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Nixon LS, Hudson N, Culley L, Lakhanpaul M, Robertson N, Johnson MRD, McFeeters M, Johal N, Hamlyn-Williams C, Boo YY, Lakhanpaul M. Key considerations when involving children in health intervention design: reflections on working in partnership with South Asian children in the UK on a tailored Management and Intervention for Asthma (MIA) study. Res Involv Engagem 2022; 8:9. [PMID: 35227322 PMCID: PMC8883750 DOI: 10.1186/s40900-022-00342-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 02/18/2022] [Indexed: 06/14/2023]
Abstract
Participatory research is an empowering process through which individuals can increase control over their lives, and allows researchers/clinicians to gain a clearer understanding of a child's needs. However, involving children in participatory research is still relatively novel, despite national and international mandates to engage children in decision making. This paper draws on the learnings from designing the Management and Intervention for Asthma (MIA) study, which used a collaborative participatory method to develop an intervention-planning framework for South Asian children with asthma. There are currently 1 million children in the UK receiving treatment for asthma, making it one of the most prevalent chronic childhood illnesses. Symptoms of asthma are often underrecognized in children from South Asian communities in the UK, contributing to increased disease severity and increased attendance at the emergency department compared to White British children. Despite this, ethnic minorities are often excluded from research and thus absent from the 'evidence base', making it essential to hear their perspectives if health inequalities are to be successfully addressed. We worked alongside healthcare professionals, community facilitators, parents, and children to identify the key concerns and priorities they had and then designed the framework around their needs. Reflecting on the process, we identified several key considerations that need to be addressed when co-developing interventions with children. These include the power dynamics between the parent/researcher and child; navigating the consent/assent process; how parental involvement might affect the research; establishing a convenient time and location; how to keep children engaged throughout the process; tailoring activities to different levels of ability; and accounting for cultural differences. These factors were considered by the researchers when designing the study, however, implementing them was not without its challenges and highlighted the need for researchers to develop expertise in this field. Tailoring existing research methods allowed us to explore children's perceptions, priorities, and experiences of illness more effectively. However, involving children in participatory research is a complex undertaking, and researchers need to ensure that they have the expertise, time, and resources necessary to be able to fully support the needs of child participants before deciding to commit to this approach.
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Affiliation(s)
- Laura S. Nixon
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Nicky Hudson
- School of Applied Social Sciences, De Montfort University, Leicester, UK
| | - Lorraine Culley
- School of Applied Social Sciences, De Montfort University, Leicester, UK
| | - Maya Lakhanpaul
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Noelle Robertson
- Department of Neuroscience Psychology and Behaviour, University of Leicester, Leicester, UK
| | | | - Melanie McFeeters
- NHS England, Direct Commissioning, Midlands Region, Leicestershire, UK
| | | | | | - Yebeen Ysabelle Boo
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
- Aceso Global Health Consultants Ltd., London, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Monica Lakhanpaul
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
- Community Paediatrics, Whittington NHS Trust, London, UK
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Yulia A, Napolitano R, Aiman A, Desai D, Johal N, Whitten M, Ushakov F, Pandya PP, Winyard PJD. Perinatal and infant outcome of fetuses with prenatally diagnosed hyperechogenic kidneys. Ultrasound Obstet Gynecol 2021; 57:953-958. [PMID: 32530118 DOI: 10.1002/uog.22121] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/18/2020] [Accepted: 05/29/2020] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Hyperechogenic kidneys are a relatively rare antenatal finding, which can generate significant parental anxiety due to uncertain prognosis. We report on the perinatal and infant outcomes of a large cohort of fetuses with antenatally diagnosed hyperechogenic kidneys. METHODS This was a retrospective analysis of all cases diagnosed prenatally with hyperechogenic kidneys between 2002 and 2017 in a large tertiary fetal medicine unit. Hyperechogenicity was defined as kidney parenchyma with greater echogenicity than that of the liver. Pregnancy, pathological and postnatal outcomes were collected from hospital and general practitioner records up to 1 year of