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3. Away from Home: A Qualitative Exploration of Health Experiences of Nigerian Students in a U.K. University

Author

Alloh, Folashade T., Tait, Desiree, and Taylor, Clare

Abstract

This study explored the factors that contribute to the health experience of Nigerian students in the United Kingdom. Challenges faced by international students include dietary issues, isolation, stress, depression, and others. Nine semi-structured interviews were conducted combination of purposive sampling and snowball sampling techniques were used to recruit participants for the study. Interviews were audio recorded, transcribed and analysed using thematic content analysis and Interpretative phenomenological analysis (IPA) to interpret themes. Two major themes from our findings were discussed under broad headings: transitional changes and financial capability. These findings have practical implications for Nigerian students' wellbeing in a U.K. university. Cultural dimension is needed to reduce culture shock experience among international students during sojourning.

Published
2018

4. Risk of interpersonal violence during and after pregnancy among people with schizophrenia: a population-based cohort study

Author

Leslie, Kelly, Barker, Lucy C., Brown, Hilary K., Chen, Simon, Dennis, Cindy-Lee, Ray, Joel G., Saunders, Natasha, Taylor, Clare, and Vigod, Simone

Subjects
Schizophrenia -- Statistics, Pregnant women -- Health aspects, Health
Abstract

Background: Schizophrenia is associated with increased risk of experiencing interpersonal violence. Little is known about risk specifically around the time of pregnancy. Methods: This population-based cohort study included all individuals (aged 15-49 yr) listed as female on their health cards who had a singleton birth in Ontario, Canada, between 2004 and 2018. We compared those with and without schizophrenia on their risk of an emergency department (ED) visit for interpersonal violence in pregnancy or within 1 year postpartum. We adjusted relative risks (RRs) for demographics, prepregnancy history of substance use disorder and history of interpersonal violence. In a subcohort analysis, we used linked clinical registry data to evaluate interpersonal violence screening and self-reported interpersonal violence during pregnancy. Results: We included 1 802 645 pregnant people, 4470 of whom had a diagnosis of schizophrenia. Overall, 137 (3.1%) of those with schizophrenia had a perinatal ED visit for interpersonal violence, compared with 7598 (0.4%) of those without schizophrenia, for an RR of 6.88 (95% confidence interval [CI] 5.66-8.37) and an adjusted RR of 3.44 (95% CI 2.86-4.15). Results were similar when calculated separately for the pregnancy (adjusted RR 3.47, 95% CI 2.68-4.51) period and the first year postpartum (adjusted RR 3.45, 95% CI 2.75-4.33). Pregnant people with schizophrenia were equally likely to be screened for interpersonal violence (74.3% v. 73.8%; adjusted RR 0.99, 95% CI 0.95-1.04), but more likely to self-report it (10.2% v. 2.4%; adjusted RR 3.38, 95% CI 2.61-4.38), compared with those without schizophrenia. Among patients who did not self-report interpersonal violence, schizophrenia was associated with an increased risk for a perinatal ED visit for interpersonal violence (4.0% v. 0.4%; adjusted RR 6.28, 95% CI 3.94-10.00). Interpretation: Pregnancy and postpartum are periods of higher risk for interpersonal violence among people with schizophrenia compared with those without schizophrenia. Pregnancy is a key period for implementing violence prevention strategies in this population., Interpersonal violence is defined as the intentional use of force or power against others, including physical, sexual and psychological abuse perpetrated by strangers, acquaintances, family members or intimate partners. (1-5) [...]

Published
2023
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7. Predicting and preventing heart failure

Author

Taylor, Clare J, primary, Beezer, Janine, additional, Fuat, Ahmet, additional, Halliday, Brian P, additional, Ludman, Andrew J, additional, Pellicori, Pierpaolo, additional, Savage, Henry Oluwasefunmi, additional, and Cleland, John G F, additional

Published
2024
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8. Diagnosis and initial management of heart failure

Author

Pellicori, Pierpaolo, primary, Ahmed, Fozia Z, additional, Beezer, Janine, additional, Fuat, Ahmet, additional, Halliday, Brian P, additional, Ludman, Andrew J, additional, Savage, Henry Oluwasefunmi, additional, Taylor, Clare, additional, and Cleland, John GF, additional

Published
2024
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9. Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial

