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Flood T, Duffy O. The effectiveness of interprofessional peer-led teaching and learning for therapeutic radiography students and Speech and Language Therapy students. PLoS One 2024; 19:e0299596. [PMID: 38696414 PMCID: PMC11065204 DOI: 10.1371/journal.pone.0299596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/12/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND Therapeutic Radiographers (RT) and Speech and Language Therapists (SLT) work closely together in caring for people with head and neck cancer and need a strong understanding of each others' roles. Peer teaching has been shown to be one of the most effective methods of teaching; however, no studies to date, have involved RT and SLT students. This research aims to establish the effectiveness and perceptions of peer-led teaching between undergraduate RT and SLT students in Ulster University. METHODS Twenty SLT students and 14 RT students participated. Knowledge tests were taken online before the peer-led teaching session (T1), after the session (T2) and 3 months later (T3). Students' perceptions of the experience were collected at the end of the session. Wilcoxon signed-rank tests were used to analyse the impact of the intervention on knowledge scores. Qualitative content analysis was used for open text response data. RESULTS RT students' own professional knowledge score at T2 was statistically significantly higher than the score at T1; the score at T3 was not deemed to be statistically significantly higher. RT students' SLT knowledge score at T2 and T3 was found to be statistically significantly higher than the score at T1. SLT students' own professional knowledge score was not statistically significantly higher at T2 or T3 than T1. They did have a statistically significantly higher score at T2 on the RT test, but score at T3 was not deemed to be statistically significantly higher. The majority of students across both professions agreed or strongly agreed that the peer-led teaching experience had a positive impact on their learning. CONCLUSION This investigation highlights the benefits of an interprofessional peer-led teaching intervention for RT and SLT students and the findings add to the evidence of more objective study of knowledge gain as a result of interprofessional peer teaching.
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Affiliation(s)
- Terri Flood
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, Newtownabbey, County Antrim, Northern Ireland
| | - Orla Duffy
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University Jordanstown Campus, Newtownabbey, County Antrim, Northern Ireland
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Flood T, Hughes CM, Wilson I, McLaughlin M. Applying the COM-B behaviour model to understand factors which impact 15-16 year old students' ability to protect themselves against acquirement of Human Papilloma virus (HPV) in Northern Ireland, UK. PLOS Glob Public Health 2024; 4:e0003100. [PMID: 38630731 PMCID: PMC11023437 DOI: 10.1371/journal.pgph.0003100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024]
Abstract
High-risk strains of Human Papillomavirus (HPV) can lead to the development of a number of cancers including cervical, vulvar, penile, anal and oropharyngeal. HPV vaccination programmes offer the HPV vaccine to males and females 12-13 years old in schools throughout the UK. However, knowledge of HPV remains low in post-primary schools. The aim of this study is to capture 15-16 year old students' perceptions regarding the current provision of HPV education, and whether providing HPV education to 15-16 year olds could influence their intention to be vaccinated and/or future sexual health decisions related to HPV. Between 5th November 2021 and 6th May 2022, seven focus groups were conducted with 34 students in post-primary schools in Northern Ireland, United Kingdom. The data was analysed using the COM-B behaviour model to explore the perceived facilitators and barriers impacting students' ability to protect themselves from acquirement of HPV. Students perceived their knowledge of HPV to be poor and supported the addition of comprehensive mandatory HPV education at 15-16 years old when many of them were becoming sexually active. They identified barriers including lack of parental education, school ethos and religion and insufficient education regarding their legal rights to self-consent to HPV vaccination. Students felt that removal of these barriers would lead to safer sexual practices, increased awareness of the importance of HPV screening and increased HPV vaccination uptake. The recommendations provided by students need to be supported by the Education Authority in conjunction with the Department of Health in order to be successfully implemented into the post-primary school curriculum.
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Affiliation(s)
- Terri Flood
- School of Health Sciences, Ulster University, Londonderry, Derry, United Kingdom
| | - Ciara M. Hughes
- School of Health Sciences, Ulster University, Londonderry, Derry, United Kingdom
| | - Iseult Wilson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Marian McLaughlin
- School of Psychology, Ulster University, Londonderry, Derry, United Kingdom
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Hughes J, Flood T. Patients' experiences of engaging with electronic Patient Reported Outcome Measures (PROMs) after the completion of radiation therapy for breast cancer: a pilot service evaluation. J Med Radiat Sci 2023; 70:424-435. [PMID: 37550951 PMCID: PMC10715367 DOI: 10.1002/jmrs.711] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 07/21/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION Over 60 % of people who develop breast cancer will receive radiation therapy (RT) as part of their treatment. Side effects of RT may include inflammation, erythema, desquamation and fatigue. Electronic Patient Reported Outcomes Measures (ePROMs) enable patients to report side effects prior to their scheduled post-RT appointment. This pilot service evaluation aims to explore patients' perceptions regarding the value of the ePROM system, ease of its use and barriers to using the system, after breast irradiation. METHODS From July-November 2021, evaluation surveys were posted to 100 people who had received RT to their breast to explore their experience of using the ePROM. Ethical approval was obtained through Ulster University and the Western Health and Social Care Trust (WHSCT), Northern Ireland. RESULTS Fifty-two people responded to the survey, of which 27 respondents indicated that they had accessed the ePROM. Despite few participants experiencing significant side effects, the majority of participants recommended the ePROM indicating that it was an important source of support. Those who experienced significant side effects found the system to be prompt and effective. Barriers to accessing the ePROM included technical issues with the link, concerns about confidentiality and forgetting to access the link. Access to the ePROM increased with higher education levels. CONCLUSIONS This pilot service evaluation demonstrated that ePROMs are valued by patients and can provide rapid real-time access to support, offering individual care and reassurance. For patients with longer RT schedules (>10 fractions), the introduction of ePROMs during RT was viewed favourably by participants. All patients may benefit from the option of receiving ePROMs post-RT.