age. Abnormal renal outcome was defined as elevated creatinine beyond 6 months of age, hypertension requiring medication or major kidney surgery, such as nephrectomy. Severe abnormal renal outcome was defined as the need for dialysis or kidney transplant at any stage. RESULTS Three-hundred and sixteen fetuses with hyperechogenic kidneys were identified at a mean gestational age of 21 (range, 13-37) weeks. The majority of cases (97%) had bilateral hyperechogenic kidneys. In the 265 cases with available follow-up data, other associated renal tract abnormalities were identified prenatally in 36%, concomitant extrarenal structural abnormalities in 39% and abnormal karyotype in 15% of cases. Of the 316 included cases, 139 did not survive, including 105 terminations of pregnancy, five intrauterine deaths and 29 early neonatal deaths. Only 4.3% (6/139) of these fetuses had isolated hyperechogenic kidneys while 28.1% (39/139) had associated multiple renal tract abnormalities alongside hyperechogenic kidneys and over two-thirds (67.6%; 94/139) had concomitant extrarenal abnormalities. Of the 177 cases that survived beyond 1 month of age, outcome data were available in 126. Of these, based on the antenatal findings, 60 (47.6%) cases had isolated hyperechogenic kidneys, 56 (44.4%) had associated renal structural abnormalities and 10 (7.9%) had additional extrarenal abnormalities. Considering renal outcome alone, kidney function was abnormal in 13 (21.7%), 10 (17.9%) and 0 (0%) infants in these three groups, respectively, although concurrent pathology clearly affected global outcome in the more complex cases. Neonatal mortality of 1.6% was observed in the isolated renal hyperechogenicity group. The presence of oligohydramnios or abnormal renal volume was not associated significantly with abnormal renal function (odds ratio (OR), 2.32 (99% CI, 0.54-10.02) and OR, 0.74 (99% CI, 0.21-2.59), respectively) in this group. CONCLUSIONS Hyperechogenic kidneys are often complicated by associated renal tract and extrarenal abnormalities, aberrant karyotype and genetic disease, and these factors have a greater effect on overall outcome than does kidney echogenicity. The renal outcome of fetuses with isolated hyperechogenic kidneys is good generally, with over 70% of cases having normal renal function postpartum. Importantly, for prognostic counseling, all of the fetuses in this non-selected series with isolated hyperechogenic kidneys and normal amniotic fluid levels had normal renal outcome in infancy. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- A Yulia
- Fetal Medicine Unit, University College London Hospital, London, UK
| | - R Napolitano
- Fetal Medicine Unit, University College London Hospital, London, UK
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - A Aiman
- Fetal Medicine Unit, University College London Hospital, London, UK
| | - D Desai
- Urology Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - N Johal
- Urology Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - M Whitten
- Fetal Medicine Unit, University College London Hospital, London, UK
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - F Ushakov
- Fetal Medicine Unit, University College London Hospital, London, UK
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - P P Pandya
- Fetal Medicine Unit, University College London Hospital, London, UK
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - P J D Winyard
- Nephro-Urology Group, Developmental Biology and Cancer Programme, UCL Great Ormond Street Institute of Child Health, London, UK
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Wong J, Wu E, Witherspoon L, Yuen W, Johal N, Liao W, Sheikoleslami S, Zarowski C, Sundar M, Higano C, Flannigan R. 014 Demographics and Characteristics of Patients Accessing a Prostate Cancer Supportive Care Program's Sexual Rehabilitation Clinic. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.084] [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: 11/24/2022]
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Lakhanpaul M, Culley L, Robertson N, Alexander EC, Bird D, Hudson N, Johal N, McFeeters M, Hamlyn-Williams C, Manikam L, Boo YY, Lakhanpaul M, Johnson MRD. A structured collaborative approach to intervention design using a modified intervention mapping approach: a case study using the Management and Interventions for Asthma (MIA) project for South Asian children. BMC Med Res Methodol 2020; 20:271. [PMID: 33138784 PMCID: PMC7607819 DOI: 10.1186/s12874-020-01148-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 10/14/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND To describe how using a combined approach of community-based participatory research and intervention mapping principles could inform the development of a tailored complex intervention to improve management of asthma for South Asian (SA) children; Management and Interventions for Asthma (MIA) study. METHODS A qualitative study using interviews, focus groups, workshops, and modified intervention mapping procedures to develop an intervention planning framework in an urban community setting in Leicester, UK. The