Publications by authors named "O'Hara J"

Background: Clinical research has offered many definitions and fragmented perspectives of joint morbidity in haemophilia. As joint damage, pain and mobility impairment can be present without clinical record of persistent bleeding, a person-centric joint morbidity characterisation remained a priority for the haemophilia community, giving rise to the 'problem joint' concept. As diagnosing and managing joint morbidity is critical, the aim of this study was to analyse the holistic burden of problem joints in people with moderate or severe haemophilia A (HA).

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Introduction: Persistent throat symptoms (PTS) are indicators for over 60 000 new patient referrals to NHS secondary care annually. PTS have been attributed to manifestation of gastro-oesophageal reflux disease (GORD) with the hypothesis that gastric refluxate damages and irritates the mucosa of the upper aerodigestive tract. Symptoms of PTS and GORD are commonly treated with proton pump inhibitors (PPIs) or alginates are often, incorrectly, advocated.

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Background: Late side effects of head and neck cancer treatment commonly affect swallowing function. Late radiation-associated dysphagia (late-RAD) often presents years post-treatment when patients have been discharged from their multidisciplinary team. Timely symptom management may provide important physical and emotional support, potentially reducing the overall healthcare burden.

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Background: Healthcare organisations risk harming patients and their families twofold. First, through the physical, emotional and/or financial harm caused by safety incidents themselves, and second, through the organisational response to incidents. The former is well-researched and targeted by interventions.

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Background: The COVID-19 pandemic dramatically impacted endoscopy practice. Recommendations were to postpone elective cases, including procedures for removal of luminal neoplasia. This provided a natural experiment to evaluate outcomes related to these decisions and the impact of time to procedure on change in histology.

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This paper presents the design and fabrication of an aluminium oxide cutting insert with an internal cooling channel formed through an additive manufacturing method. The formed insert is subjected to a controlled densification process and analysed through a series of characterisation investigations. The purpose of the study is to develop the design concept and analyse the forming and sintering parameters used in the lithographic ceramic manufacturing process.

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Article Synopsis
  • The study analyzes survival outcomes for laryngeal cancer patients in the Northern UK who received non-curative treatment, revealing critical data for informed patient decision-making.
  • Involving 373 patients, the research found that the mean survival time was 9.1 months, with variations based on disease stage and type.
  • This pioneering work emphasizes the importance of understanding prognosis in non-curative settings, aiding discussions around treatment options for patients.
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Background: Few studies have evaluated direct medical or societal costs of haemophilia in the United Kingdom (UK), and how patient characteristics impact future costs is uncertain. Cost predictors were identified and examined using cross-sectional data from the CHESS I and II studies.

Methods: Patient- and physician-reported outcomes were analysed for UK adult males aged ≤ 65, with haemophilia A or B and no recent clinical trial participation.

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An experimental testbed was constructed to rigorously assess the fundamental limits of light-wave sensing-an economic, non-contact vitals monitoring approach previously reported. We improve the testbed using lock-in amplification and demonstrate that a photodetector and a commonplace array of infrared LEDs are sufficient to detect respiratory motion and quantify respiration rate up to 2.5 meters away.

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Insects are the major pollination vectors for angiosperms, and insects native to a given habitat can play an irreplaceable ecological role in food webs and plant reproduction. With precipitous declines in insect species over the last decades, it is urgent to document insect assemblages in native plant communities to support conservation efforts. Identifying pollinators and their pollination activity is challenging; however, emerging technological methods are providing new monitoring capabilities.

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Background: Our centre (Freeman Hospital, Newcatle Upon Tyne NHS Trust) has favoured primary surgery over chemoradiotherapy for specific advanced laryngeal cancer patients (e.g. large-volume tumours, airway compromise, significant dysphagia, T disease).