Author

Emsley, Richard, Peat, George, Snow, Martyn, Campbell, Marion, Howell, Tessa, Johnson, Hilary, McDonnell, Stephen, Pinkney, Thomas, Williams, Mark, Campbell, Helen, Davies, Jackie, Li, Jiyang, Bagg, Christina, Haywood, Laura, Nicholson, Anne, Riches, Joanne, Symons, Sean, Vertue, Mark, Al Mouazzen, Louay, Bray, Rachel, Clark, Damian, Coulthard, James, Holland, Tim, Howells, Nick, Jones, Andrew, Kapur, Richard, Kiszely, Alastair, Krishnan, Harry, MacDonald-Taylor, Karen, Manara, Jon, Murray, James, Negrut, Corina, Pai, Vishai, Porteous, Andrew, Putnis, Sven, Robinson, James, Rupasinghe, Shav, Selvaratnam, Veenesh, Smith, James, Smith, Nick, Stevens, Jarrad, Taylor, Clare, Theodorides, Anthony, Vetharajan, Niraj, Vint, Helen, Young, Lucy, Bullock, Susan, Cook, Rebecca, Dodds, Alexander, Freeman-Hicks, Amanda, Hillout, Paula, Cornell, Thomas, Coutts, Abbie, Dean, Suzy, Devooght-Johnson, Nicki, Ferrell, Emma, Fletcher, Eve, Hall, Chrissie, Kent, Benjamin, Kessly, Sandra, Kincaid, Robin, Lazizi, Mohamed, Mostafa, Ahmed, Nisbett, Toby, Powell, Tim, Riddlestone, Peter, Roberton, Andrew, Summers, Jessica, Whitbread, Lucy, Wroath, Belinda, Fenlon, Emma, Hall, Andrew, Jeffrey, Helen, Thonse, Raghuram, Dunne, Debra, Metcalfe, Andy, McGowan, Kerri, Middleton, Simon, Shah, Feisal, Spalding, Tim, Marie Suddens, Charlie, Sweed, Tamar, Teuke, Joanna, Thompson, Peter, Wright, David, Amero, Justine, Brown, Emma, Chissell, Hugh, Croucher, Andrea, Dickinson, Gareth, Hawkes-Blackburn, Catherine, Peacocke, Alice, Smith, Graham, Snipe, Carol, Dearnley, Kim, Mayahi, Reza, Andrews, Barry, Barcelona, Massimo, Giles, Hazel, Gokturk, Abdulkerim, Harnett, Paul, Jeeves, Katie, Kadunyi, Joyce, Mendoza, Sheena, Reichert, Ines, Santamaria, Marta, Virdee, Harshinder, Anand, Sanjeev, Aslam-Pervez, Nayef, Draycott, Stephen, Howarth, Faye, Jina, Irfan, Maher, Niall, Ross, Denise, Worstenholme, Lindsey, Baig, Abdul, Bhaskaran, Arun, Banks, Daniel, Brear, Tracy, Christie, Carla, Cowen, Laura, Davis, Jack, Dixey, Ross, Esler, Colin, Essop-Adam, Amirah, Haines, Christina, Houchen-Wolloff, Linzy, Varachia, Husein, Wood, Richard, Gray, Glaxy, Nichols, Jessica, Panes, Alice, Partridge, Susan, Rogerson, Lawrie, Sharma, Pankaj, Triggs, David, Venables, Ian, Wilcock, Danielle, Buckley, Sarah, Darian, Thelma, Denis, Elizabeth, Duncan, Jo, Hirst, Charlotte, Newman, James, Richardson, Fern, Smith, Jon, Adcode, Megan, Cottingham, Megan, Foster, Eliza, Kelly, Andrew, McKay, Niamh, Rewbury, Jane, Whitcher, Alison, Williams, James, Zebracki, Esther, Davies, Llinos, Jayachandran, Jayadeep, Tardivel, Alison, Whitehead, Victoria, Batting, Martha, Bond, Amy, Deakin, Marc, Dodd, Christopher, Hudak, Alison, Hynes, Samantha, Jones, Luke, Lang, Gail, McKenna, David, Morris, Susan, Scott-Dempster, Clare, Sykes, Adam, Vichos, Iason, Wood, Simon, Clifton, Rupert, Diaz, Stephanie, Hendy, Craig, Modi, Nishil, O'Mahony, Brendan, O'Sullivan, Susan, Parker, Nicola, Pecheva, Mira, Rumonovic, Rowan, McLoughlin, Emma, Rushbrook, Jeremy, Thornhill, Anna, Parkinson, Valerie, Sales, Rafael, Van