom.
| | - A Morley-Davies
- Imaging Department, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom.
| | - R Balasubramaniam
- Imaging Department, University Hospital of North Midlands, Stoke-on-Trent, United Kingdom.
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Boaden E, Nightingale J, Hives L, Bradbury C, Benfield J, Patel T, Georgiou R. Current videofluoroscopy practice in the United Kingdom: A survey of imaging professionals. Radiography (Lond) 2020; 27:499-504. [PMID: 33234485 DOI: 10.1016/j.radi.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/28/2020] [Accepted: 11/05/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Videofluoroscopy (VFSS) is a frequently used radiological investigation for dysphagia and is conducted within a radiology setting by speech and language therapists (SLTs) working alongside imaging personnel (radiologists and/or radiographers). Previous surveys of SLT practice have reported variability in VFSS protocols and procedures. The aim of this study was to explore current clinical practice for VFSS from the perspective of imaging personnel engaged in VFSS within the United Kingdom. METHODS A comprehensive online survey enabled exploration of current practices of imaging professionals. Target participants were diagnostic imaging personnel (radiographers and radiologists) with experience of working in VFSS clinics. Descriptive statistics describe and summarise the data alongside inferential statistics where appropriate. RESULTS 54 survey participants represented 40 unique acute healthcare organisations in the UK, in addition to two respondents from the Republic of Ireland. The survey demonstrated high variance in clinical practice across all stages of the VFSS procedure. Clinicians were not always compliant with current UK guidelines and the roles and responsibilities of different professionals working within the clinics were often not clearly defined. CONCLUSION Further research is required to develop new international, interprofessional VFSS guidelines to standardise service delivery for VFSS, improving diagnostic accuracy, efficiency and patient experience. IMPLICATIONS FOR PRACTICE In the absence of VFSS guidelines for imaging personnel, practitioners should familiarise themselves with the UK Royal College of Speech and Language Therapists VFSS Position paper; IR (ME)R guidelines and DRLs for the client groups with which they work to guide clinics and improve practice. Clinicians should revisit protocols and clinical governance regarding safe practice in order to improve the quality of care within the VFSS clinic.
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Affiliation(s)
- E Boaden
- University of Central Lancashire, Preston, Lancashire, UK
| | - J Nightingale
- Dept of Allied Health Professions, Sheffield Hallam University, Sheffield, UK.
| | - L Hives
- University of Central Lancashire, Preston, Lancashire, UK
| | - C Bradbury
- Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Staffordshire, UK
| | - J Benfield
- Division of Medical Sciences, School of Medicine, University of Nottingham, UK; Derbyshire Community Health Services NHS Foundation Trust, UK
| | - T Patel
- University of Central Lancashire, Preston, Lancashire, UK
| | - R Georgiou
- University of Central Lancashire, Preston, Lancashire, UK
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Boaden E, Nightingale J, Bradbury C, Hives L, Georgiou R. Clinical practice guidelines for videofluoroscopic swallowing studies: A systematic review. Radiography (Lond) 2020; 26:154-162. [DOI: 10.1016/j.radi.2019.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/24/2019] [Accepted: 10/25/2019] [Indexed: 12/24/2022]
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Bradbury C, Britton I, Lille K, Wright-White H. Abdominal radiograph preliminary clinical evaluation image test bank project. Radiography (Lond) 2019; 25:250-254. [DOI: 10.1016/j.radi.2019.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 02/05/2019] [Accepted: 02/09/2019] [Indexed: 12/12/2022]
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Bradbury C, Houlton AE, Akiki S, Gregg R, Rindl M, Khan J, Ward J, Khan N, Griffiths M, Nagra S, Hills R, Burnett A, Russell N, Vyas P, Grimwade D, Craddock C, Freeman SD. Prognostic value of monitoring a candidate immunophenotypic leukaemic stem/progenitor cell population in patients allografted for acute myeloid leukaemia. Leukemia 2014; 29:988-91. [PMID: 25425198 PMCID: PMC4391965 DOI: 10.1038/leu.2014.327] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- C Bradbury
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - A E Houlton
- 1] Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK [2] Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | - S Akiki
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - R Gregg
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - M Rindl
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - J Khan
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - J Ward
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - N Khan
- Department of Clinical Immunology, University of Birmingham, Birmingham, UK
| | - M Griffiths
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - S Nagra
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - R Hills
- Department of Haematology, Cardiff University, Cardiff, UK
| | - A Burnett
- Department of Haematology, Cardiff University, Cardiff, UK
| | - N Russell
- Department of Haematology, Nottingham University Hospital NHS Trust, Nottingham, UK
| | - P Vyas
- 1] MRC Molecular Haematology Unit, WIMM, University of Oxford, Oxford, UK [2] Department of Haematology, Radcliffe Hospitals NHS Trust, Oxford, UK
| | - D Grimwade