modified form of intervention mapping (IM) included: systematic evidence synthesis; community study; families and healthcare professionals study; and development of potential collaborative intervention strategies. Participants in the community study were 63 SA community members and 12 key informants; in-depth semi-structured interviews involved 30 SA families, 14 White British (WB) families and 37 Healthcare Professionals (HCPs) treating SA children living with asthma; prioritisation workshops involved 145 SA, 6 WB and 37 HCP participants; 30 participants in finalisation workshops. RESULTS Two key principles were utilised throughout the development of the intervention; community-based participatory research (CBPR) principles and intervention mapping (IM) procedures. The CBPR approach allowed close engagement with stakeholders and generated valuable knowledge to inform intervention development. It accounted for diverse perceptions and experiences with regard to asthma and recognised the priorities of patients and their families/caregivers for service improvement. The 'ACT on Asthma' programme was devised, comprising four arms of an intervention strategy: education and training, clinical support, advice centre and raising awareness, to be co-ordinated by a central team. CONCLUSIONS The modified IM principles utilised in this study were systematic and informed by theory. The combined IM and participatory approach could be considered when tailoring interventions for other clinical problems within diverse communities. The IM approach to intervention development was however resource intensive. Working in meaningful collaboration with minority communities requires specific resources and a culturally competent methodology.
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Affiliation(s)
- Monica Lakhanpaul
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London, WC1N 1EH, UK. .,Whittington Health NHS Trust, London, UK.
| | - Lorraine Culley
- School of Applied Social Sciences, De Montfort University, The Gateway, Leicester, LE1 9BH, UK
| | - Noelle Robertson
- Clinical Psychology, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Lancaster Road, Leicester, LE1 7HA, UK
| | - Emma C Alexander
- Paediatric Liver, GI and Nutrition Centre and Mowatlabs, King's College Hospital, London, SE5 9RS, UK.,Aceso Global Health Consultants Ltd., 3 Abbey Terrace, London, SE2 9EY, UK
| | - Deborah Bird
- Child Development Team, Ealing Services for Children with Additional Needs, West London NHS Trust, Carmelita House, 21-22 The Mall, Ealing, W5 2PJ, UK
| | - Nicky Hudson
- School of Applied Social Sciences, De Montfort University, The Gateway, Leicester, LE1 9BH, UK
| | | | - Melanie McFeeters
- Specialised Commissioning, NHS England and NHS Improvement, Midlands Region, Fosse House, 6 Smith Way, Grove Park, Enderby, Leicester, LE19 1SX, UK
| | - Charlotte Hamlyn-Williams
- Center for Health Services and Clinical Research, University of Hertfordshire, College Lane Campus, Hatfield, AL10 9AB, UK
| | - Logan Manikam
- Aceso Global Health Consultants Ltd., 3 Abbey Terrace, London, SE2 9EY, UK.,UCL Institute of Epidemiology & Healthcare, 1 - 19 Torrington Place, London, WC1E 7HB, UK
| | - Yebeen Ysabelle Boo
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London, WC1N 1EH, UK.,Aceso Global Health Consultants Ltd., 3 Abbey Terrace, London, SE2 9EY, UK.,Nuffield Department of Population Health, University of Oxford Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Maya Lakhanpaul
- Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Mark R D Johnson
- Faculty of Health and Life Sciences, Mary Seacole Research Centre, De Montfort University, The Gateway, Leicester, LE1 9BH, UK
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Lakhanpaul M, Culley L, Huq T, Bird D, Hudson N, Robertson N, McFeeters M, Manikam L, Johal N, Hamlyn-Williams C, Johnson MRD. Qualitative study to identify ethnicity-specific perceptions of and barriers to asthma management in South Asian and White British children with asthma. BMJ Open 2019; 9:e024545. [PMID: 30782908 PMCID: PMC6411253 DOI: 10.1136/bmjopen-2018-024545] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE This paper draws on the data from the Management and Interventions for Asthma (MIA) study to explore the perceptions and experiences of asthma in British South Asian children using semi-structured interviews. A comparable cohort of White British children was recruited to identify whether any emerging themes were subject to variation between the two groups so that generic and ethnicity-specific themes could be identified for future tailored intervention programmes for South Asian children with asthma. SETTING South Asian and White British children with asthma took part in semi-structured interviews in Leicester, UK. PARTICIPANTS Thirty three South Asian and 14 White British children with asthma and aged 5-12 years were interviewed. RESULTS Both similar and contrasting themes emerged from the semi-structured interviews. Interviews revealed considerable similarities in the experience of asthma between the South Asian and White British children, including the lack of understanding of asthma (often confusing trigger with cause), lack of holistic discussions with healthcare professionals (HCPs), an overall neutral or positive experience of interactions with HCPs, the role of the family in children's self-management and the positive role of school and friends. Issues pertinent to South Asian children related to a higher likelihood of feeling embarrassed and attributing physical activity to being a trigger for asthma symptoms. CONCLUSIONS The two ethnicity-specific factors revealed by the interviews are significant in children's self-management of asthma and therefore, indicate the need for a tailored intervention in South Asian children.