De Snepscheut-Jones, Katja, Wilcock, David, Wright, Daniel, Allison, Joanna, Baker, Simon, Beesley, Kate, Ferrari, Gill, Lankester, Benedict, Lewis, Alison, Lyons, Joanne, O'Callaghan, Jamie, Sutcliffe, Sarah, Wood, Dianne, Bannister, Emily, Brown, Chloe, Burden, Debbie, Campbell, Terence, Craig, Emma, Easow, Rashmi, Foxton, Julie, Hazlerigg, Alexandra, Jayabev, Chethan, Murdoch, Rosie, Parsons, Georgie, Brown, Harry, Carvelli, Paula, Montaser, Rugaia, Pepper, Ali, Sivarajan, Sinduja, Templeton-Ward, Oliver, Wilson, Eva, Cronin, Julie, Diment, Sarah, King, Victoria, Shean, Katharine, Vachtsevanos, Leonidas, Wilcocks, Katharine, Wilson, Ben, McNestry, Paul, Ollerenshaw, Joanna, Stoddard, James, Sutton, Paul, Anand, Sanjay, Bell, Judith, Chikate, Albert, Daniel, Diane, Davies, Timothy, Finnigan, Tom, Frasquet-Garcia, Antonio, Hopkins, Susan, Kerrison, Sharon, McGowan, Angela, Sands Johnson, David, Smith, Lara, Turner, Philip, Wilkinson, Helen, Allsop, Lynne, Anthony, Deborah, Boulton, Rebecca, Brown, Sarah, Desai, Vikram, Gill, Mandy, Heeley, Cheryl, Kulkarni, Sushrut, Lovegrove, Wayne, Nash, Dominic, Ann Sewell, Terri, Shelton, Sarah, Slack, Katie, Cartwright, James, Connor, Lynda, Davies, Andrew, Davies, Caroline, Gainard, Glyn, Graham-Woollard, Dave, Murphy, Carl, Quinn, Leanne, Thomas, Caradog, Travers, Jenny, Williams, Marie, Bell, Amanda, Deo, Sunny, Francis, Katharine, Jackson, Tracy, McCafferty, Laura, Navadgi, Basalingappa, Plank, Karan, Satish, Venkat, Thelwall, Claire, Knight, Rachel, Patel, Rahul, Paton, Bruce, Acharya, Ashutosh, Aland, Utuman, Areirobulos, Miltiades, de Feyter, Pascal, Ditchfield, Lisa, Iqbaz, Hafiz, Massey, Daniel, Stables, Gareth, Appleby, Sarah, Brown, Michael, Cable, Sarah, Damen, Alexander, Da Rocha, Joana, Foster, Louise, Hamilton, Elizabeth, Hatton, Catriona, Honeywell, Cassie, Kulkarni, Kunal, Markham, Lucy, Mohammed, Haadiya, O'Grady, John, Joshi, Yogesh, Mclintock, Heather, Morgan, Tania, Stockport, Jane, Agrawal, Pranshu, Armstrong, Jo, Briggs, Shannon, Coupe, Ben, Evans, Anne, Gilbert, Rob, Latham, Sandra, Mohammed, Aslam, Beard, David J, Davies, Loretta, Cook, Jonathan A, Stokes, Jamie, Leal, Jose, Fletcher, Heidi, Abram, Simon, Chegwin, Katie, Greshon, Akiko, Jackson, William, Bottomley, Nicholas, Dodd, Matt, Bourke, Henry, Shirkey, Beverly A, Paez, Arsenio, Lamb, Sarah E, Barker, Karen, Phillips, Michael, Brown, Mark, Lythe, Vanessa, Mirza, Burhan, Carr, Andrew, Monk, Paul, Morgado Areia, Carlos, O'Leary, Sean, Haddad, Fares, Wilson, Chris, and Price, Andrew

