Author(s): Loynes, H; Rao, J
Source: British dental journal; Aug 2017; vol. 223 (no. 4); p. 244-246
Publication Type(s): Journal Article
Abstract:This article reviews my experience as a profoundly deaf dental core trainee (DCT) in oral and maxillofacial surgery at Wythenshawe Hospital - working on call, carrying out daily clinics and assisting in theatre. A novel set of challenges presented, such as understanding conversations on the phone and minimising interference from background noise. Support was sought from Occupational Health, Access to Work and FM Hearing Systems, who provided practical advice and technological solutions. This year has improved my confidence and who I am as a person, and as a dentist. Plus, due to my newfound technical support I am able to hear a lot better on the phone now. It is hoped this article this will provide a useful insight for employers on how to support employees with hearing difficulties, and inspire future candidates.
Single-incision surgery and trocar-site hernia: A systematic review and meta-analysis with trial sequential analysis
Author(s): Hajibandeh S.; Garcia-Alamino J.; Weitzendorfer M.; Emmanuel K.; Muysoms F.; Granderath F.; Chalkiadakis G.; Antoniou S.; Antoniou G.; Gioumidou M.; Iliopoulou-Kosmadaki S.; Mathioudaki M.; Souliotis K.
Source: Surgical Endoscopy and Other Interventional Techniques; Jun 2017; vol. 31 (no. 2)
Publication Date: Jun 2017
Publication Type(s): Conference Abstract
Abstract:Aim: Single-incision laparoscopic surgery (SILS) is a novel concept, aiming at further minimizing abdominal wall trauma and improving cosmesis. Concerns have been raised about the risk of trocar site hernia following SILS. This study aims at assessing the comparative risk of trocar site hernia following SILS and conventional laparo-scopic surgery, and investigating whether current evidence is conclusive. Methods: We performed a systematic search of Medline, AMED, CINAHL, CENTRAL and OpenGrey. Randomized clinical trials of SILS and conventional laparoscopic surgery providing trocar-site hernia rates were considered for inclusion. Pooled odds ratios with 95% confidence intervals were calculated using the Mantel Haenszel method. Trial sequential analysis with the Land and DeMets approach was performed to assess the possibility of type I error and to compute the information size. Results: Twenty-three articles reporting on 2471 patients were included. SILS was associated with higher odds of trocar-site hernia compared to conventional laparoscopic surgery (odds ratio 2.37, 95% confidence interval 1.25-4.50, p=0.008). There was no evidence of between study heterogeneity or small study effects. The information size was calculated at 1687 patients and the Z-curve crossed the O'Brien Fleming alpha-spending boundaries at 1137 patients, which suggests that the evidence of higher risk of trocar-site hernia following SILS compared to conventional laparoscopic surgery can be considered conclusive. Conclusion: Single-incision laparoscopic procedures through the umbilicus are associated with a higher risk of trocar-site hernia compared to conventional laparoscopic surgery.
Quantitative Evaluation of Biologic Therapy Options for Psoriasis: A Systematic Review and Network Meta-Analysis
Author(s): Jabbar-Lopez Z.K.; Yiu Z.Z.N.; Warren R.B.; Ward V.; Exton L.S.; Mohd Mustapa M.F.; Samarasekera E.; Burden A.D.; Murphy R.; Owen C.M.; Parslew R.; Venning V.; Smith C.H.