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Affiliation(s)
- Monica Lakhanpaul
- Population, Policy and Practice, University College London Institute of Child Health, London, UK
| | - Lorraine Culley
- School of Applied Social Sciences, De Montfort University, Leicester, UK
| | - Tausif Huq
- School of Medical Education, King’s College London, Guy’s King’s and St Thomas’ Hospital, London, UK
| | - Deborah Bird
- Ealing Community Paediatric Service, Ealing Child Development Team, London, UK
| | - Nicky Hudson
- School of Applied Social Sciences, De Montfort University, Leicester, UK
| | - Noelle Robertson
- Department of Clinical Psychology, Centre for Medical Humanities, University of Leicester, Leicester, UK
| | - Melanie McFeeters
- NHS England, Specialised Commissioning East Midlands, Leicestershire, UK
| | - Logan Manikam
- Department of Epidemiology and Public Health, University College London Institute of Epidemiology and Health Care, London, UK
| | | | | | - Mark R D Johnson
- Mary Seacole Research Centre, DeMonfort University, Leicester, UK
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Barkham B, Johal N, Kumar P. Systemic BCG-Osis Following Intravesical BCG Therapy Affecting a Meckel's Diverticulum. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.486] [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: 10/18/2022]
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Lakhanpaul M, Culley L, Robertson N, Bird D, Hudson N, Johal N, McFeeters M, Angell E, Hamlyn-Williams C, Abbas N, Manikam L, Johnson M. A qualitative study to identify parents' perceptions of and barriers to asthma management in children from South Asian and White British families. BMC Pulm Med 2017; 17:126. [PMID: 28931381 PMCID: PMC5607610 DOI: 10.1186/s12890-017-0464-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 08/29/2017] [Indexed: 12/20/2022] Open
Abstract
Background Over one million children receive treatment for asthma in the UK. South Asian children experience excess morbidity and higher rates of hospitalization than the White population. This study aimed to explore perceptions and experiences of asthma and asthma management in British South Asian and White British families, to identify barriers to optimal management and to inform culturally appropriate interventions to improve management. Methods A qualitative methodology, using semi-structured interviews was adopted. Members of 30 families from six major South Asian ethnic-religious groups were purposively sampled (n = 49). For comparison, 17 White British parents were interviewed. Topics included understandings of asthma; day-to-day management; interactions with health care providers and the perceived quality of healthcare services. Data were analyzed using interpretive thematic analysis, facilitated by NVivo. Similarities and differences between South Asian and White families were analysed across key themes. Results Many of the problems facing families of a child with asthma were common to South Asian and White British families. Both had limited understanding of asthma causes and triggers and expressed confusion about the use of medications. Both groups reported delays in receiving a clear diagnosis and many experienced what was perceived as uncoordinated care and inconsistent advice from health professionals. No family had received an asthma plan. South Asian families had more difficulty in recognising severity of symptoms and those with limited English faced additional barriers to receiving adequate information and advice about management due to poor communication support systems. South Asian parents reported higher levels of involvement of wider family and higher levels of stigma. Attendance at the emergency department was related to previous experience, difficulties in accessing primary care, lack of knowledge of alternatives and difficulties in assessing severity. Conclusions Barriers to optimal asthma management exist at the individual family, community and healthcare systems levels. Culturally sensitive, holistic and collaboratively designed interventions are needed. Improved communication support for families with lower proficiency in English is required. Healthcare professionals need to ensure that families receive an asthma plan and make greater efforts to check families’ understandings of asthma triggers, use of medications, assessment of asthma severity and accessing help.