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Affiliation(s)
- Jane Hughes
- North West Cancer Centre, Altnagelvin HospitalWestern Health and Social Care TrustDerryUK
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Ioakeim-Ioannidou M, Yeap BY, Flood T, Marinelli J, Giantsoudi D, Philip N, Tarbell NJ, Yock TI, Grosshans DR, McAleer MF, McGovern SL, MacDonald SM. Multi-Institutional Phase I Feasibility Trial of Vertebral Body Sparing CSI for Pediatric Brain Tumors. Int J Radiat Oncol Biol Phys 2023; 117:e519-e520. [PMID: 37785619 DOI: 10.1016/j.ijrobp.2023.06.1787] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Craniospinal irradiation (CSI) is an essential part of curative treatment for several pediatric brain tumors. Proton CSI allows for sparing of the organs anterior to the vertebral bodies (VBs), but this technique still includes the entire VB in the target for growing children. providing no advantage in marrow sparing or adverse effects on growth. Advances in proton therapy including Proton Beam Scanning (PBS) allow for delivery of proton CSI with substantial vertebral body sparing (VBS). We sought to determine the feasibility of VBS CSI using PBS based on the effects on tumor control and growth, and the occurrence of grade III/IV hematologic toxicity. MATERIALS/METHODS Clinical and treatment characteristics were recorded for 20 pediatric patients with medulloblastoma (n = 14) or germ cell tumor (GCT) (n = 6) who received proton VBS CSI without concurrent chemotherapy or with concurrent single-agent vincristine in a multi-institutional clinical trial. The following standard variables were extracted for each patient: age, histology, radiation dose, chemotherapy regimen, and growth hormone replacement status. Complete blood counts (CBC) with differential and data on height/weight were recorded at baseline pre-RT, weekly during RT, and after completion of cancer treatment. Hematologic toxicity was graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4 (CTCAE v4). RESULTS Median age of 13 male and 7 female patients receiving proton VBS CSI was 10 years (range: 5.1 - 15.1). All GCT patients (n = 6, 30%) received pre-RT chemo. Median CSI dose was 23.4 Gy (range: 21.0 - 37.8), and total dose to tumor bed was 54 Gy in 18 patients (90%) while 2 patients with pure germinoma received a total dose of 36 and 37.5 Gy, respectively. 11 patients (55%) did not receive concurrent vincristine. At a median follow up of 26.4 months (range: 12.5 - 56.3) from the start of RT, no patients relapsed. 17 patients (85%) developed grade ≥3 hematologic toxicity including grade 3 lymphopenia (n = 16), leukopenia (n = 9), neutropenia (n = 8), anemia (n = 1), and grade 4 neutropenia (n = 1). The patient who developed grade 4 neutropenia had low white blood counts prior to RT. 14 patients (70%) received post-RT chemo. No patients required platelet transfusion during RT. Those findings are similar to historical controls. 4 patients started growth hormone replacement therapy after RT. No patients developed spine deformities after the completion of treatment. CONCLUSION Proton VBS CSI is a feasible and well tolerated treatment for children with brain tumors. Longer follow up is needed to assess for late effects on tumor control. It is too early to assess for height in this cohort but for the patients that had longer follow up, normal height was achieved.
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Affiliation(s)
- M Ioakeim-Ioannidou
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - B Y Yeap
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - T Flood
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, Boston, MA
| | - J Marinelli
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, Boston, MA
| | - D Giantsoudi
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - N Philip
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - T I Yock
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - D R Grosshans
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M F McAleer
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S L McGovern
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S M MacDonald
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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Flood T, McLaughlin M, Hughes CM, Wilson IM. Applying the COM-B behaviour model to understand factors which impact school immunisation nurses' attitudes towards designing and delivering a HPV educational intervention in post-primary schools for 15-17 year old students in Northern Ireland, UK. Vaccine 2023; 41:5630-5639. [PMID: 37543445 DOI: 10.1016/j.vaccine.2023.07.066] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023]
Abstract
INTRODUCTION Human Papilloma Virus (HPV) is responsible for the development of cervical, vaginal, vulvar, penile, oropharyngeal and anal cancers. Throughout the UK, Immunisation nurses (IMNs) deliver school-based HPV vaccinations to students 12-13 years old. Providing HPV education to 15-17 year old students may promote decision-making regarding their sexual health and award opportunity for unvaccinated students to self-consent to the vaccination. This study aims to explore the perceptions of IMNs regarding the value of providing HPV education to 15-17 year old students and to explore whether IMNs feel that the design/delivery of this education should form part of their professional role. METHODS Six focus groups were conducted online with IMNs from all five Health and Social Care Trusts in Northern Ireland, UK, between January-June 2021. Data were analysed using the COM-B model to identify factors that might influence IMNs' behaviour towards designing/delivering this education for 15-17 year old students. RESULTS IMNs were highly motivated to design and deliver this HPV education. Facilitators promoting this behaviour included their specialist training, their previous sexual health teaching experience and their desire to educate young people. Barriers negatively influencing this behaviour included lack of time/resources, parental influences, lack of school support and lack of teaching/presentation skills training. CONCLUSION IMNs feel that they are the most appropriate professionals to design/deliver HPV education for 15-17 year old students. National policy change, based on collaboration between the Public Health Agency and Education Authority, is a key factor in facilitating IMNs to implement this school-based HPV education intervention.
