Publications
Results
- Showing results for:
- Reset all filters
Search results
-
Conference paperGupta A, Maslen C, Vindlacheruvu M, et al., 2022,
LB VPP - 840: Digital Health Interventions for Osteoporosis and Post-Fragility Fracture Care
, Annual Meeting of the American-Society-for-Bone-and-Mineral-Research (ASBMR), Publisher: Wiley, Pages: 184-184, ISSN: 0884-0431 -
Journal articleNewington L, Alexander CM, Wells M, 2022,
What is a clinical academic? Qualitative interviews with healthcare managers, research-active nurses and other research-active healthcare professionals outside medicine
, Journal of Clinical Nursing, Vol: 31, Pages: 378-389, ISSN: 0962-1067AIM AND OBJECTIVES: To explore the concept of 'clinical academic' from the perspectives of healthcare managers and research-active healthcare professionals outside medicine. BACKGROUND: Clinical academics are understood to be healthcare professionals who combine clinical and research responsibilities within their role. However, there is no agreed definition for this term either within or across nursing, midwifery and the other healthcare professions outside medicine. DESIGN: Qualitative service evaluation, reported using the COREQ checklist. METHODS: Semi-structured qualitative interviews were conducted with a purposive sample of eight healthcare managers and 12 research-active clinicians within a UK hospital group. Interviews were audio recorded, transcribed verbatim, and analysed using the Framework method. RESULTS: Clinical academics were described in four themes. Two themes explored the components of the role and the contribution of these individuals to their profession: combining clinical practice, research and education; and pushing boundaries. The third theme identified the clinical academic label as: a title that doesn't fit. The final theme examined a characteristic mindset of research-active clinicians. There were no clear differences in the perceptions of managers and research-active clinicians. CONCLUSIONS: Clinical academics were perceived as valuable members of their team and were able to push the boundaries to move their profession forward. Some research-active clinicians did not identify with the term 'clinical academic' and for some managers and research-active clinicians, the term was viewed as jargonistic. A clear and accepted definition would aid development of clinical academic career pathways and identities. It would also assist in evaluating the impact of these roles. RELEVANCE TO PRACTICE: As clinical academics roles and opportunities are being developed across the professions outside medicine, it is important to have a shared common understa
-
Journal articleLogishetty K, Edwards T, Ponniah HS, et al., 2022,
How to prioritise patients and redesign care to safely resume planned surgery during the COVID-19 pandemic. A clinical validation study
, Bone & Joint Open, Vol: 2, Pages: 134-140, ISSN: 2633-1462Background and Purpose: Restarting planned surgery during the COVID-19 pandemic is a clinical and societal priority, but it is unknown whether it can be done safely and include high-risk or complex cases. We developed a Surgical Prioritization and Allocation Guide (SPAG). Here, we validate its effectiveness and safety in COVID-free sites. Patients and Methods: A multidisciplinary Surgical Prioritisation Committee developed the SPAG, incorporating procedural urgency, shared decision making, patient safety and biopsychosocial factors; and applied it to 1142 adult patients awaiting orthopaedic surgery. Patients were stratified into four priority groups and underwent surgery at three COVID-free sites – including one with access to a High Dependency Unit (HDU) or Intensive Care Unit (ICU) and specialist resources. Safety was assessed by the number of patients requiring inpatient postoperative HDU/ICU admission, contracting COVID-19 within 14 days postoperatively, and mortality within 30 days postoperatively. Results: 1142 patients were included, 47 declined surgery. 110 were deemed high-risk or requiring specialist resources. In the 10-week study period, 28 high-risk patients underwent surgery, during which 68% of Priority 2 (P2, surgery within 1 month) patients underwent surgery, and 15% of P3 (<3 months) and 16% of P4 (>3 months) groups. Of the 1032 low-risk patients, 322 patients underwent surgery. Twenty-one P3 and P4 patients were expedited to ‘Urgent’ based on biopsychosocial factors identified by the SPAG. During the study period, 91% of the Urgent group, 52% of P2, 36% of P3, and 26% of P4 underwent surgery. No patients died or were admitted to HDU/ICU, or contracted COVID-19. Interpretation: Our widely generalisable model enabled the restart of planned surgery during the CO