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Article Synopsis
  • Transoral robotic surgery (TORS) and transoral laser microsurgery (TLM) show promising outcomes for HPV-related oropharyngeal squamous cell carcinoma, with TORS potentially offering better tumor margin clearance.
  • This study aimed to assess how the surgical method (TORS vs. TLM) impacts early postoperative swallowing function, feeding tube usage, and quality of life in patients.
  • Findings indicated that patients who underwent TORS had significantly higher rates of nasogastric tube insertion compared to those who had TLM, with TLM showing slightly better overall quality of life scores, though the effect size was small.
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  • The study shifts from blaming individuals in healthcare to promoting a system-wide approach that values the involvement of those affected by serious incidents, highlighting the importance of understanding current policies related to this involvement.
  • A documentary analysis of 43 local serious incident investigation policies from the English NHS revealed a significant lack of direct reference or support for involving affected individuals, which undermines the active learning process needed after incidents.
  • While policies stress the importance of learning from serious incidents, the language used is vague, focusing more on generating arbitrary recommendations rather than fostering a participatory approach that addresses the underlying systems and processes involved.
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Background: Healthcare staff adapt to challenges faced when delivering healthcare by using workarounds. Sometimes, safety standards, the very things used to routinely mitigate risk in healthcare, are the obstacles that staff work around. While workarounds have negative connotations, there is an argument that, in some circumstances, they contribute to the delivery of safe care.

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Objective: The objective of this systematic review is to understand the experiences of care partner engagement in patient safety at the direct care level from the perspective of care partners, patients, and health care professionals.

Introduction: Care partner engagement is a strategy for promoting patient safety in hospitals at the direct care level (ie, at the point where patient care is delivered). When present, care partners can increase safety by watching, listening, and taking action to protect admitted patients.

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Background: The role of objective nasal airflow measures using peak nasal inspiratory flow (PNIF) and rhinospirometry in supporting clinical examination findings when offering patients septoplasty remain undefined.

Objective: To explore the baseline relationships between clinical examination findings, subjective reported symptoms and objective nasal patency measures in nasal obstruction.

Methods: This is a sub-study of the NAIROS trial.

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Background: Early retrospective data identify that dysphagia is common in older persons with burn injury, suggesting a rate of 47 %, and that it is associated with medical, burn, and nutritional outcomes.

Aims: To prospectively (1) explore the incidence, (2) describe associations, and (3) evaluate risk factors for dysphagia in patients ≥ 75 years old hospitalised with burn injury.

Methods: All patients > 75 years old admitted to Concord-Repatriation-General-Hospital with burn injury over 4 years (2019-2023) were assessed for dysphagia on presentation and were continually monitored throughout their admission.

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Purpose: People living with head and neck cancer (HNC) often endure permanent and life changing adverse effects of treatment and reduced health-related quality of life. Study of post-traumatic growth (PTG), is gaining traction to understand why some people living with cancer have better psychosocial outcomes than others. Current theoretical models on PTG point to the importance of 'socio-cultural influences' but do not provide insight into how such socio-cultural factors influence survivorship outcomes.

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Introduction: Haemophilia A (HA) is a congenital bleeding disorder caused by a deficiency/absence of factor VIII (FVIII) and characterised by frequent, acute and prolonged spontaneous or traumatic bleeding events, often leading to haemophilic arthropathy and progressive joint deterioration. HA severity is characterized by endogenous FVIII activity: mild (> 5-40%), moderate (1-5%), or severe (< 1%). HA poses a substantial clinical and socioeconomic burden on people with HA (PWHA), their caregivers, and society.

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  • The study aimed to evaluate how accurate cone-beam CT (CBCT) is in diagnosing different types of intracranial hemorrhage (ICH), focusing on intraparenchymal, subarachnoid, and intraventricular hemorrhages.
  • A meta-analysis included seven studies with 466 patients, using multidetector CT as the reference standard; findings showed high sensitivity (0.88) and specificity (0.99) for identifying ICH.
  • The results indicated that while CBCT has moderate diagnostic odds ratios, it demonstrates high specificity, particularly for intraparenchymal hemorrhage with a sensitivity of 0.98.
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