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Affiliation(s)
- Terri Flood
- School of Health Sciences, Ulster University, Jordanstown, United Kingdom.
| | | | - Ciara M Hughes
- Institute of Nursing and Health Research, Ulster University, Jordanstown, United Kingdom.
| | - Iseult M Wilson
- School of Nursing and Midwifery, Queen's University Belfast, United Kingdom; College of Nursing and Midwifery, Mohammed Bin Rashid University, Dubai, United Arab Emirates.
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Flood T, O Neill A, Oliveira CM, Barbosa B, Soares AL, Muscat K, Guille S, McClure P, Hughes C, McFadden S. Patients' perspectives of the skills and competencies of therapy radiographers/radiation therapists (TRs/RTTs) in the UK, Portugal and Malta; a qualitative study from the SAFE Europe project. Radiography (Lond) 2023; 29 Suppl 1:S117-S127. [PMID: 36959043 DOI: 10.1016/j.radi.2023.03.002] [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: 12/09/2022] [Revised: 02/08/2023] [Accepted: 03/02/2023] [Indexed: 03/25/2023]
Abstract
INTRODUCTION The role of the Therapy Radiographer/Radiation Therapist (TR/RTT) is to provide radiotherapy to patients with a cancer diagnosis. This includes, not only administration of treatment, but also management of side-effects and provision of support/care. Despite this role being consistent throughout Europe, there is currently no standardisation of education for TRs/RTTs. The SAFE EUROPE project aims to standardize TR/RTT education to enable 'safe and free exchange' of TRs/RTTs across Europe. Consequently, this study aims to explore patients' perspectives regarding the current skills and competencies of TRs/RTTs. METHODS From May 2021 to February 2022, semi-structured interviews were conducted with patients who had recently received radiotherapy in the UK, Malta and Portugal. Ethical approval for this study was granted by the NHS Research Ethics Committee with additional local approvals obtained. RESULTS Forty-eight participants from the UK (n = 18), Portugal (n = 19), and Malta (n = 11) completed interviews. Participants described high satisfaction with TRs'/RTTs' competence and skills in all three countries. The main theme arising from the analysis was the importance of trust building with TRs/RTTs. Six factors were identified as influencing levels of trust: communication; side-effect management; team consistency; relational skills; patient dignity; and competence. A small number of patients reported feeling rushed and not having their physical and emotional needs met by TRs/RTTs. CONCLUSION This multicentre study demonstrated that patients perceive TRs/RTTs in the UK, Malta and Portugal as highly competent and skilled. Practical recommendations are provided to address identified deficits in practice, which can be addressed through adaptation of TR/RTT education/training and clinical practice. IMPLICATIONS FOR PRACTICE Recommendations arising from this study are important to ensure that TRs/RTTs have transferable skills that provide consistently high quality care to patients throughout Europe.
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Affiliation(s)
- T Flood
- Lecturer in Radiotherapy and Oncology, Ulster University Northern Ireland, UK.
| | - A O Neill
- Ulster University, Northern Ireland, UK.
| | - C M Oliveira
- Radiotherapy Department, Instituto Português de Oncologia Do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - B Barbosa
- Radiotherapy Department, Instituto Português de Oncologia Do Porto (IPO Porto), R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal.
| | - A L Soares
- Medical Physics Service,Portuguese Oncology Institute of Porto, Porto, Portugal.
| | - K Muscat
- University of Malta, MSD 2080, Malta.
| | - S Guille
- Ulster University, Northern Ireland, UK.
| | - P McClure
- Ulster University, Northern Ireland, UK.
| | - C Hughes
- School of Nursing and School of Health Sciences, Ulster University, Northern Ireland, UK.
| | - S McFadden
- Senior Lecturer, Ulster University, Northern Ireland, UK.
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Mc Fadden S, Flood T, Watson A, Shepherd P. The lessons learned working in diagnostic and therapeutic radiography departments through the COVID-19 pandemic in Northern Ireland, UK. What can we do differently the next time? Radiography (Lond) 2022; 28 Suppl 1:S68-S76. [PMID: 36008264 PMCID: PMC9359931 DOI: 10.1016/j.radi.2022.07.006] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Following the emergence of the COVID-19 pandemic in January 2020, a radical restructure of NHS services occurred, prioritising the acute needs of infected patients. This included suspending routine procedures, leading to an inevitable resurgence in the future, placing increased demands on the NHS, including diagnostic and therapeutic radiographers. With radiography departments already experiencing staff shortages due to COVID-19 related illnesses and vulnerable staff shielding, there is a need to implement plans within radiography departments to ensure their sustainability in the future. METHODS A mixed methods study was undertaken in Northern Ireland, involving distribution of a survey to diagnostic and therapeutic radiographers alongside conducting interviews with radiography department managers. RESULTS 106 radiographers completed the survey, with 9 radiography managers and 2 band eight superintendents participating in interviews. Over 60% of participants felt that morale declined in their departments, with the majority feeling that the pandemic had a negative impact on their physical or mental health and wellbeing. Managers felt that to improve staff morale and motivation, incentives need to be offered including remuneration, flexible working and support for professional development. CONCLUSION Whilst predicting when the next wave of a COVID-19 variant or the next pandemic will occur is impossible, preparation and planning will help manage the situation better. This requires identifying clinical areas for expansion/retraction and having access to additional staff to meet the demands on the service to ensure all patients receive care not just those acutely ill. IMPLICATIONS FOR PRACTICE This study has identified key lessons learned from the pandemic within the radiography departments. This will enable preparation and strategic planning for future pandemics.