Published
2022
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10. Maternal Disability and Early Child Preventive Care.

Author

Brown, Hilary K., Taylor, Clare, Camden, Andi, Lunsky, Yona, Vigod, Simone, Santiago, Maria, Fung, Kinwah, Cohen, Eyal, Guttmann, Astrid, Telner, Deanna, Ray, Joel, Zwicker, Jennifer, and Saunders, Natasha

Subjects
*CHILDREN'S health, *IMMUNIZATION, *POISSON distribution, *MENTAL health, *MOTHERS, *DESCRIPTIVE statistics, *SENSORY disorders, *RELATIVE medical risk, *DEVELOPMENTAL disabilities, *INTELLECTUAL disabilities, *MEDICAL appointments, *MEDICAL screening, *SOCIODEMOGRAPHIC factors, *CONFIDENCE intervals, *PREVENTIVE health services
Abstract

OBJECTIVES: Preventive health care for children comprises routine well-child visits and immunizations. Women with physical, sensory, or intellectual or developmental disabilities tend to experience more barriers to preventive health care; yet it is unknown whether such barriers are observed among their young children. METHODS: This population-based study in Ontario, Canada included children born between 2012 and 2019 whose mothers had a physical (n = 74 084), sensory (n = 26 532), or intellectual or developmental (n = 1391) disability, multiple disabilities (n = 5774), or no disability (n = 723 442). Primary outcomes were receipt of the recommended number of well-child visits and routine immunizations in the first 2 years. Secondary outcomes included receipt of the enhanced 18-month developmental assessment and any developmental screen. Relative risks (aRR) were generated using modified Poisson regression and adjusted for maternal sociodemographics and mental health and child sex. RESULTS: Compared with children of mothers without disabilities, those whose mothers had intellectual or developmental disabilities were less likely to receive the recommended number of well-child visits (56.3% vs 63.2%; aRR 0.92, 95% confidence interval [CI] 0.88-0.97), routine immunizations (43.8% vs 53.7%; aRR 0.88, 95% CI 0.83-0.94), enhanced 18-month developmental assessment (52.3% vs 60.8%; aRR 0.92, 95% CI 0.88-0.97), or any developmental screen (54.9% vs 62.5%; aRR 0.94, 95% CI 0.90-0.99). Other disability groups did not experience such disparities. CONCLUSIONS: There is a need to develop resources to improve access to preventive health care for young children of women with intellectual or developmental disabilities. [ABSTRACT FROM AUTHOR]

Published
2024
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11. Crossing the Thames at Taplow : The Challenges of a Slender Arch Footbridge

Author

Firth, Ian, Taylor, Clare, Jenkins, Richard, Chunge, Musa, Correia, José A. F. O., Series Editor, De Jesus, Abílio M. P., Series Editor, Ayatollahi, Majid Reza, Advisory Editor, Berto, Filippo, Advisory Editor, Fernández-Canteli, Alfonso, Advisory Editor, Hebdon, Matthew, Advisory Editor, Kotousov, Andrei, Advisory Editor, Lesiuk, Grzegorz, Advisory Editor, Murakami, Yukitaka, Advisory Editor, Carvalho, Hermes, Advisory Editor, Zhu, Shun-Peng, Advisory Editor, Arêde, António, editor, and Costa, Cristina, editor

Published
2020
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12. The New GP′s Handbook

Author

Davies, Peter, primary, Moran, Lindsay, additional, Gandhi, Hussain, additional, Roebuck, Adrian, additional, and Taylor, Clare J, additional

Published
2022
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13. The clinical pathway of patients with heart failure in primary care

Author

Taylor, Clare Joanne

Subjects
616.1, RC Internal medicine
Abstract

Background: Heart failure is a common clinical syndrome associated with major adverse symptoms and poor outlook for patients, and high costs for healthcare systems globally. This thesis examines four aspects of the clinical pathway of patients with heart failure in primary care. Methods: Routinely collected GP records are used to estimate the number of newly diagnosed heart failure cases by year. A qualitative interview study explores the patient experience of the diagnostic pathway. Survival analysis is used to determine prognosis of patients following a first diagnostic label. Finally, a screening study examines who develops heart failure over time. Results: The incidence of heart failure has been static at 2.3 cases per 1,000 person-years since 2006. Patients initially normalise their symptoms so delay seeking help, GP access is challenging and communication in secondary care, particularly delivery of diagnosis, could be improved. Survival rates are 81.5%, 51.6% and 29.5% at 1, 5 and 10 years, respectively, and have not changed over time. Screening provides an alternative pathway to identify patients with heart failure. Conclusions: Strategies to reduce the number of new cases of heart failure, enhance patient experience, improve survival and explore new diagnostic pathways should be important priorities for the NHS.