-
Journal articleTurner S, Belsi A, McGregor AH, 2022,
Issues faced by people with amputation(s) during lower limb prosthetic rehabilitation: a thematic analysis
, Prosthetics and Orthotics International, Vol: 46, Pages: 61-67, ISSN: 0309-3646Background: Successful rehabilitation is essential to improve the physical and mental outcomes of people with lower limb amputation(s). Individuals have different goals and expectations of successful rehabilitation and experience issues that affect their quality of life.Objectives: To determine factors affecting lower limb prosthetic rehabilitation from people with amputation(s), important for studies focusing on prosthetic and socket design and fitting because they provide context of need and user issues.Study design: Thematic analysis of semistructured interviews.Methods: Ten people with amputation(s) were self-selected from a survey identifying factors affecting lower limb prosthetic rehabilitation. The telephone interviews were semistructured exploring the biggest impactors on and frustrations with rehabilitation and the socket. A thematic analysis was completed by following the undermentioned steps: familiarization, coding, generating themes, reviewing themes, defining and naming themes, and reporting.Results: Five distinct but interrelated themes were identified: External to Prosthesis, Body Impactors, Consequences of Ill-Fit, Prosthesis Irritants, and Work and Social Impact. Those living with amputation(s) mentioned prosthetic-related issues affecting their work and social life, including difficulties wearing their prosthesis all day, the socket's rigidity, and the ability to participate in hobbies.Conclusions: The study provides new insights into the issues experienced during prosthetic rehabilitation, highlighting impacts beyond just physical health consequences. The study provides an evidence base for areas of the rehabilitation journey which could be improved to improve the quality of life of people with amputation(s)
-
Journal articleMohammad HR, Liddle AD, Judge A, et al., 2022,
A Matched Comparison of Long-Term Outcomes of Total and Unicompartmental Knee Replacements in Different Ages Based on National Databases: Analysis of Data From the National Joint Registry for England, Wales, Northern Ireland, and the Isle of Man
, JOURNAL OF ARTHROPLASTY, Vol: 37, Pages: 243-251, ISSN: 0883-5403- Cite
- Citations: 11
-
Journal articleTurner S, Belsi A, McGregor AH, 2022,
Issues faced by prosthetists and physiotherapists during lower-limb prosthetic rehabilitation: a thematic analysis
, Frontiers in Rehabilitation Sciences, Vol: 2, ISSN: 2673-6861Successful prosthetic rehabilitation is essential to improve the physical and mental outcomes of people with lower-limb amputation. Evaluation of prosthetic services from a prosthesis user perspective have been published and commissioned by the national bodies, however, the perspectives of clinicians working with service users during rehabilitation have not to date been sought. We sought to determine factors impacting lower-limb prosthetic rehabilitation from a clinician’s perspective to inform studies focusing on prosthetic and socket design and fitting. Six clinician (2 prosthetists, 4 physiotherapists) interviewees were self-selected from a survey exploring issues and frustrations during lower-limb prosthetic rehabilitation. Semi-structured interviews explored the impactors on and frustrations with rehabilitation and the prosthetic socket. A thematic analysis was subsequently conducted to identify themes in the responses. Five themes were identified: Service Disparity, Body Impactors, Consequences of Ill-Fit, Prosthesis Irritants, and Limitations of Practice. Each theme, though distinct, relates to the others either as a cause or consequence and should be viewed as such. Addressing the themes will have benefits beyond the issues addressed but also expand into the other themes. This study provides an insight into the clinician perspectives on lower-limb prosthetic rehabilitation, which has not been formally documented to date.