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Affiliation(s)
- Monica Lakhanpaul
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London, WC1N 1EH, UK.
| | - Lorraine Culley
- School of Applied Social Sciences, De Montfort University, The Gateway, Leicester, LE1 9BH, UK
| | - Noelle Robertson
- Clinical Psychology, University of Leicester, Centre for Medicine, Lancaster Road, Leicester, LE1 7HA, UK
| | - Deborah Bird
- Department of Community Paediatrics, Buckinghamshire Healthcare NHS Trust, Wycombe Hospital, Queen Alexandra Road, High Wycombe, HP11 2TT, UK
| | - Nicky Hudson
- School of Applied Social Sciences, De Montfort University, The Gateway, Leicester, LE1 9BH, UK
| | | | - Melanie McFeeters
- Specialised Commissioning East Midlands, NHS England, Fosse House, 6 Smith Way, Grove Park, Leicestershire, Enderby, LE19 1SX, UK
| | - Emma Angell
- Department of Health Sciences, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - Charlotte Hamlyn-Williams
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London, WC1N 1EH, UK
| | - Nadine Abbas
- School of Medicine, University of Southampton, University Road, Southampton, SO17 1BJ, England
| | - Logan Manikam
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London, WC1N 1EH, UK
| | - Mark Johnson
- Faculty of Health and Social Studies, Mary Seacole Research Centre, De Montfort University, The Gateway, Leicester, LE1 9BH, UK
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Durell J, Johal N, Burge D, Wheeler R, Griffiths M, Kitteringham L, Stanton M, Manoharan S, Steinbrecher H, Malone P, Griffin SJ. Testicular atrophy following paediatric primary orchidopexy: A prospective study. J Pediatr Urol 2016; 12:243.e1-4. [PMID: 27422375 DOI: 10.1016/j.jpurol.2016.05.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 05/26/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND With the Nordic consensus statement advocating orchidopexy at an earlier age, the present study sought to investigate the outcomes of primary paediatric orchidopexy at a tertiary UK centre. OBJECTIVE To prospectively assess testicular atrophy following primary orchidopexy for undescended testes in a paediatric population. Secondary outcomes were complication rates and whether outcomes were dependent on grade of operating surgeon. STUDY DESIGN Prospective data regarding age at operation, classification of the undescended testis, length of follow-up, and subjective comparison of intraoperative and postoperative testicular volumes compared with the contralateral testis were collected. Testicular atrophy was defined as >50% loss of testicular volume or a postoperative testicular volume <25% of the volume of the contralateral testis. Patients were excluded for incomplete data and follow-up <6 months. RESULTS Data for 234 patients were analysed. Testicular atrophy occurred in 2.6% of cases. There was no reported testicular re-ascent. All secondary acquired cases underwent a previous ipsilateral hernia repair. There was no significant difference in outcomes comparing the grade of surgeon (consultant n = 8, trainee/staff-grade surgeon n = 7-8). There was a trend towards postoperative catch-up growth in approximately one fifth of cases. DISCUSSION Previous studies have reported a testicular atrophy rate of 5%. The present study reported a similar rate of 2.6%. In agreement with a previous publication, it was also found that testicular atrophy was not dependent on the grade of operating surgeon. The mechanism for testicular catch-up growth is not well understood. Animal studies have supported the hypothesis that increased temperature has a detrimental effect on testicular volume. However, follow-up in the present cohort was short (median 6.9 months), making interpretation of this finding difficult. It is acknowledged that clinical palpation alone to determine testicular volume potentially introduces intra-observer and inter-observer error. However, prospective studies using ultrasound to determine testicular volumes following orchidopexy have reported catch-up growth. CONCLUSION This study represented one of the larger collections of prospective assessments of outcomes following primary orchidopexy. It was acknowledged that subjectively assessing testicular volume is not ideal; however, the data correlated with similar studies.
