Transforming nursing care for children with serious long-term conditions: A mixed methods exploration of the impact of Roald Dahl Specialist Nurses in the United Kingdom.

Purpose: A new model of paediatric nursing, funded initially by a charitable organisation working in partnership with UK healthcare providers, was implemented to support children living with serious long-term conditions. This study explored, from the perspective of multiple stakeholders, the impact of services provided by 21 'Roald Dahl Specialist Nurses' (RDSN) within 14 NHS Trust hospitals.

Design And Methods: A Mixed Methods Exploratory design commenced with interviews with RDSNs (n = 21) and their managers (n = 15), alongside a medical clinician questionnaire (n = 17).

The changing role of pre-admission work experience (clinical visits) in Therapeutic Radiography, Diagnostic Radiography and Operating Department Practice: Student perspectives (Part 1).

Introduction: Clinical visits (work experience opportunities) are a recommended part of admissions processes for many diagnostic and therapeutic radiography courses but not for operating department practice (ODP) where observational visits are challenging for applicants to obtain. The Covid-19 pandemic interrupted access to visits for all prospective students; this study presents a review of the value of clinical visits and alternatives.

Methods: This article reports the initial qualitative phase of a three-phase mixed methods study.

The changing role of pre-admission work experience (clinical visits) in therapeutic radiography, diagnostic radiography and operating department practice: Academic perspectives (part 2).

Introduction: A clinical visit (work experience) provides an opportunity for prospective students, prior to registration, to visit a clinical department to observe health professionals in practice. The Covid-19 pandemic interrupted access to clinical visits; this article explores the value of clinical visits and the alternatives implemented as a response to Covid-19 restrictions from an academic perspective.

Methods: This article reports the quantitative phase of a three-phase mixed methods study.

Student nurses' career intentions following placements in general practice through the advanced training practices scheme (ATPS): findings from an online survey.

Background: The demand for General Practice services in the UK, and elsewhere, is rising quickly. In part, the increasing demand is from an aging population that requires management of multiple long-term conditions. The General Practice Nurse is increasingly taking on the role.

Who attends out-of-hours general practice appointments? Analysis of a patient cohort accessing new out-of-hours units.

Objectives: This report describes the patients who used additional out-of-hours (OOH) appointments offered through a UK scheme intended to increase patient access to primary care by extending OOH provision.

Design: Cohort study and survey data.

Setting: OOH appointments offered in four units in one region in England (October 2015 to November 2016).

Valuing Health Using Time Trade-Off and Discrete Choice Experiment Methods: Does Dimension Order Impact on Health State Values?

Background: Health states defined by multiattribute instruments such as the EuroQol five-dimensional questionnaire with five response levels (EQ-5D-5L) can be valued using time trade-off (TTO) or discrete choice experiment (DCE) methods. A key feature of the tasks is the order in which the health state dimensions are presented. Respondents may use various heuristics to complete the tasks, and therefore the order of the dimensions may impact on the importance assigned to particular states.

Views and experiences of using integrated care pathways (ICPs) for caring for people in the last days to hours of life: results from a cross-sectional survey of UK professionals.

Objectives: To determine the views and experiences of health and social care professionals on using integrated care pathways (ICPs)for caring for people in the last days to hours of life.

Methods: Online cross-sectional questionnaire survey of UK professionals working in UK primary and secondary care settings.

Results: 1331 professionals returned completed questionnaires.

Clonal B-cell lymphocytosis exhibiting immunophenotypic features consistent with a marginal-zone origin: is this a distinct entity?

The biological and clinical significance of a clonal B-cell lymphocytosis with an immunophenotype consistent with marginal-zone origin (CBL-MZ) is poorly understood. We retrospectively evaluated 102 such cases with no clinical evidence to suggest a concurrent MZ lymphoma. Immunophenotyping revealed a clonal B-cell population with Matutes score ≤2 in all cases; 19/102 were weakly CD5 positive and all 35 cases tested expressed CD49d.

Developing and testing methods for deriving preference-based measures of health from condition-specific measures (and other patient-based measures of outcome).

Objectives: Generic preference-based measures such as EQ-5D are widely used to estimate quality-adjusted life-years but may not be available or, more importantly, appropriate in some medical conditions. Condition-specific preference-based measures (CSPBMs) provide an alternative to generic measures that may be more relevant in some conditions. This project conducted five studies to examine issues in the development and use of CSPBMS: (1) literature review of measures; (2) deriving health states values for classifications with highly correlated dimensions; (3) impact of condition labelling; (4) impact of add-on dimensions; and (5) comparative performance of measures.

It's all in the name, or is it? The impact of labeling on health state values.

Background: Many descriptions of health used in vignettes and condition-specific measures name the medical condition. This article assesses the impact of referring to the medical condition in the descriptions of health states valued by members of the general population.

Methods: A valuation study was conducted using face-to-face interviews involving the time trade-off valuation technique.

Putting a value on the avoidance of false positive results when screening for inherited metabolic disease in the newborn.

Despite the increase in the number of inherited metabolic diseases that can be detected at birth using a single dried blood spot sample, the impact of false positive results on parents remains a concern. We used an economic approach - the contingent valuation method - which asks parents to give their maximum willingness to pay for an extension in a screening programme and the degree to which the potential for false positive results diminishes their valuations. 160 parents of a child or children under the age of 16 years were surveyed and given descriptions of the current screening programme in the UK, an extended programme and an extended programme with no false positives.

A semi-structured clinical interview for psychosis sub-groups (SCIPS): development and psychometric properties.