-
Journal articleChew E, Sharma A, Gupte C, 2022,
Triple dislocation around the knee joint: a case report
, JOURNAL OF MEDICAL CASE REPORTS, Vol: 16 -
Journal articleGoss C, Culley FJ, Parthasarathy P, et al., 2022,
A paradigm shift in assessment of scientific skills in undergraduate medical education
, Advances in Medical Education and Practice, Vol: 13, Pages: 123-127, ISSN: 1179-7258The General Medical Council’s publication ‘Outcomes for Graduates’ places emphasis on doctors being able to integrate biomedical science, research and scholarship with clinical practice. In response, a new paradigm of assessment was introduced for the intercalated Bachelor of Science program at Imperial College School of Medicine in 2019. This innovative approach involves authentic “active learning” assessments analogous to tasks encountered in a research environment and intends to test a wider range of applied scientific skills than traditional examinations. Written assessments include a “Letter to the Editor”, scientific abstract, and production of a lay summary. A clinical case study titled “Science in Context” presents a real or virtual patient, with evaluation of current and emerging evidence within that field. Another assessment emulates the academic publishing process: groups submit a literature review and engage in reciprocal peer review of another group’s work. A rebuttal letter accompanies the final submission, detailing how feedback was addressed. Scientific presentation skills are developed through tasks including a research proposal pitch, discussion of therapies or diagnostics, or review of a paper. A data management assignment develops skills in hypothesis generation, performing analysis, and drawing conclusions. Finally, students conduct an original research project which is assessed via a written report in the format of a research paper and an oral presentation involving critical analysis of their project. We aspire to train clinicians who apply scientific principles to critique the evidence base of medical practice and possess the skillset to conduct high-quality research underpinned by the principles of best clinical and academic practice. Assessment drives learning, and active learning has been demonstrated to enhance academic performance and reduce attainment gaps in science education.
-
Conference paperPaszkiewicz FP, Wilson S, Oddsson M, et al., 2022,
Microphone Mechanomyography Sensors for Movement Analysis and Identification
, 7th IEEE International Conference on Advanced Robotics and Mechatronics, Publisher: IEEE, Pages: 118-125- Author Web Link
- Cite
- Citations: 2
-
Journal articleNewington L, Alexander C, Wells M, 2021,
Would you like to be contacted about future research?
, BMC Research Notes, Vol: 14, ISSN: 1756-0500Many research participants are willing to be contacted about future research opportunities, however this question is not always asked. Furthermore, if participants do consent for contact about future research, this information is not always accessible to other research teams. We discuss our experience of recruiting individuals who have previously taken part in healthcare research and suggest potential strategies to support this process and enable greater research participation.
-
Journal articleTukanova K, Chidambaram S, Guidozzi N, et al., 2021,
Physiotherapy regimens in esophagectomy and gastrectomy: a systematic review and meta-analysis
, Annals of Surgical Oncology, Vol: 29, ISSN: 1068-9265BackgroundEsophageal and gastric cancer surgery are associated with considerable morbidity, specifically postoperative pulmonary complications (PPCs), potentially accentuated by underlying challenges with malnutrition and cachexia affecting respiratory muscle mass. Physiotherapy regimens aim to increase the respiratory muscle strength and may prevent postoperative morbidity.ObjectiveThe aim of this study was to assess the impact of physiotherapy regimens in patients treated with esophagectomy or gastrectomy.MethodsAn electronic database search was performed in the MEDLINE, EMBASE, CENTRAL, CINAHL and Pedro databases. A meta-analysis was performed to assess the impact of physiotherapy on the functional capacity, incidence of PPCs and postoperative morbidity, in-hospital mortality rate, length of hospital stay (LOS) and health-related quality of life (HRQoL).ResultsSeven randomized controlled trials (RCTs) and seven cohort studies assessing prehabilitation totaling 960 patients, and five RCTs and five cohort studies assessing peri- or postoperative physiotherapy with 703 total patients, were included. Prehabilitation resulted in a lower incidence of postoperative pneumonia and morbidity (Clavien–Dindo score ≥ II). No difference was observed in functional exercise capacity and in-hospital mortality following prehabilitation. Meanwhile, peri- or postoperative rehabilitation resulted in a lower incidence of pneumonia, shorter LOS, and better HRQoL scores for dyspnea and physical functioning, while no differences were found for the QoL summary score, global health status, fatigue, and pain scores.ConclusionThis meta-analysis suggests that implementing an exercise intervention may be beneficial in both the preoperative and peri- or postoperative periods. Further investigation is needed to understand the mechanism through which exercise interventions improve clinical outcomes and which patient subgroup will gain the maximal benefit.