Published
2016

16. Multiprofessional heart failure self-development framework

Author

Forsyth, Paul, primary, Young, Susan, additional, Hughes, Kirsty, additional, James, Ruby, additional, Oxley, Cheryl, additional, Kelly, Ruth, additional, Jones, Rebecca, additional, Briggs, Sarah, additional, Mackay-Thomas, Lynn, additional, Millerick, Yvonne, additional, Simpson, Maggie, additional, Taylor, Clare J, additional, Beggs, Simon, additional, Piper, Susan, additional, and Duckett, Simon, additional

Published
2024
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17. Recommendations for occupational therapy interventions for adults with ADHD: a consensus statement from the UK adult ADHD network

Author

Adamou, Marios, Asherson, Philip, Arif, Muhammad, Buckenham, Louise, Cubbin, Sally, Dancza, Karina, Gorman, Kirstie, Gudjonsson, Gísli, Gutman, Sharon, Kustow, James, Mabbott, Kerry, May-Benson, Teresa, Muller-Sedgwick, Ulrich, Pell, Emma, Pitts, Mark, Rastrick, Suzanne, Sedgwick, Jane, Smith, Kath, Taylor, Clare, Thompson, Lucy, van Rensburg, Kobus, and Young, Susan

Published
2021
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20. Musical Instrument Covers and their Makers in Eighteenth- and Nineteenth-Century Britain and Ireland.

Author

TAYLOR, CLARE

Abstract

Methods of protecting musical instruments when they were not being played is an under-researched area. This article draws on recent and hitherto unpublished archival and site research, rooted in the author's wider work on the uses of leather in the interior. It not only demonstrates the links to London's eighteenth-century gilt leather makers, who made covers for early keyboard instruments, but also discusses extant examples of covers in Ireland supplied for a grand piano and a pedal harp respectively. The detailed analysis offered of these objects shows that they had practical functions, protecting from the effects of light, heat and humidity and also in the case of the harp controlling access. However, it also demonstrates that they had aesthetic functions, harmonising with leather covers on other items of cased furniture and even interiors themselves, enabling musical instruments to be seen as an integral part of a decorative scheme. [ABSTRACT FROM AUTHOR]

Published
2024

23. Maternal and infant outcomes associated with lithium use in pregnancy: an international collaborative meta-analysis of six cohort studies

Author

Munk-Olsen, Trine, Liu, Xiaoqin, Viktorin, Alexander, Brown, Hilary K, Di Florio, Arianna, D'Onofrio, Brian M, Gomes, Tara, Howard, Louise M, Khalifeh, Hind, Krohn, Holly, Larsson, Henrik, Lichtenstein, Paul, Taylor, Clare L, Van Kamp, Inge, Wesseloo, Richard, Meltzer-Brody, Samantha, Vigod, Simone N, and Bergink, Veerle

Published
2018
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25. 'Figured paper for hanging rooms' : the manufacture, design and consumption of wallpapers for English domestic interiors, c.1740-c.1800

Author

Taylor, Clare

Subjects
708
Abstract

This thesis focuses on paper hangings, an hitherto understudied material in comparison to other components of the Eighteenth century domestic interior. Drawing on recent theories of consumption and the nature of domestic space, the thesis uses study of extant and reconstructed schemes, surviving papers and archival material to illuminate the material's increasingly important role in decoration during the second half of the century. Papers studied include Chinese papers and English papers in the Chinese style, English papers imitating architectural, sculpted and painted ornament and late century English and imported prints and panelled schemes. Three key issues are examined. Firstly, the thesis focuses attention on the structure of the trade, constructing a new model for understanding the way in which the manufacture, retailing, distribution and hanging of papers was organised. Examining the role of imports as well as the rapid expansion of the domestic trade, the thesis argues that control of this trade was contested by both new, and established, trades involved in decoration. Secondly, the role of design is analysed, particularly in terms of the relationship between imitation and innovation. Study of papers' sources further illuminates this issue, for example by examining how far English manufacturers sought to imitate Chinese originals and also how some Chinese papers rework European models. The relationship with other types of wall decoration and three dimensional ornament is also considered; the argument here is that far from merely copying printed designs, papers appropriated design sources from stucco, ceramics and textiles. Thirdly, and finally, aspects of consumption are examined. The thesis investigates how far the selection of paper supports the argument that the period witnessed increased differentiation of space, by gender or function. It questions easy distinctions between the choices of male and female consumers, arguing that both negotiated the materials' positive and negative associations.