Source: Journal of Investigative Dermatology; Aug 2017; vol. 137 (no. 8); p. 1646-1654
Publication Date: Aug 2017
Publication Type(s): Article
Abstract:Multiple biologic treatments are licensed for psoriasis. The lack of head-to-head randomized controlled trials makes choosing between them difficult for patients, clinicians, and guideline developers. To establish their relative efficacy and tolerability, we searched MEDLINE, PubMed, Embase, and Cochrane for randomized controlled trials of licensed biologic treatments for skin psoriasis. We performed a network meta-analysis to identify direct and indirect evidence comparing biologics with one another, methotrexate, or placebo. We combined this with hierarchical cluster analysis to consider multiple outcomes related to efficacy and tolerability in combination for each treatment. Study quality, heterogeneity, and inconsistency were evaluated. Direct comparisons from 41 randomized controlled trials (20,561 participants) were included. All included biologics were efficacious compared with placebo or methotrexate at 3-4 months. Overall, cluster analysis showed adalimumab, secukinumab, and ustekinumab were comparable in terms of high efficacy and tolerability. Ixekizumab and infliximab were differentiated by very high efficacy but poorer tolerability. The lack of longer term controlled data limited our analysis to short-term outcomes. Trial performance may not equate to real-world performance, and so results need to be considered alongside real-world, long-term safety and effectiveness data. These data suggest that it is possible to discriminate between biologics to inform clinical practice and decision making (PROSPERO 2015:CRD42015017538).Copyright © 2017 The Authors
An exploration of mammographers' attitudes towards the use of social media for providing breast screening information to clients
Author(s): Scragg, B.; Shaikh, S.; Shires, G.; Stein Hodgins, J.; Mercer, C.; Robinson, L.; Wray, J.
Source: Radiography; Aug 2017; vol. 23 (no. 3); p. 249-255
Publication Date: Aug 2017
Publication Type(s): Academic Journal
Abstract:Introduction Increasingly patients and clients of health services are using social media to locate information about medical procedures and outcomes. There is increasing pressure for health professionals to engage in on-line spaces to provide clear and accurate information to their patient community. Research suggests there are some anxieties on the part of practitioners to do this. This study aimed to explore the attitudes of the NHS breast screening programme workforce towards engaging in online discussions with clients about breast screening. Method 78 practitioners, representing a range of professional roles within the NHS Breast Screening Programme, attended one of 4 workshops. We used a Nominal Group Technique to identify and rank responses to the question: " What are the challenges that practitioners face in using SoME as part of their role?" Responses were categorised into themes. Participants were also asked to identify solutions to these challenges. Results Challenges : We identified two overarching themes: (1) Working within boundaries : which was further categorised into (a) Professional/legal accountability; (b) Information accuracy and (c)Time as a boundary, and (2) Support : further categorised into (a) Employer and (b) Manager. Solutions: These included: training in technical and interactional aspects of on-line communication and a responsibility to better understand employer and professional body SoMe policies. Conclusion The study participants appeared willing and motivated to engage in SoMe. However, in keeping with the literature from other disciplines, a number of challenges need to be overcome for its use to be adopted more widely by breast screening professionals.
Author(s): Scragg, B.; Shaikh, S.; Robinson, L.; Mercer, C.
Source: Radiography; Aug 2017; vol. 23 (no. 3); p. 235-241
Publication Date: Aug 2017
Publication Type(s): Academic Journal
Abstract:Introduction Despite National Health Service (NHS) information strategy promoting the use of Social Media (SoMe) to encourage greater engagement between service users and providers, a team investigating online SoMe interaction between breast screening practitioners and clients found that practitioners alleged discouragement from employers' policies. This study aimed to investigate whether this barrier was genuine, and illuminate whether local policy differed from national strategy. Method The study used a qualitative grounded theory approach to generate a theory. Nine policies from the North West of England were analysed. A framework was derived from the data, and an analysis of policy tone followed by a detailed coding of policy content was undertaken. Comparative analysis continued by reviewing the literature, and a condensed framework revealed five broad categories that policies addressed. Results The analysis revealed the policies varied in content, but not in tone, which was mostly discouraging. Coding the content revealed that the most frequently addressed point was that of protecting the employers' reputation, and after further analysis, the resultant condensed framework showed that policies were imbalanced and heavily skewed towards Security, Conduct & Behaviour and Reputation. Conclusion Practitioners within breast screening services are discouraged by overly prohibitive and prescriptive SoMe policies; with these varying tremendously in comprehensiveness, but with a narrow focus on security and employers reputation; in contrast with national strategy. Recommendations are that policy revision is undertaken with consultation by more than one stakeholder, and SoMe training is offered for all members of NHS staff.
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