-
Journal articleMusbahi O, Syed L, Le Feuvre P, et al., 2021,
Public patient views of artificial intelligence in healthcare: A nominal group technique study
, Digital Health, Vol: 7, Pages: 1-11, ISSN: 2055-2076Objectives: The beliefs of laypeople and medical professionals often diverge with regards to disease, and technology has had a positive impact on how research is conducted. Surprisingly, given the expanding worldwide funding and research into Artificial Intelligence (AI) applications in healthcare, there is a paucity of research exploring the public patient perspective on this technology. Our study sets out to address this knowledge gap, by applying the Nominal Group Technique (NGT) to explore patient public views on AI. Methods: A Nominal Group Technique (NGT) was used involving four study groups with seven participants in each group. This started with a silent generation of ideas regarding the benefits and concerns of AI in Healthcare. This was followed by a group discussion. Then a round-robin process was conducted until no new ideas were generated. Participants then ranked their top five benefits and top five concerns regarding the use of AI in healthcare. A final group consensus was reached. Results: Twenty-Eight participants were recruited with the mean age of 47 years. The top five benefits were: Faster health services, Greater accuracy in management, AI systems available 24/7, reducing workforce burden, and equality in healthcare decision making. The top five concerns were: Data cybersecurity, bias and quality of AI data, less human interaction, algorithm errors and responsibility, and limitation in technology. Conclusion: This is the first formal qualitative study exploring patient public views on the use of AI in healthcare, and highlights that there is a clear understanding of the potential benefits delivered by this technology. Greater patient public group involvement, and a strong regulatory framework is recommended.
-
Journal articleTukanova K, Chidambaram S, Guidozzi N, et al., 2021,
ASO author reflections: the role of physiotherapy regimens in esophagectomy and gastrectomy for cancer
, Annals of Surgical Oncology, Vol: 29, Pages: 3168-3169, ISSN: 1068-9265PASTDespite advancements in surgical management, esophageal and gastric cancer surgery is still associated with a significant morbidity. Traditionally, esophagectomy and gastrectomy via an open surgical approach has been the treatment of choice for esophageal and gastric cancer, respectively.1,2 Enhanced recovery after surgery (ERAS) protocols commonly include physiotherapy regimens or early mobilization intervention. These programs are well-established in colorectal cancer surgery and have shown to reduce postoperative complication rates and shortened the length of hospital stay (LOS).3Only a small number of studies have assessed the role of respiratory physiotherapy in gastrointestinal cancer surgery, while this patient group commonly present with pre-existing respiratory disease and is particularly at risk for malnutrition and loss of muscle mass.4 Although there is growing evidence of the benefits of physiotherapy implementation in decreasing the risk for postoperative morbidity, there is currently insufficient strong evidence for routine implementation of standardized respiratory physiotherapy in esophageal and gastric cancer surgery.PRESENTThis is the first meta-analysis assessing the effect of prehabilitation and peri- or postoperative physiotherapy regimens on postoperative mortality and morbidity in esophageal and gastric cancer surgery.5 A lower incidence of pneumonia was observed following both prehabilitation and peri- or postoperative rehabilitation. Furthermore, a lower incidence of postoperative morbidity was seen in patients undergoing prehabilitation, while peri- or postoperative rehabilitation resulted in a shorter LOS and better health-related quality-of-life scores for dyspnea and physical functioning. These results suggest that implementation of a physiotherapy regimen in both the pre- and peri- or postoperative setting may be beneficial. This meta-analysis is however limited by the lack of a standardized physiotherapy protocol for patients unde
-
Journal articleDandridge O, Garner A, Jeffers JRT, et al., 2021,