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Affiliation(s)
- S Mc Fadden
- Diagnostic Radiography and Imaging School of Health Sciences University of Ulster Shore Road Newtownabbey Co. Antrim, BT37 OQB, UK.
| | - T Flood
- Radiotherapy and OncologySchool of Health Sciences, Ulster University, BT37 0QB, UK.
| | - A Watson
- School of Health Sciences, Ulster University, BT37 0QB, UK.
| | - P Shepherd
- Radiotherapy and Oncology School of Health Sciences, Ulster University, Jordanstown Campus, Newtownabbey, BT37 0QB, UK.
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Flood T, McFadden S, Shepherd P. The impact of COVID-19 on the mental health of radiography staff and managers in Northern Ireland, UK: The radiography managers’ perspective. Radiography (Lond) 2022; 28 Suppl 1:S27-S34. [PMID: 35803870 PMCID: PMC9234019 DOI: 10.1016/j.radi.2022.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/16/2022] [Accepted: 06/19/2022] [Indexed: 12/02/2022]
Abstract
Introduction Increasing evidence suggests that the COVID-19 pandemic has influenced the mental health of health professionals, including radiographers. Less is known about the effect of the pandemic on the mental health of radiography managers. Radiography managers have led their teams through the pandemic, making unpopular decisions to safeguard staff and patients. This study explores radiography managers’ perceptions regarding the impact of the COVID-19 pandemic on the mental health of themselves and their staff. Methods Ethical approval was obtained from the NHS Research Ethics Committee (ID 287032). Eleven interviews were conducted with therapeutic and diagnostic radiography managers between March–April 2021. Written information was also included from a paediatric diagnostic radiography manager. Data was analysed independently by 2 researchers using thematic analysis. Results Three central themes emerged: 1) Factors perceived to have negatively influenced mental health, which included changing PPE guidance, restructuring of work conditions, social isolation, challenges to patient care and lack of quality vacation leave. 2) Factors perceived to have positively influenced mental health, which included witnessing staff resilience and team camaraderie. 3) Support provided for mental health. Conclusion Managers felt that they had implemented appropriate strategies to support their staff throughout the first year of the pandemic and expressed feeling responsible for the wellbeing of their staff. Strong empathy was evident towards staff and their experiences. Despite the availability of mental health support services, managers felt that resources were underutilised by radiography teams. Implications for practice Managers should be proactive in communicating their appreciation for their staff in an era where remote working can add to disconnect between staff and management. Mental health support services should be promoted and continually reviewed, to ensure that appropriate support services are maintained.
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Affiliation(s)
- T Flood
- Radiotherapy and Oncology, School of Health Sciences, Ulster University, UK.
| | - S McFadden
- Diagnostic Imaging, School of Health Sciences, Ulster University, UK
| | - P Shepherd
- Radiotherapy and Oncology, School of Health Sciences, Ulster University, UK
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Flood T, Wilson IM, Prue G, McLaughlin M, Hughes CM. Impact of school-based educational interventions in middle adolescent populations (15-17yrs) on human papillomavirus (HPV) vaccination uptake and perceptions/knowledge of HPV and its associated cancers: A systematic review. Prev Med 2020; 139:106168. [PMID: 32603795 DOI: 10.1016/j.ypmed.2020.106168] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 08/06/2019] [Revised: 06/04/2020] [Accepted: 06/06/2020] [Indexed: 11/25/2022]
Abstract
The American Academy of Paediatrics (AAP) divides adolescence into early (12-14 years), middle (15-17 years), and late (18-21 years) stages. School-based HPV educational interventions are largely directed at parents of early adolescents at the time of vaccination. As the average age of first sexual intercourse in high income countries is 15-17 years old, a second educational intervention for middle adolescents could have a strong impact on HPV prevention, providing an opportunity for self-consenting to HPV vaccination in many countries. This paper appraises literature exploring the impact of school-based educational interventions in 15-17 year olds, on HPV vaccination uptake and/or perceptions/knowledge of HPV and its associated cancers. Randomised controlled trials (RCTs) and quasi-experimental designs (QEDs) (2007-2019) were included if they delivered a school-based educational intervention for 15-17 year olds, and the outcome measures included HPV vaccination uptake, knowledge of HPV and associated cancers or perception/attitude regarding self-protection against HPV. Fifteen studies met the inclusion criteria and were assessed for quality using the Quality Assessment Tool for Quantitative Studies. All studies demonstrated a statistically significant improvement in at least one major outcome measure post-intervention, despite the wide range in design of interventions, though only three studies actually measured changes to HPV vaccination uptake. Stakeholder engagement was absent in most intervention designs and many were not grounded in evidenced theory. Content was largely focused on female cervical cancer, rarely discussing oropharyngeal cancer, the most pre-dominant HPV-associated cancer in men. An optimal mixed gender intervention remains to be established for middle adolescents.
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Affiliation(s)
- Terri Flood
- School of Health Sciences, Ulster University, Jordanstown, United Kingdom.
| | - Iseult M Wilson
- School of Nursing and Midwifery, Queen's University Belfast, United Kingdom.
| | - Gillian Prue
- School of Nursing and Midwifery, Queen's University Belfast, United Kingdom.
| | | | - Ciara M Hughes
- Institute of Nursing and Health Research, Ulster University, Jordanstown, United Kingdom.