- 1] Department of Medical & Molecular Genetics, King's College London, Faculty of Life Sciences and Medicine, London, UK [2] Department of Haematology, Guy's & St. Thomas' NHS Foundation Trust, London, UK
| | - C Craddock
- 1] Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK [2] Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | - S D Freeman
- 1] Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK [2] Department of Clinical Immunology, University of Birmingham, Birmingham, UK
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Khatib N, Bradbury C, Chalker V, Koh GCKW, Smit E, Wilson S, Watson J. Prevalence of Trichomonas vaginalis, Mycoplasma genitalium and Ureaplasma urealyticum in men with urethritis attending an urban sexual health clinic. Int J STD AIDS 2014; 26:388-92. [PMID: 24925897 DOI: 10.1177/0956462414539464] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 05/14/2014] [Indexed: 11/15/2022]
Abstract
We conducted a study to determine the prevalence of Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) and Ureaplasma urealyticum (UU) in men with urethritis, attending an urban sexual health clinic, in order to inform screening and treatment policies. Men attending an urban sexual health clinic between June 2011 and January 2012 were evaluated. Urine samples were collected from men with urethritis and tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC) and TV using transcription-mediated amplification and for MG and UU using polymerase chain reaction. Eighty-three samples were analysed. The prevalence of CT was 33.7% (28/83), GC was 16.8% (14/83), TV was 3.6% (3/83), MG was 12.0% (10/83) and UU was 4.8% (4/83). Fifteen men had recurrent urethritis. Of these, three were found to have had TV, five to have had MG and none to have had UU, at initial presentation. Given the prevalence of MG in this study, there is an urgent need for further larger studies looking at optimal treatment regimens and screening strategies in urethritis.
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Affiliation(s)
- N Khatib
- Heart of England Foundation Trust, Heartlands Hospital, Birmingham, UK
| | - C Bradbury
- Heart of England Foundation Trust, Heartlands Hospital, Birmingham, UK
| | | | - G C K W Koh
- Heart of England Foundation Trust, Heartlands Hospital, Birmingham, UK
| | - E Smit
- Public Health Laboratory Birmingham, Public Health England, Heartlands Hospital, Birmingham, UK
| | - S Wilson
- Public Health Laboratory Birmingham, Public Health England, Heartlands Hospital, Birmingham, UK
| | - J Watson
- Heart of England Foundation Trust, Heartlands Hospital, Birmingham, UK
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Bradbury C, Parvaiz MA, Sircar T. Innovative postoperative bra for patients with drains following breast surgery. Ann R Coll Surg Engl 2014; 96:241. [PMID: 24780798 DOI: 10.1308/rcsann.2014.96.3.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Sharma B, Bradbury C, Mikulis D, Green R. Missed diagnosis of traumatic brain injury in patients with traumatic spinal cord injury. J Rehabil Med 2014; 46:370-3. [DOI: 10.2340/16501977-1261] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Singh S, Dhir S, Marmai K, Rehou S, Silva M, Bradbury C. Efficacy of ultrasound-guided transversus abdominis plane blocks for post-cesarean delivery analgesia: a double-blind, dose-comparison, placebo-controlled randomized trial. Int J Obstet Anesth 2013; 22:188-93. [DOI: 10.1016/j.ijoa.2013.03.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 02/21/2013] [Accepted: 03/01/2013] [Indexed: 11/25/2022]
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Ficociello J, Bradbury C, Morris A, Lappin MR. Detection of Bartonella henselae IgM in serum of experimentally infected and naturally exposed cats. J Vet Intern Med 2011; 25:1264-9. [PMID: 22092615 DOI: 10.1111/j.1939-1676.2011.00820.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 07/01/2011] [Accepted: 09/01/2011] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Results of Bartonella henselae blood culture, polymerase chain reaction (PCR) assay on blood, or IgG antibody assays do not always correlate with the presence or absence of clinical disease in cats, and B. henselae IgG antibodies in serum do not always correlate with bacteremia. However, little is known concerning Bartonella spp. IgM antibodies in naturally exposed cats. HYPOTHESIS Bartonella spp. IgM antibodies in serum are associated with fever, stomatitis, and bacteremia based on PCR assay results in experimentally infected or client-owned cats. ANIMALS Stored sera from cats experimentally infected with B. henselae by exposure to Ctenocephalides felis, client-owned cats with and without fever, and client-owned cats with and without stomatitis were studied. METHODS A Bartonella spp. IgM ELISA was titrated with samples from experimentally infected cats and then test sera from client-owned cats were assayed. Associations among IgM ELISA results, clinical findings, and bacteremia as defined by Bartonella spp. PCR assay were assessed. RESULTS All experimentally infected cats developed Bartonella spp. IgM antibodies. Bartonella spp. IgM antibody assay results were not always in agreement with PCR assay results in client-owned cats (60%). Bartonella spp. DNA in blood, IgM antibodies, and IgG antibodies were not associated with the presence of fever or stomatitis. CONCLUSIONS AND CLINICAL IMPORTANCE Because Bartonella spp. IgM antibodies as measured by this assay were not associated with fever or stomatitis and were not always in agreement with PCR assay results, there appears to be little need for assessing individual client-owned cats for this antibody class alone.