Validity of repeated-measures analyses of in vitro arthroplasty kinematics and kinetics
, JOURNAL OF BIOMECHANICS, Vol: 129, ISSN: 0021-9290- Cite
- Citations: 5
-
Journal articleBates A, McGregor A, Alexander C, 2021,
Prolonged standing behaviour in people with Joint Hypermobility Syndrome
, BMC Musculoskeletal Disorders, Vol: 22, ISSN: 1471-2474Background: Joint Hypermobility Syndrome (JHS) is a rare Heritable Disorder of Connective tissue characterised by generalised joint laxity and chronic widespread pain. Joint Hypermobility Syndrome has a large impact on patients’ day to day activities, and many complain of symptoms when standing for prolonged periods. This study investigates whether people with JHS exhibit the same behaviours to deal with the effects of prolonged standing as people with equal hypermobility and no pain, and people with normal flexibility and no pain.Methods: 23 people with JHS, 22 people with Generalised Joint Hypermobility (GJH), and 22 people with normal flexibility (NF) were asked to stand for a maximum of 15 minutes across two force-plates. Fidgets were counted and quantified using a cumulative sum algorithm and sway parameters of the quiet standing periods between fidgets were calculated. Results: Average standing time for participants with JHS was 7.35 minutes and none stood for the full 15 minutes. All participants with GJH and NF completed 15 minutes of standing. There were no differences in fidgeting behaviour between any groups. There was a difference in anteroposterior sway (p=.029) during the quiet standing periods.Conclusion: There is no evidence to suggest people with JHS exhibit different fidgeting behaviour. Increased anteroposterior-sway may suggest a muscle weakness and strengthening muscles around the ankle may reduce postural sway and potentially improve the ability to stand for prolonged periods.
-
Journal articleArnold M, Zhao S, Doyle R, et al., 2021,
Power tool use in orthopaedic surgery: iatrogenic injury, its detection and technological advances
, JBJS Open Access, Vol: 6, Pages: 1-16, ISSN: 2472-7245Background: Power tools are an integral part to orthopaedic surgery but have the capacity to cause iatrogenic injury. This systematic review aimed to investigate the prevalence of iatrogenic injury due to power tools in orthopaedic surgery and discuss the current methods 9that can be used to reduce this. Methods: A systematic review of all English language articles using a keyword search was undertaken in Medline, Embase, PubMed and Scopus databases. Exclusion criteria included injuries related to cast saw, temperature induced damage and complications not clearly related to power tool use. Results: 3694 abstracts were retrieved, and 88studies were included in the final analysis. Only a few studies and individual case reports directly looked at prevalence of injury due to power tools. This included 2 studies looking at frequency of vascular injury during femoral fracture fixation (0.49% and 0.2%),2 studies investigating frequency of vertebral artery injury during spinal surgery (0.5% and 0.08%)and 3 studies investigating vascular injury during total joint arthroplasty (124 vascular injuries involving 138 blood vessels,0.13% and 0.1% incidence)in addition to 1 questionnaire sent electronically to surgeons. There are multiple methods to prevent damage during the use of power tools. These include robotics, Revised Manuscript (Maximum 3000 Words)simulation, specific drill settings and real-time feedback techniques such as spectroscopy and electromyography. Conclusion: Power tools have the potential to cause iatrogenic injury to surrounding structures during orthopaedic surgery. Fortunately, the published literature suggests the frequency of iatrogenic injury using orthopaedic power tools is low. There are multiple technologies available to reduce damage using power tools. In high-risk operations the use of advanced technologies to reduce the chance of iatrogenic injury should be considered. Clinical Relevance: Power tools used during orthopaedic surgery have the potentia
-
Journal articleUrbanczyk CA, Bonfiglio A, McGregor AH, et al., 2021,
Comparing optical and electromagnetic tracking systems to facilitate compatibility in sports kinematics data.
