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Harris L.,University of Dundee | Fioratou E.,University of Dundee | Broadis E.,Royal Hospital for Sick Children Yorkhill
Burns | Year: 2016

Background: A burn prevention and education programme - the Reduction of Burn and Scald Mortality and Morbidity in Children in Malawi project - was implemented from January 2010-2013 in Queen Elizabeth Central Hospital, Malawi. This study aimed to investigate the barriers and facilitators of implementing education-training programmes. Methods: Semi-structured interviews with 14 Scottish and Malawian staff delivering and receiving teaching at training education programmes were conducted. All interviews were recorded, transcribed and analysed using thematic analysis. Results: Overarching barriers and facilitators were similar for both sets of staff. Scottish participants recognised that limited experience working in LMICs narrowed the challenges they anticipated. Time was a significant barrier to implementation of training courses for both sets of participants. Lack of hands on practical experience was the greatest barrier to implementing the skills learnt for Malawian staff. Sustainability was a significant facilitator to successful implementation of training programmes. Encouraging involvement of Malawian staff in the co-ordination and delivery of teaching enabled those who attend courses to teach others. Conclusions: A recognition of and response to the barriers and facilitators associated with introducing paediatric burn education training programmes can contribute to the development of sustainable programme implementation in Malawi and other LMICs. © 2015 Elsevier Ltd and ISBI. Source


Coda A.,University of Newcastle | Fowlie P.W.,Ninewells Hospital | Davidson J.E.,Royal Hospital for Sick Children | Walsh J.,Royal Hospital for Sick Children Yorkhill | And 2 more authors.
Archives of Disease in Childhood | Year: 2014

Introduction: There is limited evidence supporting the podiatric treatment of children with juvenile idiopathic arthritis (JIA). This multicentre randomised controlled trial aimed to determine whether preformed foot orthoses (FOs) impacted on pain and quality of life (QoL) in children with JIA. Methods: Eligible children were randomised to receive either 'fitted ' FOs with customised chair-side corrections or 'control' FOs made without corrections. Changes in pain and QoL were measured using a visual analogue scale and Paediatric Quality of Life questionnaire, respectively. JIA children were assessed at baseline, 3 months and 6 months. Results: 60 children were recruited. 179 out of a possible 180 assessments (99.4%) were completed. A statistically significant greater difference in pain reduction (baseline - 6 months) was seen between the two groups favouring fitted FOs (p=0.029). The reduction in pain in the fitted FOs group was clinically important (8 mm). Significant differences in QoL favouring fitted FOs were also identi fied as measured by the children and independently by their parents/carers. Conclusions: Fitted FOs may reduce pain and improve QoL in selected children with JIA. Trial registration number: NCT02001844. Source


Lam F.C.,Tennent Institute of Ophthalmology | Lovett F.,3 Kaimhill | Dutton G.N.,Royal Hospital for Sick Children Yorkhill | Dutton G.N.,Glasgow Caledonian University
Journal of Visual Impairment and Blindness | Year: 2010

Damage to the areas of the brain that are responsible for higher visual processing can lead to severe cerebral visual impairment (CVI). The prognosis for higher cognitive visual functions in children with CVI is not well described. We therefore present our six-year follow-up of a boy with CVI and highlight intervention approaches that have proved consistently effective. © 2010 AFB, All Rights Reserved. Source


Lim J.B.T.,University of Glasgow | Huntley J.S.,Royal Hospital for Sick Children Yorkhill
TheScientificWorldJournal | Year: 2011

The aetiology and form of hallux valgus (HV) is varied with many corrective procedures described. We report a 39-year-old woman, previously treated with a Chevron osteotomy, who presented with recurrent right HV, metatarsus primus varus, and associated bunion. Osteotomies were performed at two levels as a revisional procedure. This report highlights (1) limitations of the Chevron osteotomy and (2) the revisional procedure of the two level osteotomies: (i) proximal opening-wedge basal osteotomy and (ii) distal short Scarf with medial closing wedges. If a Chevron osteotomy is used inappropriately, for example, in an attempt to correct too large a deformity, it may angulate laterally causing a malunion with an increased distal metatarsal articular angle. Secondly, it is feasible to correct this combined deformity using a combination of proximal opening-wedge and distal short Scarf osteotomies. ©2011 with author. Published by TheScientificWorld. Source


Clark G.R.,University of Cambridge | Sciacovelli M.,University of Cambridge | Gaude E.,University of Cambridge | Walsh D.M.,University of Birmingham | And 9 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2014

Context: At least a third of the patients with pheochromocytoma (PCC) or paraganglioma (PGL) harbor an underlying germline mutation in a known PCC/PGL gene. Mutations in genes (SDHB, SDHD, SDHC, and SDHA) encoding a component of the tricarboxylic acid cycle, succinate dehydrogenase (SDH), are a major cause of inherited PCC and PGL. SDHB mutations are also, albeit less frequently, associated with inherited renal cell carcinoma. Inactivation of SDH and another tricarboxylic acid cycle component, fumarate hydratase (FH), have both been associated with abnormalities of cellular metabolism, responsible for the activation of hypoxic gene response pathways and epigenetic alterations (eg, DNA methylation). However, the clinical phenotype of germline mutations in SDHx genes and FH is usually distinct, with FH mutations classically associated with hereditary cutaneous and uterine leiomyomatosis and renal cell carcinoma, although recently an association with PCC/PGL has been reported.Objective and Design: To identify potential novel PCC/PGL predisposition genes, we initially undertook exome resequencing studies in a case of childhood PCC, and subsequently FH mutation analysis in a further 71 patients with PCC, PGL, or head and neck PGL.Results: After identifying a candidate FH missense mutation in the exome study, we then detected a further candidate missense mutation (p.Glu53Lys) by candidate gene sequencing. In vitro analyses demonstrated that both missense mutations (p.Cys434Tyr and p.Glu53Lys) were catalytically inactive.Conclusions: These findings 1) confirm that germline FH mutations may present, albeit rarely with PCC or PGL; and 2) extend the clinical phenotype associated with FH mutations to pediatric PCC. Copyright © 2014 by the Endocrine Society. Source

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