Background: Clinical sub-groups of schizophrenia, namely drug related, traumatic, anxiety and stress sensitivity sub-types, have been proposed for use in research, training and practice. They were developed on the basis of clinical observation but have not yet been used in research or clinical practice to any great extent.

Aims: To develop a semi-structured clinical interview for psychosis sub-groups (SCIPS) and determine the best diagnostic criteria with the highest inter-rater reliability, test-retest reliability and concurrent validity for sub-grouping patients with schizophrenia according to a newly developed classification scheme.

Methylation markers identify high risk patients in IGHV mutated chronic lymphocytic leukemia.

Chronic lymphocytic leukemia (CLL) exhibits a very variable clinical course. Altered DNA methylation of genes has shown promise as a source of novel prognostic makers in a number of cancers. Here we have studied the potential utility of a panel of methylation markers (CD38, HOXA4 and BTG4) in 118 CLL patients.

TP53 mutation profile in chronic lymphocytic leukemia: evidence for a disease specific profile from a comprehensive analysis of 268 mutations.

The TP53 mutation profile in chronic lymphocytic leukemia (CLL) and the correlation of TP53 mutations with allele status or associated molecular genetics are currently unknown. We performed a large mutation analysis of TP53 at four centers and characterized the pattern of TP53 mutations in CLL. We report on 268 mutations in 254 patients with CLL.

A comprehensive genetic and histopathologic analysis identifies two subgroups of B-cell malignancies carrying a t(14;19)(q32;q13) or variant BCL3-translocation.

The biologic and pathologic features of B-cell malignancies bearing a translocation t(14;19)(q32;q13) leading to a fusion of IGH and BCL3 are still poorly described. Herein we report the results of a comprehensive cytogenetic, fluorescence in situ hybridization (FISH), molecular and histopathological survey of a large series of B-cell malignancies with t(14;19) or variant translocations. A total of 56 B-cell malignancies with a FISH-proven BCL3 involvement were identified with the translocation partners being IGH (n=51), IGL (n=2), IGK (n=2) and a non-IG locus (n=1).

Telomeric IGH losses detectable by fluorescence in situ hybridization in chronic lymphocytic leukemia reflect somatic VH recombination events.

Routine interphase fluorescence in situ hybridization (FISH) analysis of chronic lymphocytic leukemia (CLL) with LSI IGH/CCND1 assay, applied to differentiate CLL from leukemic mantle cell lymphoma, identified a subset of cases (42/174) with translocation-like IGH signal pattern. To unravel the underlying 14q32/IGH aberrations, 14 of these cases were subjected to cytogenetic, detailed FISH, and V(H) mutation analyses. FISH identified cryptic losses of various portions of the IGHV region in all 14 cases.

Evaluation of ZAP-70 expression by flow cytometry in chronic lymphocytic leukemia: A multicentric international harmonization process.

The clinical course of patients with chronic lymphocytic leukemia (CLL) is heterogeneous with some patients requiring early therapy whereas others will not be treated for years. The evaluation of an individual CLL patient's prognosis remains a problematic issue. The presence or absence of somatic mutations in the IgVH genes is currently the gold-standard prognostic factor, but this technique is labor intensive and costly.

ZAP-70 by flow cytometry: a comparison of different antibodies, anticoagulants, and methods of analysis.

Background: The clinical course of chronic lymphocytic leukaemia (CLL) is variable. ZAP-70 expression is believed to provide prognostic information. The flow cytometric detection of ZAP-70 is difficult because it is an intracellular antigen with weak expression in CLL.

Ultralong Raman fiber lasers as virtually lossless optical media.

By transforming the optical fiber span into an ultralong cavity laser, we experimentally demonstrate quasilossless transmission over long (up to 75 km) distances and virtually zero signal power variation over shorter (up to 20 km) spans, opening the way for the practical implementation of integrable nonlinear systems in optical fiber. As a by-product of our technique, the longest ever laser (to the best of our knowledge) has been implemented, with a cavity length of 75 km. A simple theory of the lossless fiber span, in excellent agreement with the observed results, is presented.

ZAP-70 in B cell malignancies.

ZAP-70 has emerged as a protein of potential prognostic importance in chronic lymphocytic leukemia (CLL) following gene expression profiling which compared the 2 well established prognostic sub-sets, those with unmutated and mutated IgVH genes. This protein tyrosine kinase (PTK), known to be of importance in T and NK cell signaling but absent in normal peripheral B cells, is expressed in the majority of the poorer prognosis unmutated CLL and absent in most cases with mutated IgVH genes. ZAP-70 has been shown to be functionally important in the CLL cases in which it is expressed; it is also important in B cell development in mice and there is preliminary evidence for its expression in human B cell progenitors and activated B cells.

Splenic marginal zone lymphoma: 7q abnormalities.

7q abnormalities are the most common cytogenetic or genetic aberrations found in splenic marginal zone lymphoma. The molecular methods whereby these regions of genetic loss can be characterized are discussed in this chapter. Emphasis is given to careful experimental design, for example sample purification and optimization, that is, ensuring that only target sequences are amplified.

DLEU2 encodes an antisense RNA for the putative bicistronic RFP2/LEU5 gene in humans and mouse.

Our group previously identified two novel genes, RFP2/LEU5 and DLEU2, within a 13q14.3 genomic region of loss seen in various malignancies. However, no specific inactivating mutations were found in these or other genes in the vicinity of the deletion, suggesting that a nonclassical tumor-suppressor mechanism may be involved.