Published
2010
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26. Working through change : an insider's analysis of FE teachers and tutors lived experience in a time of initiative overload

Author

Taylor, Clare, Leask, M., and Green, A.

Subjects
370.15, Teacher's attitudes, Behaviour & teaching, Stress & teaching, ITT for F.E., New labour policies
Abstract

This is an investigation by a participant researcher into the 'hidden world' of Further Education (FE). I became interested in how the many innovations, which have occurred in the past twenty years have made FE staff feel and how this effected their work and how they coped with what often felt like the conflicting demands of constant change. This is longitudinal insider research with a political edge as it is an examination of one of New Labour's major inclusion strategies, as it covers almost all of the twelve years they were in power. Over this period I have seen staff concerns change, as have their 'folk devils', and as lecturers and support staff went through different 'moral panics' during a period of massive change and uncertainty in the post compulsory sector. The original grounded theory type emergent categories and my own personal ontology lead me to adopt the position of a 'critical realist' where I have also attempted to incorporate a Feminist stance with some insights from sociological theorists like Bourdieu. Through the Literature Review I looked at the wider social and political issues of 'new managerialism', 'globalisation', 'proletarianisation', 'intensification of labour', the 'audit culture' and the casualisation and 'deprofessionalisation' of academic staff. These and other issues had emerged as possible reasons for the way staff said they felt in my interviews with tutors and my long term participant observations in three colleges and the results from one local stress survey and one national questionnaire of college managers. My conclusions are that many staff who choose to stay in FE are to a degree alienated but not anomic, they still believe in their role despite the changes and take pride and pleasure in their work, especially their interaction with students. The work place and division of labour are gendered both vertically and horizontally. Staff and trainers are unsure of the effectiveness of the new training but recognise that they need more skills to deal with the newer student groups. The different cultural capital, 'habitus' and 'fields' work against a common professionalism developing and these are unlikely to disappear.

Published
2009

29. Polymicrogyria and deletion 22q11.2 syndrome: Window to the etiology of a common cortical malformation

Author

Robin, Nathaniel H, Taylor, Clare J, McDonald‐McGinn, Donna M, Zackai, Elaine H, Bingham, Peter, Collins, Kevin J, Earl, Dawn, Gill, Deepak, Granata, Tiziana, Guerrini, Renzo, Katz, Naomi, Kimonis, Virginia, Lin, Jean‐Pierre, Lynch, David R, Mohammed, Shehla N, Massey, Roger F, McDonald, Marie, Rogers, R Curtis, Splitt, Miranda, Stevens, Cathy A, Tischkowitz, Marc D, Stoodley, Neil, Leventer, Richard J, Pilz, Daniela T, and Dobyns, William B

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Intellectual and Developmental Disabilities (IDD), Clinical Research, Neurosciences, Pediatric, Rare Diseases, Brain Disorders, Congenital Structural Anomalies, Aetiology, 2.1 Biological and endogenous factors, Congenital, Cerebellum, Cerebral Cortex, Chromosome Deletion, Chromosomes, Human, Pair 22, Female, Humans, Magnetic Resonance Imaging, Male, Syndrome, Tomography, X-Ray Computed, Velopharyngeal Insufficiency, Genetics, Clinical sciences
Abstract

Several brain malformations have been described in rare patients with the deletion 22q11.2 syndrome (DEL22q11) including agenesis of the corpus callosum, pachygyria or polymicrogyria (PMG), cerebellar anomalies and meningomyelocele, with PMG reported most frequently. In view of our interest in the causes of PMG, we reviewed clinical data including brain-imaging studies on 21 patients with PMG associated with deletion 22q11.2 and another 11 from the literature. We found that the cortical malformation consists of perisylvian PMG of variable severity and frequent asymmetry with a striking predisposition for the right hemisphere (P = 0.008). This and other observations suggest that the PMG may be a sequela of abnormal embryonic vascular development rather than a primary brain malformation. We also noted mild cerebellar hypoplasia or mega-cisterna magna in 8 of 24 patients. Although this was not the focus of the present study, mild cerebellar anomalies are probably the most common brain malformation associated with DEL22q11.