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Montgomery L, Flood T, Shepherd P. A review and evaluation of the immobilisation techniques adopted for breast cancer patients with large and/or pendulous breasts while receiving external beam radiotherapy. Radiography (Lond) 2020. [DOI: 10.1016/j.radi.2019.11.040] [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: 11/16/2022]
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Flood T, Wilson I, Cathcart J. Service user involvement in radiotherapy and oncology education; the patient perspective. Radiography (Lond) 2018; 24:185-191. [DOI: 10.1016/j.radi.2018.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 01/11/2018] [Accepted: 01/12/2018] [Indexed: 10/18/2022]
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French K, Flood T. Neonatal Nasal Trauma - an unusual cause of developmental facial deformity. Br J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.bjoms.2014.07.168] [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: 10/24/2022]
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Abstract
Dental implants have shown great success in recent years. However, in certain circumstances they can suffer from complications. It usually results from a combination of infection and host inflammatory responses or a lack thereof. This report documents an extra-oral cutaneous fistula associated with an osseointegrated dentoalveolar implant.
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Affiliation(s)
- R Mahmood
- Aintree University Hospital, Liverpool, L9 7AL, UK.
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Flood T, Bom IVD, Strittmatter L, Hendricks G, Puri A, Wakhloo A, Gounis M. P-016 Quantitative Assessment of Stent Induced Neointimal Hyperplasia with Contrast Enhanced Cone-Beam CT: In Vivo Validation with Histomorphometry. J Neurointerv Surg 2013. [DOI: 10.1136/neurintsurg-2013-010870.48] [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: 11/03/2022]
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Sanghrajka N, Mahmood R, Tank M, Al-Gholmy M, Downie I, Flood T. Cleft vs non-cleft osteotomies: a quality of life comparison. Br J Oral Maxillofac Surg 2012. [DOI: 10.1016/j.bjoms.2012.04.238] [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: 10/28/2022]
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Al-Gholmy M, Scott R, Mahmood R, Sanghrajka N, Robinson S, Flood T. Surgical modifications and the use of skeletal anchorage to reduce relapse rates in cleft osteotomies. Br J Oral Maxillofac Surg 2012. [DOI: 10.1016/j.bjoms.2012.04.155] [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: 11/28/2022]
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Singh MK, Shekar K, Flood T, Greenstein A. Transnasal K-wire to stabilise a complex zygomatic fracture: a forgotten method of fixation. Ann R Coll Surg Engl 2012; 94:e157-8. [PMID: 22613286 DOI: 10.1308/003588412x13171221590494] [Citation(s) in RCA: 2] [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] [Indexed: 11/22/2022] Open
Abstract
Zygomatic complex fractures make up approximately 60% of facial fractures. The vast majority treated surgically use titanium miniplates. These require longer operating times and facial incisions to access the fracture. The use of a K-wire was first described 60 years ago. As a new generation of surgeons emerges, it is important to be aware of the various techniques available to increase their surgical armamentarium. One of its benefits is that it has a significantly reduced operative time and does not require any incisions.
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Andrade FCD, Vazquez-Vidal I, Flood T, Aradillas-Garcia C, Vargas-Morales JM, Medina-Cerda E, Teran-Garcia M. One-year follow-up changes in weight are associated with changes in blood pressure in young Mexican adults. Public Health 2012; 126:535-40. [PMID: 22546507 DOI: 10.1016/j.puhe.2012.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 01/04/2012] [Accepted: 02/10/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Increasing overweight and obesity rates in Mexico have been associated with increases in mortality from cardiovascular disease (CVD). This study assessed changes in body mass index (BMI) and body weight over 1 year, and explored whether these were associated with changes in CVD risk factors of blood pressure and fasting glucose in a cohort of young Mexican adults. STUDY DESIGN Longitudinal data were obtained from a cohort of young Mexican adults applying to college. METHODS Data were collected from college applicants for the 2008 academic year who re-applied in 2009. In total, 795 college applicants aged 18-20 years, of both sexes (48% males and 52% females), were included in the study. The screen included height, weight, and systolic (SBP) and diastolic (DBP) blood pressure measurements plus a blood draw following an overnight fast for fasting glucose. RESULTS At baseline, 31.8% of the participants were overweight or obese. The mean 1-year change in body weight and BMI were 0.80 kg and 0.35 kg/m(2), respectively. One-year changes in body weight and BMI were associated with increased SBP and DBP for both men and women (P < 0.05), independent of baseline BMI. A weight gain of 5% or more was positively associated with increases in blood pressure among women (P < 0.05), but not among men. A weight loss of 5% or more was associated with reductions in SBP among women. CONCLUSIONS One-year changes in weight were associated with changes in blood pressure.
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Affiliation(s)
- F C D Andrade
- University of Illinois at Urbana-Champaign, 905 S. Goodwin Avenue, 445 Bevier Hall, Urbana, IL 61801, USA
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Abstract
A cluster of four confirmed cases of meningococcal disease was seen in the same nuclear family across a 15-week period. The cases were three siblings and a parent and all recovered well. The first case was confirmed by meningococcal PCR only but the subsequent three cases were due to indistinguishable strains of serogroup B (B:NT:P1.19-1,15-11). Contact tracing was initially undertaken and reviewed in detail after each subsequent case. Antibiotic prophylaxis was administered to close family contacts on three separate occasions, including switching of antibiotic agents, with good compliance. Subsequent investigation of the family has not revealed any obvious immunological problem and no further significant infections have been recognised. A cluster of meningococcal disease of this nature and timescale is highly unusual. Details of the cluster, investigation and implications for health protection practice are discussed.
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Affiliation(s)
- P Acheson
- Health Protection Agency North East, North East Health Protection Unit, Floor 2, Citygate, Gallowgate, Newcastle upon Tyne NE1 4WH, UK.