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Affiliation(s)
- J Ficociello
- Department of Clinical Sciences, Colorado State University, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO 80523, USA
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Mishra M, Bisht K, Bradbury C, Gius D. The Epigenome as Molecular Target for Multi-Modality Resistant Tumor Cells. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kearney M, Bradbury C, Ellahi B, Hodgson M, Thurston M. Mainstreaming prevention: prescribing fruit and vegetables as a brief intervention in primary care. Public Health 2005; 119:981-6. [PMID: 16185735 DOI: 10.1016/j.puhe.2005.08.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2005] [Indexed: 11/29/2022]
Abstract
UNLABELLED This paper examines a brief preventive intervention as a model for embedding public health action in primary care. BACKGROUND Low fruit and vegetable intake is a major risk factor for cancer, coronary heart disease and stroke. The recommended intake of five portions per day would reduce death rates from these causes by 20%. However, average daily consumption in the UK is under three portions, and it is significantly lower in men, young people and lower socio-economic groups. In order to tackle risk factors such as poor diet, the white paper Choosing Health promises action and funding to mainstream prevention and transform the NHS from a sickness service to a genuine health service. THE INTERVENTION To promote increased fruit and vegetable consumption, primary care professionals working in a deprived area issue prescriptions which offer the patient discounts on fruit and vegetable purchases. Hand over of each prescription to the patient is linked explicitly to key five a day messages. This brief intervention takes 1-2 min to deploy. IMMEDIATE OUTCOMES Evaluation is ongoing. However, early feedback suggests that the intervention of prescription plus key messages has a significant impact on patients in highlighting the connection between food and health. Clinicians express satisfaction at having a preventive intervention that can be deployed with confidence and consistency in routine primary care consultations. DISCUSSION This brief intervention is presented as a potential model for embedding prevention in the day-to-day work of health professionals. Primary care is a natural setting for the promotion of health, but despite success in implementing some public health programmes, it has a patchy record in primary prevention. The reasons for this are examined, the impact of new contractual and commissioning levers is explored, and a general framework for mainstreaming public health action in primary care is proposed.
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Affiliation(s)
- M Kearney
- Castlefields Health Centre, Chester Close, Runcorn, and Community Studies Unit, School of Medical Education, University of Liverpool, Liverpool L69 3GH, UK.
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Karimpour S, Bradbury C, Mattson D, Bisht K, Gius D. Increased radiosensitization in cervical tumor cells following HSP90 inhibition with geldanamycin. Int J Radiat Oncol Biol Phys 2003. [DOI: 10.1016/s0360-3016(03)01161-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Orford J, Natera G, Velleman R, Copello A, Bowie N, Bradbury C, Davies J, Mora J, Nava A, Rigby K, Tiburcio M. Ways of coping and the health of relatives facing drug and alcohol problems in Mexico and England. Addiction 2001; 96:761-74. [PMID: 11331034 DOI: 10.1046/j.1360-0443.2001.96576111.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To compare two contrasting socio-cultural groups in terms of parameters relating to the stress - coping - health model of alcohol, drugs and the family, and to test hypotheses derived from the model in each of the two groups separately. DESIGN Cross-sectional, comparative and correlational, using standard questionnaire data, supplemented by qualitative interview data to illuminate the findings. PARTICIPANTS One hundred close relatives, mainly partners or parents, from separate families in Mexico City, and 100 from South West England. Data sources. Coping Questionnaire (CQ), Family Environment Scale (FES), Symptom Rating Test (SRT), Semi-structured interview. FINDINGS Mean symptom scores were high in both groups, and not significantly different. The hypothesis that relatives in Mexico City, a more collectivist culture, would show more tolerant - inactive coping was not supported, but there was support for the prediction that relatives in South West England would show more withdrawal coping. This result may be as much due to differences in poverty and social conditions as to differences in individualism - collectivism. As predicted by the stress - coping - health model, tolerant - inactive coping was correlated with symptoms, in both groups, after controlling for family conflict, but there was only limited support for a moderating role of coping. Wives of men with alcohol problems in Mexico City, and wives of men with other drug problems in South West England, reported particularly high levels of both engaged and tolerant - inactive coping. CONCLUSIONS Tolerant - inactive coping may be bad for relatives' health: causality may be inferred but is not yet proved. Certain groups are more at risk of coping in this way. Qualitative data help understand the nature of tolerant - inactive coping and why it occurs despite the view of relatives themselves that it is counter-productive.