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Affiliation(s)
- J Durell
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - N Johal
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - D Burge
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - R Wheeler
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - M Griffiths
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - L Kitteringham
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - M Stanton
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - S Manoharan
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - H Steinbrecher
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - P Malone
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK
| | - S J Griffin
- Department of Paediatric Surgery and Urology, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, UK.
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Patel V, Johal N, McArdle L, McDonald F. Expure and Bonding of Unerupted Posterior Teeth. J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.joms.2015.06.015] [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: 10/23/2022]
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Lakhanpaul M, Bird D, Culley L, Hudson N, Robertson N, Johal N, McFeeters M, Hamlyn-Williams C, Johnson M. The use of a collaborative structured methodology for the development of a multifaceted intervention programme for the management of asthma (the MIA project), tailored to the needs of children and families of South Asian origin: a community-based, participatory study. Health Services and Delivery Research 2014. [DOI: 10.3310/hsdr02280] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundAsthma is one of the most common chronic childhood illnesses in the UK. South Asian children are more likely to suffer from their asthma and be admitted to hospital. While this inequality needs to be addressed, standard behaviour-change interventions are known to be less successful in minority ethnic groups. Evidence suggests a need to enhance services provided to ethnic minority communities by developing culturally sensitive tailored interventions.ObjectivesThe Management and Interventions for Asthma (MIA) project aimed to test an iterative multiphase participatory approach to intervention development underpinned by the socioecological model of health, producing an intervention-planning framework and enhancing an evidence-based understanding of asthma management in South Asian and White British children.DesignInterviews and focus groups facilitated by community facilitators (CFs) were used to explore knowledge and perceptions of asthma among South Asian communities, children, families and healthcare professionals (HCPs). A smaller comparison group of White British families was recruited to identify aspects of asthma management that could be addressed either by generic interventions or by a tailored approach. Collaborative workshops were held to develop an intervention planning framework and to prioritise an aspect of asthma management that would be used as an exemplar for the development of the tailored, multifaceted asthma intervention programme.SettingThe community study was based in a largely urban environment in Leicester, UK.ParticipantsParticipants were recruited directly from the South Asian (Indian, Pakistani and Bangladeshi) and White British communities, and through the NHS. Children were aged between 4 and 12 years, with a range of asthma severity.Intervention developmentThe study had four phases. Phase 1 consisted of an evidence review of barriers and facilitators to asthma management in South Asian children. Phase 2 explored lay understandings of childhood asthma and its management among South Asian community members (n = 63). Phase 3 explored perceptions and experiences of asthma management among South Asian (n = 82) and White British families (n = 31) and HCP perspectives (n = 37). Using a modified intervention mapping approach incorporating psychological theory, phase 4 developed an intervention planning framework addressing the whole asthma pathway leading to the development of an exemplar multifaceted, integrated intervention programme called ‘ACT [Awareness, Context (cultural and organisational) and Training] on Asthma’.ResultsData on the social patterning of perceptions of asthma and a lack of alignment between the organisation of health services, and the priorities and competencies of British South Asian communities and families were produced. Eleven key problem areas along the asthma pathway were identified. A four-arm multifaceted tailored programme, ‘ACT on Asthma’, was developed, focusing on the theme ‘getting a diagnosis’. This theme was chosen