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Slatter M, Rao K, Chiesa R, Amrolia P, Nademi Z, Flood T, Abinun M, Cant A, Hambleton S, Goulden N, Davies G, Qasim W, Gaspar H, Gennery A, Veys P. Treosulfan, Fludarabine and Alemtuzumab Conditioning for Hematopoietic Stem Cell Transplantation in Children with Primary Immunodeficiency: UK Experience. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.092] [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: 10/14/2022]
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Moreira D, Slatter M, Nademi Z, Brigham K, Barge D, Jackson A, Flood T, Cant A, Abinun M, Hambleton S, Gennery A. Immune Reconstitution and Clinical Outcome After HSCT Infusion for Severe Combined Immunodeficiency in Newcastle. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.321] [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: 10/14/2022]
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Romitti PA, Flood T, Feldkamp ML, Krikov S, Puzhankara S, Goedken R, Fluchel M, Little J, Botto LD. P2-259 Cancer risk in children with birth defects: a longitudinal, population-based assessment among 2.7 million births. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976j.92] [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: 11/04/2022]
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Sanghrajka N, Mahmood R, Flood T, Singh M. Rhinoplasty in cleft care: evaluating perceived impact on quality of life and nasal function. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.203] [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: 11/26/2022]
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Prudon S, Wake J, Barge D, Simmister C, Tremble S, Stevenson V, Flood T, Spencer DA. S29 Mannose binding lectin deficiency in children with respiratory infection. Thorax 2010. [DOI: 10.1136/thx.2010.150912.29] [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: 11/03/2022]
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Rensing-Ehl A, Warnatz K, Fuchs S, Schlesier M, Salzer U, Draeger R, Bondzio I, Joos Y, Janda A, Gomes M, Abinun M, Hambleton S, Cant A, Shackley F, Flood T, Waruiru C, Beutel K, Siepermann K, Dueckers G, Niehues T, Wiesel T, Schuster V, Seidel MG, Minkov M, Sirkiä K, Kopp MV, Korhonen M, Schwarz K, Ehl S, Speckmann C. Clinical and immunological overlap between autoimmune lymphoproliferative syndrome and common variable immunodeficiency. Clin Immunol 2010; 137:357-65. [PMID: 20832369 DOI: 10.1016/j.clim.2010.08.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 08/10/2010] [Accepted: 08/12/2010] [Indexed: 12/27/2022]
Abstract
Autoimmune lymphoproliferative syndrome (ALPS) is mainly caused by defects in the CD95 pathway. Raised CD3+TCRαβ+CD4-CD8- double negative T cells and impaired T cell apoptosis are hallmarks of the disease. In contrast, the B cell compartment has been less well studied. We found an altered distribution of B cell subsets with raised transitional B cells and reduced marginal zone B cells, switched memory B cells and plasma blasts in most of 22 analyzed ALPS patients. Moreover, 5 out of 66 ALPS patients presented with low IgG and susceptibility to infection revealing a significant overlap between ALPS and common variable immunodeficiency (CVID). In patients presenting with lymphoproliferation, cytopenia, hypogammaglobulinemia and impaired B cell differentiation, serum biomarkers were helpful in addition to apoptosis tests for the identification of ALPS patients. Our observations may indicate a role for apoptosis defects in some diseases currently classified as CVID.
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Affiliation(s)
- A Rensing-Ehl
- Centre of Chronic Immunodeficiency, University Medical Centre, Freiburg, Germany
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Slatter M, Rao K, Amrolia P, Flood T, Abinun M, Cant A, Hambleton S, Goulden N, Gennery A, Veys P. UK Experience Of Treosulfan-Based Conditioning Regimens In Children With Primary Immunodeficiency Or Severe Immune Dysregulation. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.102] [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: 10/19/2022]
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Flood T, Scott JK, Webb RM. O.062 Guided tissue regeneration techniques in secondary bone grafting. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71186-7] [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] Open
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Taha Y, Taylor C, Gennery A, Abinun M, Flood T, Clarke J, Al-Aufi N, Al-Husamy H, Cant A. Human herpesvirus-6 viraemia in children with primary immunodeficiency undergoing stem-cell-transplantation. J Clin Virol 2006. [PMCID: PMC7128294 DOI: 10.1016/s1386-6532(06)80871-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ferry C, Ouachée M, Leblanc T, Michel G, Notz-Carrére A, Tabrizi R, Flood T, Lutz P, Fischer A, Gluckman E, Donadieu J. Hematopoietic stem cell transplantation in severe congenital neutropenia: experience of the French SCN register. Bone Marrow Transplant 2004; 35:45-50. [PMID: 15489867 DOI: 10.1038/sj.bmt.1704718] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [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: 11/09/2022]
Abstract
Our objective was to study the outcome of allogeneic hematopoietic stem cell transplantation (HSCT) in patients with severe congenital neutropenia (SCN). Among 101 cases of SCN included in the French Severe Chronic Neutropenia Registry, nine patients received HSCT between 1993 and 2003, in seven institutions. The indications were nonresponse to G-CSF therapy in four cases, bone marrow failure in one case, and myelodysplastic syndrome or leukemia in four cases. The conditioning regimen consisted of total body irradiation in two cases and chemotherapy alone in the other seven cases. Seven patients received stem cells from unrelated donors and two from identical siblings. Engraftment occurred in all but one of the patients. Three patients died. The respective causes of death were graft-versus-host disease, infection, and EBV post-transplant lymphoproliferative disease. Six patients are alive and in complete remission, with a median follow-up of 3.1 years. These results indicate that HSCT is feasible for patients with SCN who do not respond to G-CSF, who have malignant transformation, or who are at a high risk of malignant transformation, even if an HLA-identical sibling donor is not available.