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Affiliation(s)
- J Orford
- School of Psychology, University of Birmingham, Edgbaston, UK.
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McGrath P, Corcoran V, O'Malia A, Tefay M, Bradbury C, Gilroy M, McCray S. An assessment of the needs of oncology outpatients for the development of allied health services. AUST HEALTH REV 2000; 23:134-51. [PMID: 11010566 DOI: 10.1071/ah000134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This article presents the findings of a study that arose out of the desire by the Allied Health Professionals (AHP) at the Mater Hospital, Brisbane, to better understand the needs of their clients in order to be able to offer a more effective and appropriate service. A questionnaire designed specifically to explore the needs of patients and their families for AHP services was administered to consecutive patients (n = 62) attending the Mater out-patient oncology clinic during one month. The findings provide a wealth of practical information for AHPs to use in planning for the effective utilisation of their services, as well as fresh insights into a number of theoretical issues that need further research.
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Affiliation(s)
- P McGrath
- Centre for Public Health Research, Queensland University of Technology
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Abstract
The study investigates whether the higher rates of sharing needles and syringes reported by female injecting drug users (IDUs) also occur in sharing other types of injecting equipment. Structured interviews were carried out with 181 IDUs in two cities (100 in Bournemouth, 81 in Bath), with almost equal numbers of males and females in each sample, recruited through needle exchanges and 'snowballing'. Almost all (92%) had shared some equipment in the previous six months: 40% had shared syringes in the month before interview. Several methods of assessing sharing found that women received previously used injecting equipment significantly more often than men. Significantly more males had passed on equipment other than syringes in the previous six months. Fine-grained analyses of 547 injecting episodes found that women received needles and syringes, and syringes significantly more often than did men. The pattern of gender differences reported suggests that women are at higher risk of blood borne viral infections because they receive more types of used equipment and do so more frequently. These results have implications for practice and research.
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Affiliation(s)
- G A Bennett
- Addiction Service, Dorset HealthCare NHS Trust, Bournemouth.
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Orford J, Natera G, Davies J, Nava A, Mora J, Rigby K, Bradbury C, Bowie N, Copello A, Velleman R. Tolerate, engage or withdraw: a study of the structure of families coping with alcohol and drug problems in south west England and Mexico City. Addiction 1998; 93:1799-813. [PMID: 9926569 DOI: 10.1046/j.1360-0443.1998.931217996.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To explore the structure underlying individual differences in the ways family members cope with drinking or drug problems. DESIGN Cross-sectional interview and questionnaire study of a series of family members in two contrasting socio-cultural groups. SETTING Mexico City and South West England. PARTICIPANTS Two hundred and seven family members from separate families, three-quarters women, one-quarter men, mostly partners or parents. DATA Long semi-structured interviews; the Coping Questionnaire (CQ). FINDINGS Factor and subscale analyses of the CQ data and textual analysis of the interview reports were used to test the hypothesis that the underlying structure to coping could be described in terms of eight or nine coherent and distinct ways of coping. Neither form of analysis gave strong support to this hypothesis. CONCLUSIONS It is concluded that the structure of coping can best be described in terms of three broad coping positions: tolerating, engaging and withdrawing. These conclusions challenge some previous assumptions about functional and dysfunctional ways of coping with excessive appetitive behaviour in the family.
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Affiliation(s)
- J Orford
- School of Psychology, University of Birmingham, UK
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Bradbury C. "Night duty is more interesting...stimulating...and rewarding". Nurs Mirror Midwives J 1971; 133:17. [PMID: 5210078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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