Published
2006

38. The use of fluorescence in situ hybridisation techniques in the diagnosis and prognosis of malignancy

Author

Taylor, Clare Petronella Florence

Subjects
610, Tumours, Tumorigenesis
Abstract

Specific and consistent genetic rearrangements have been found to be associated with particular tumours. The observation of these genetic changes highlights areas of the genome which may be involved in tumorigenesis, providing an opening for insights into the molecular mechanisms involved. The presence of a specific genetic aberration may also define the diagnosis in certain tumours, or may be associated with particular prognostic significance in others. Ewing's sarcoma and PNET are members of a group of childhood solid tumours which may be subject to diagnostic difficulty. These tumours are characterised by the presence of a t(11;22) translocation, and the detection of this in a tissue sample allows a firm diagnosis to be made, facilitating appropriate treatment. In this study fluorescence in situ hybridisation (FISH) has been carried out on interphase nuclei using probes flanking the translocation breakpoint on chromosome 22 to visualise the translocation. With proper controls and statistical analysis a test has been established which can be used routinely in the diagnosis of Ewing's sarcoma and PNET. The initial diagnosis of neuroblastoma is not usually difficult, but the natural history of the disease varies greatly depending on whether certain genetic alterations are present. Deletions of chromosome 1p, amplification of N-myc and a near-diploid or near-tetraploid karyotype are associated with a poor clinical outcome, while those with a triploid karyotype have a good prognosis. Knowledge of these genetic data may influence the choice of treatment. In this study FISH techniques have been modified for use on fresh tumour imprints to produce a rapid and reliable method of detecting each of these genetic changes. A large series of patients has been studied and the results correlated with those obtained using conventional methods. The technique is now being used routinely in some centres.

Published
1995

39. Low-dose spironolactone and cardiovascular outcomes in moderate stage chronic kidney disease: a randomized controlled trial

Author

Hobbs, F. D. Richard, McManus, Richard J., Taylor, Clare J., Jones, Nicholas R., Rahman, Joy K., Wolstenholme, Jane, Kim, Sungwook, Kwon, Joseph, Jones, Louise, Hirst, Jennifer A., Yu, Ly-Mee, and Mort, Sam

Abstract

Chronic kidney disease (CKD) is associated with a substantial risk of progression to end-stage renal disease and vascular events. The nonsteroidal mineralocorticoid receptor antagonist (MRA), finerenone, offers cardiorenal protection for people with CKD and diabetes, but there is uncertainty if the steroidal MRA, spironolactone, provides the same protection. In this prospective, randomized, open, blinded endpoint trial, we assessed the effectiveness of 25 mg spironolactone in addition to usual care or usual care alone for reducing cardiovascular outcomes in stage 3b CKD among an older community cohort (mean age = 74.8 years and s.d. = 8.1). We recruited 1,434 adults from English primary care, of whom 1,372 (96%) were included in the primary analysis. The primary outcome was time from randomization until the first occurrence of death, hospitalization for heart disease, stroke, heart failure, transient ischemic attack or peripheral arterial disease, or first onset of any condition listed not present at baseline. Across 3 years of follow-up, the primary endpoint occurred in 113 of 677 participants randomized to spironolactone (16.7%) and 111 of 695 participants randomized to usual care (16.0%) with no significant difference between groups (hazard ratio = 1.05, 95% confidence interval: 0.81–1.37). Two-thirds of participants randomized to spironolactone stopped treatment within 6 months, predominantly because they met prespecified safety stop criteria. The most common reason for stopping spironolactone was a decrease in the estimated glomerular filtration rate that met prespecified stop criteria (n= 239, 35.4%), followed by participants being withdrawn due to treatment side effects (n= 128, 18.9%) and hyperkalemia (n= 54, 8.0%). In conclusion, we found that spironolactone was frequently discontinued due to safety concerns, with no evidence that it reduced cardiovascular outcomes in people with stage 3b CKD. Spironolactone should not be used for people with stage 3b CKD without another explicit treatment indication. ClinicalTrials.gov registration: ISRCTN44522369.

Published
2024
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