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Affiliation(s)
- C Ferry
- Service de Transplantation médullaire, Hôpital St Louis, Paris, France
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Lakshman R, Gennery AR, Arkwright PD, Flood T, Abinun M, Spickett G, Borrows R, Cant AJ, Balmer P, Borrow R. Assessing immune responses to pneumococcal vaccines. Arch Dis Child 2003; 88:648-9. [PMID: 12818930 PMCID: PMC1763169 DOI: 10.1136/adc.88.7.648] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Fairbanks LD, Simmonds HA, Duley JA, Gaspar HB, Flood T, Steward CA. ADA activity and DATP levels in erythrocytes after bone marrow transplantation. Adv Exp Med Biol 2002; 486:51-5. [PMID: 11783527 DOI: 10.1007/0-306-46843-3_10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Zeidler C, Welte K, Barak Y, Barriga F, Bolyard AA, Boxer L, Cornu G, Cowan MJ, Dale DC, Flood T, Freedman M, Gadner H, Mandel H, O'Reilly RJ, Ramenghi U, Reiter A, Skinner R, Vermylen C, Levine JE. Stem cell transplantation in patients with severe congenital neutropenia without evidence of leukemic transformation. Blood 2000; 95:1195-8. [PMID: 10666190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
Severe congenital neutropenia (CN) (Kostmann syndrome) is a hematologic disorder characterized by a maturation arrest of myelopoiesis at the promyelocyte/myelocyte stage of development. This arrest results in severe neutropenia leading to absolute neutrophil counts (ANC) below 0.2 x 10(9)/L associated with severe bacterial infections from early infancy. Data on over 300 patients with CN collected by the Severe Chronic Neutropenia International Registry (SCNIR) beginning in 1994 indicate that more than 90% of these patients respond to recombinant human granulocyte-colony stimulating factor (r-HuG-CSF) treatment with an ANC greater than 1. 0 x 10(9)/L. For patients who are refractory to r-HuG-CSF treatment and continue to have severe and often life-threatening bacterial infections, hematopoietic stem cell transplantation is the only currently available treatment. We report on a total of 11 patients with CN reported to the SCNIR who underwent transplantation for reasons other than malignant transformation between 1976 and 1998. Of these patients, 8 were nonresponders or showed only partial response to r-HuG-CSF treatment with ongoing infections. Results from these patients suggest that transplantation of stem cells from an HLA-identical sibling is beneficial for patients refractory to r-HuG-CSF. (Blood. 2000;95:1195-1198)
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Affiliation(s)
- C Zeidler
- Medizinische Hochschule, Hannover, Germany.
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Galloway A, Fulton B, Flood T. Meningococcal disease in healthcare workers. Long term effects and costs are unclear. BMJ 2000; 320:248; author reply 248-9. [PMID: 10712020] [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: 02/15/2023]
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Crano J, Knowles D, Kwiatkowski P, Flood T, Ross R, Chiang L, Lasch J, Chadha R, Siuzdak G. Structure of three novel photochromic compounds; X-ray crystallographic and theoretical studies. Acta Crystallogr B Struct Sci 1994. [DOI: 10.1107/s0108768194005938] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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McGibney CA, Byrne PJ, Lawlor P, Denham B, Hennessy TPJ, Greally P, Hampton FJ, MacFadyen UM, Simpson H, Gururangan S, McMahon C, Guiney EJ, Fitzgerald RJ, O’Donnell B, Breathnach F, Thomas G, Lambert I, Gill D, Ledwith MV, Conlon P, Cronin C, O’Halpin D, Donoghue V, Webb DW, Osborne JP, Naughten E, Darling G, Saul I, Prakash N, McDonald M, Cosgrove J, Costigan C, Naughten ER, King M, Rowland P, Bressan J, Lillis DF, Loftus BG, Fitzgerald J, Jackson J, Fleming P, Deb L, Temperley IJ, Daly NJ, McShane D, Jackson JF, O’Nuallain EM, Reen DJ, Monaghan H, Dorman A, Ball R, Curran B, Leader M, O’Meara A, Flood T, Sweed Y, Puri P, Twomey M, Duncan J, Kiernan M, Kearney PJ, Abushaban L, Denham B, Duff D, Donnelly MJ, Maguire AJ, Dennis AR, Donnelly M, Aziz MA, Gormally SM, Matthews TG, Fitzsimons R, Ahmed Z, Hensey O, Deshpande D, George A, Rao JS, Gaffney E, Gorman W, Kierce B, Quinn F, Drumm B, Naughton A, McMenamin JB, Stack J, Coveney E, Ninan G, Praedeep Dumar VK, Watson B, O’Neill M. Irish paediatric association. Ir J Med Sci 1992. [DOI: 10.1007/bf02942160] [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: 11/29/2022]
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Clegg W, Norman NC, Flood T, Sallans L, Kwak WS, Kwiatkowski PL, Lasch JG. Structures of three photochromic compounds and three non-photochromic derivatives; the effect of methyl substituents. Acta Crystallogr C 1991. [DOI: 10.1107/s010827019000899x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Wilson S, Flood T, Kramer N, McTigue DJ, Steinberg B. A study of facially expressed emotions as a function of age, exposure time, and sex in children. Pediatr Dent 1990; 12:28-32. [PMID: 2399179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Facial expressions and body language constitute a major component of communication in the human population. There are no studies in the dental literature that have examined children's ability to recognize facial expressions. The purpose of this study was to determine children's accuracy and latency to respond to facial expressions (photographs) as a function of age and sex. Sixty children were recruited randomly and placed into three groups according to their age (3, 6, and 9 years) with 20 children per group. They were shown photographs of three different emotions (happiness, anger, and sadness) expressed by actors at three different exposure times (0.2, 0.5, and 1.0 sec), tachistoscopically. The children's responses (accuracy and latency) were recorded. The results indicated that three year olds were significantly less accurate and took longer to respond than the older children. Factors that may have influenced the results and clinical implications are discussed.