following prioritisation by families during the collaborative workshops, demonstrating the participatory, iterative, phased approach used for the intervention design.ConclusionsThe MIA study demonstrated barriers to optimal asthma management in children at the family, provider and healthcare system levels and across the whole asthma pathway. Interventions need to address each of these levels to be effective. Minority ethnic communities can be successfully engaged in collaborative intervention development with a community-focused and culturally sensitive methodology.Future workFurther research is required to (1) assess the feasibility and effectiveness of the proposed ‘ACT on Asthma’ programme, (2) develop methods to increase active participation of children in research and service development, (3) develop and test strategies to enhance public understanding of asthma in South Asian communities and (4) identify effective means of engaging the wider family in optimising asthma management.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Monica Lakhanpaul
- General and Adolescent Paediatrics Unit, Institute of Child Health, University College London, London, UK
- Department of Medical and Social Care Education, University of Leicester, Leicester, UK
| | - Deborah Bird
- Department of Medical and Social Care Education, University of Leicester, Leicester, UK
- Cheyne Child Development Centre, Chelsea and Westminster Hospital, London, UK
| | - Lorraine Culley
- School of Applied Social Sciences, Health and Life Sciences, De Montfort University, Leicester, UK
| | - Nicky Hudson
- School of Applied Social Sciences, Health and Life Sciences, De Montfort University, Leicester, UK
| | | | | | - Melanie McFeeters
- University Hospitals of Leicester NHS Trust, School of Nursing and Midwifery, De Montfort University, Leicester, UK
| | - Charlotte Hamlyn-Williams
- General and Adolescent Paediatrics Unit, Institute of Child Health, University College London, London, UK
| | - Mark Johnson
- Mary Seacole Research Centre, De Montfort University, Leicester, UK
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Ahluwalia RS, Johal N, Kouriefs C, Kooiman G, Montgomery BSI, Plail RO. The surgical risk of suprapubic catheter insertion and long-term sequelae. Ann R Coll Surg Engl 2006; 88:210-3. [PMID: 16551422 PMCID: PMC1964072 DOI: 10.1308/003588406x95101] [Citation(s) in RCA: 142] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Suprapubic catheter (SPC) insertion is a common urological procedure, which is often referred to as safe and simple even in inexperienced hands. There is, however, very little published evidence on the safety of this procedure. Our study aimed to provide evidence on the associated morbidity and mortality and provide guidance for practising clinicians. PATIENTS AND METHODS A total of 219 patients who underwent SPC insertion under cystoscopic guidance at two urology institutions between 1994 and 2002 were identified and their case notes reviewed. RESULTS The intra-operative complication rate was 10% and the 30-day complications rate was 19%. Mortality rate was 1.8%. Long-term complications included recurrent UTIs (21%), catheter blockage (25%) resulting in multiple accident and emergency attendance (43%). Despite this, the satisfaction rate was high (72%) and most patients (89%) prefer the SPC over the urethral catheter. CONCLUSIONS SPC bladder drainage results in a high patient satisfaction rate. Patients and clinicians should be aware of the potential complications associated with SPC insertion.
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Affiliation(s)
- RS Ahluwalia
- Department of Urology, Hastings and Eastbourne NHS TrustUK
| | - N Johal
- Department of Urology, Hastings and Eastbourne NHS TrustUK
| | - C Kouriefs
- Department of Urology, Hastings and Eastbourne NHS TrustUK
| | - G Kooiman
- Department of Urology, Frimley Park HospitalUK
| | | | - RO Plail
- Department of Urology, Hastings and Eastbourne NHS TrustUK
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Johal N, Kumar P, Sellaturay S, Arya M, Cuckow P. Severe proximal hypospadias. Br J Hosp Med (Lond) 2005; 66:307. [PMID: 15920863 DOI: 10.12968/hmed.2005.66.5.18428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- N Johal
- Institute of Child Health, London WC1N 1EH
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Sellaturay S, Arya M, Johal N, Cuckow PM. Bladder extrophy. Br J Hosp Med (Lond) 2005; 66:177. [PMID: 15791881 DOI: 10.12968/hmed.2005.66.3.17691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S Sellaturay
- Department of Urology, Great Ormond Street Hospital, London
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