, International Biomechanics, Vol: 8, Pages: 75-84, ISSN: 2333-5432Electromagnetic (EM) tracking has been used to quantify biomechanical parameters of the lower limb and lumbar spine during ergometer rowing to improve performance and reduce injury. Optical motion capture (OMC) is potentially better suited to measure comprehensive whole-body dynamics in rowing. This study compared accuracy and precision of EM and OMC displacements by simultaneously recording kinematics during rowing trials at low, middle, and high rates on an instrumented ergometer (n=12). Trajectories calculated from OMC and EM sensors attached to the pelvis, lumbar spine, and right leg were highly correlated, but EM tracking lagged behind ergometer and OMC tracking by approximately 6%, yielding large RMS errors. When this phase-lag was corrected by least squares minimization, agreement between systems improved. Both systems demonstrated an ability to adequately track large dynamic compound movements in the sagittal plane but struggled at times to precisely track small displacements and narrow angular ranges in medial/lateral and superior/inferior directions. An OMC based tracking methodology can obtain equivalence with a previously validated EM system, for spine and lower limb metrics. Improvements in speed and consistency of data acquisition with OMC are beneficial for dynamic motion studies. Compatibility ensures continuity by maintaining the ability to compare to prior work.
-
Journal articleKennedy DL, Vollert J, Ridout D, et al., 2021,
The responsiveness of quantitative sensory testing-derived sensory phenotype to disease-modifying intervention in patients with entrapment neuropathy: a longitudinal study
, Pain, Vol: 162, Pages: 2881-2893, ISSN: 0304-3959ABSTRACT: The German Research Network on Neuropathic Pain (DFNS) quantitative sensory testing (QST) method for sensory phenotyping is used to stratify patients by mechanism associated sensory phenotype, theorised to be predictive of intervention efficacy. We hypothesised that change in pain and sensory dysfunction would relate to change in sensory phenotype. We investigated the responsiveness of sensory phenotype to surgery in patients with an entrapment neuropathy.With ethical approval and consent, this observational study recruited patients with neurophysiologically confirmed carpal tunnel syndrome. Symptom and pain severity parameters and DFNS QST were evaluated prior to and after carpal tunnel surgery. Surgical outcome was evaluated by patient-rated change. Symptom severity score of the Boston Carpal Tunnel Questionnaire and associated pain and paraesthesia subgroups were comparators for clinically relevant change.QST results (n=76) were compared to healthy controls (n=54). At 6 months post-surgery 92% participants reported a good surgical outcome and large decrease in pain and symptom severity (p<.001). Change in QST parameters occurred for thermal detection, thermal pain and mechanical detection thresholds with a moderate to large effect size. Change in mechanical pain measures were not statistically significant. Change occurred in sensory phenotype post-surgery (p<.001); sensory phenotype was associated with symptom subgroup (p=.03) and patient-rated surgical outcome (p =.02).QST derived sensory phenotype is sensitive to clinically important change. In an entrapment neuropathy model, sensory phenotype was associated with patient-reported symptoms and demonstrated statistically significant, clinically relevant change after disease modifying intervention. Sensory phenotype was independent of disease severity and may reflect underlying neuropathophysiology.
-
Journal articleFederer SJ, Jones GG, 2021,
Artificial intelligence in orthopaedics: A scoping review
, PLOS ONE, Vol: 16, ISSN: 1932-6203- Author Web Link
- Cite
- Citations: 40
-
Journal articleTurner S, Jain S, Patel A, et al., 2021,
Visual biofeedback tool for quantitative pressure monitoring in lower-limb prosthetic sockets
, Prosthesis, Vol: 3, Pages: 394-405, ISSN: 2673-1592Obtaining a good socket fit is an iterative process dependent on the skill and experience of the prosthetist creating it and requires individualisation based on the size and shape. There is no standard measurement system used to aid prosthetic socket creation despite the severe impacts on physical health and quality of life if one is ill fitting. Pressure sensors embedded in a prosthetic socket were used to collect data at the socket–residuum interface. To choose an interpolation method, the sensor array was simplified to a 2D grid with a border for extrapolation and tested using previously collected walking test pressure data. Four multivariable interpolation methods were evaluated to create a colour map of the pressure data. Radial basis function interpolation was chosen, as it produced a clear image with a graduated interpolation between data points, and was used to create a colour map across the surface of a 3D prosthetic socket model. For the model to be accessible to clinical audiences, a desktop application was created using PyQt to view the model. The application allowed for connection to the sensors via Bluetooth, with the pressure data updating on the 3D model in real time. Clinician feedback on the application showed the potential for a clinical product; however, further development informed by feedback from rehabilitation clinicians and prosthesis users is required.
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.