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Affiliation(s)
- S Wilson
- Ohio State University and Children's Hospital, Columbus
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Abstract
The efficacy of daily intramuscular injection of mixed gangliosides (Cronassial) for highly symptomatic diabetic neuropathy was investigated in a randomized double-blind trial. There were 37 patients treated with 40 mg of gangliosides or placebo for 12 weeks and studied with physical examination, symptom scales, and electrophysiologic parameters. There was no demonstrated benefit of therapy. Given the spontaneous variation in the measurements employed, larger numbers of patients would have been needed to identify a significant change of 10% owing to therapy.
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Affiliation(s)
- M Hallett
- Department of Medicine, Brigham and Women's Hospital, Boston, MA
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Abstract
We diagnosed Whipple's disease from the vitreous aspirate of two patients who underwent vitrectomies . In one case, the vitrectomy specimen would have indicated the diagnosis three years before the jejunal biopsy was performed had the appropriate PAS stain been used. In the second case, the PAS-positive macrophages were identified at the time of surgery.
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Hallett M, Harrington H, Tyler HR, Flood T, Slater N. Trials of ganglioside therapy for amyotrophic lateral sclerosis and diabetic neuropathy. Adv Exp Med Biol 1984; 174:575-9. [PMID: 6377851 DOI: 10.1007/978-1-4684-1200-0_48] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Double blind placebo controlled trials of dialy intramuscular injections of 40 mg of mixed gangliosides were carried out in ALS and diabetic neuropathy. Forty patients with ALS were treated for six months and monitored with tests of strength and pulmonary function. No effect of gangliosides was found. Forty patients with symptomatic diabetic neuropathy will be treated for three months. Some of the data from the first 25 patients to complete the study were analyzed in a preliminary fashion. While no difference in nerve conduction studies was found in the treated group compared to the control group, there was greater symptomatic improvement in the patients treated with gangliosides.
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Abstract
Two large angiomas (greater than 3 disc diameters) in two patients with von Hippel disease were removed successfully by eye wall resection. The resection of angioma in the first case resulted in improved visual acuity from counting fingers to 20/140, decreased exudates, and cessation of preoperative diffuse retinal capillary leakage observed by fluorescein angiography. The resection in the second case with pre-existing local tractional retinal detachment was tolerated well. The patient retained her preoperative visual acuity of 20/25, and retinal traction was released. Although a complicated surgical procedure, resection of large angiomas offers a good alternative therapy to tumors resistant to cryocoagulation or photocoagulation.
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Powell TR, Michalski JP, McCombs CC, Danilovs JA, Terasaki PI, Park MS, Flood T, Boone WB. HLA-Bw44 and HLA-DRw4 in male Sjögren's syndrome patients with associated rheumatoid arthritis. Clin Immunol Immunopathol 1980; 17:463-8. [PMID: 6933029 DOI: 10.1016/0090-1229(80)90118-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Kuberski T, Flood T, Tera T. Cholera in the Gilbert Island. I. Epidemiological features. Am J Trop Med Hyg 1979; 28:677-84. [PMID: 464187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
An explosive epidemic of cholera due to Vibrio cholerae, biotype El Tor, serotype Inaba, was centered on the coral atoll of Tarawa, Gilbert Islands. This outbreak was a unique experience in the South and Central Pacific region. The principal mode of spread during the peak of the outbreak was probably through contamination of the main water supply. Tarawa lagoon water and shellfish were found to be contaminated with V. cholerae and ingestion of raw fish and shellfish from the lagoon also served as a source of transmission. This outbreak raises the concern of Rother outbreaks of cholera occuring on remote and poorly equipped Pacific islands where the environmental circumstances are conducive to cholera spread.
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Roberts AB, Harris JR, Taitai T, Taraam T, Tekanene J, Cati A, Flood T, Teburae M. Cholera in the Gilbert Islands. II. Clinical and laboratory findings. Am J Trop Med Hyg 1979; 28:685-91. [PMID: 464188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
An epidemic of cholera due to Vibrio cholerae biotype El Tor occurred in 1977 on Tarawa in the Gilbert Islands. No cholera epidemic had occurred there previously and special problems were encountered in both the diagnosis and clinical management. The clinical features of the 585 hospital admissions on Tarawa during the first 64 days of the epidemic were recorded. Eight hospital deaths occurred in this period. A marked increase in cholera among malnourished Gilbertese children was noted. Simplified regimes for management were devised for the circumstances including schemes for oral and intravenous rehydration. Coconut water was used extensively in oral rehydration. Paramedical personnel were used effectively during the epidemic. Prophylactic tetracycline was used in household contacts of patients and was effective in reducing subsequent illness.
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Abstract
To determine the modes of transmission in a cholera epidemic in a newly infected population on an atoll, two studies were conducted, in which persons with cholera were individually matched, by age and sex, with neighbourhood controls. Among the first recognised cases, cholera was associated with frequent (daily or weekly) consumption of raw lagoon fish that had been salted and partially dried. Vibrio cholerae was isolated from the lagoon, which was contaminated by human wastes. During the declining phase of the epidemic, cholera was associated with consumption of raw clams, salt-fish, sardines, and other fish from the lagoon. When seafood from enclosed bodies of faecally contaminated water is frequently eaten raw, imported V. cholerae can become established and can be extremely difficult to eradicate.
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Clouse ME, Gramm HF, Legg M, Flood T. Diabetic osteoarthropathy. Clinical and roentgenographic observations in 90 cases. Am J Roentgenol Radium Ther Nucl Med 1974; 121:22-34. [PMID: 4833885 DOI: 10.2214/ajr.121.1.22] [Citation(s) in RCA: 89] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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