Publications by authors named "Paul Carding"

Background: For women at low risk of complications during labour and birth, in the United Kingdom, planned birth in a 'community' setting (at home or a freestanding midwifery unit) is generally safe, and intrapartum emergencies are uncommon. Limited exposure may affect midwives' experience of managing an emergency.

Aim: Identify and synthesise available evidence about midwives' experiences of managing intrapartum emergencies during labour in a community setting.

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Background: Over 200,000 patients are referred onto the suspected head and neck cancer (HNC) pathway annually in the UK, with around 3% receiving a cancer diagnosis. With new HNC advancements in identifying patients at low risk of a cancer diagnosis, one proposal is a speech and language therapy (SLT)-led first point of contact clinic for low-risk patients presenting with voice or swallowing symptoms.

Aims: To explore ear, nose and throat (ENT) surgeons' views regarding this model.

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Background: Management of benign vocal fold lesions (BVFLs) is variable with individuals receiving surgery, voice therapy, or a combination of these approaches. Some evidence suggests that the best outcomes may be achieved when patients are offered pre- and post-operative voice therapy in addition to phonosurgery, but what constitutes pre- and post-operative voice therapy is poorly described. The pre- and post-operative voice therapy (PAPOV) intervention has been developed and described according to the TIDieR checklist and Rehabilitation Treatment Specification System (RTSS) for voice.

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Background: The unprecedented rapid re-deployment of healthcare workers from different care pathways into newly created and fluid COVID-19 teams provides a unique opportunity to examine the interaction of many of the established non-technical factors for successful delivery of clinical care and teamwork in healthcare settings. This research paper therefore aims to address these gaps by qualitatively exploring the impact of COVID work throughout the pandemic on permanent and deployed personnel's experiences, their ability to effectively work together, and the effect of social dynamics (e.g.

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Purpose: This research investigates the relative effectiveness of independent online and blended learning approaches for novice analysts' development of videofluoroscopic swallowing study (VFSS) analytical skills. The secondary aims were to explore the impact of training on decision-making and to describe learners' perspectives of training outcomes.

Method: Undergraduate speech-language pathology students ( = 74) who had completed the dysphagia academic curriculum in an undergraduate speech-language pathology program were recruited for a randomised control trial.

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Background: Perceptual, cognitive and previous clinical experience may influence a novice Videofluoroscopic Swallowing Study (VFSS) analyst's trajectory towards competency. Understanding these factors may allow trainees to be better prepared for VFSS training and may allow training to be developed to accommodate differences between trainees.

Aims: This study explored a range of factors previously suggested in the literature as influencing the development of novice analysts' VFSS skills.

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Introduction: Voice therapy management of benign vocal fold lesions (BVFLs) is variable and there are currently no clinical guidelines. Poor descriptions of voice therapy interventions lead to unwarranted variation in treatment. Triangulation of the current evidence identifies a number of potential best practice elements, but also a number of outstanding questions to be explored.

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Background: Pre- and post-operative voice therapy may improve voice and quality-of-life outcomes for patients undergoing phonosurgery to remove benign vocal fold lesions (BVFLs). However, what constitutes voice therapy in this population is poorly described, resulting in a poor evidence base, lack of clinical guidelines and unwarranted variation in management. In order to develop the evidence base, a robust, iterative process of intervention development work should precede feasibility testing and effectiveness studies.

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The rapid increase of acute and intensive care capacities in hospitals needed during the response to COVID-19 created an urgent demand for skilled healthcare staff across the globe. To upscale capacity, many hospitals chose to increase their teams in these departments with rapidly re-deployed inter-professional healthcare personnel, many of whom had no prior experience of working in a high-risk environment and were neither prepared nor trained for work on such wards. This systematic review of reviews examines the current evidence base for successful teamwork in rapidly deployed interprofessional teams in intensive and acute care settings, by assessing systematic reviews of empirical studies to inform future deployments and support of rapidly formed clinical teams.

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Background: Evidence across a range of musically trained, hearing disordered and voice disordered populations present conflicting results regarding the relationship between pitch discrimination (PD) and voice quality. PD characteristics of female speakers with and without a musical training background and no self-reported voice disorder, and the relationship between PD and voice quality in this particular population, have not been investigated.

Aims: To evaluate PD characteristics in a cohort of female participants without a self-reported voice disorder and the relationship between PD and acoustic voice measures.

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Auditory perception plays an important role in voice control. Pitch discrimination (PD) is a key index of auditory perception and is influenced by a variety of factors. Little is known about the potential effects of voice disorders on PD and whether PD testing can differentiate people with and without a voice disorder.

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Anterior drooling is common in children with cerebral palsy (CP) and poses significant risks to the child's health. Causes of drooling include oro-motor dysfunction, inefficient swallowing and reduced sensation in the orofacial musculature. Behavioural interventions are frequently recommended to reduce drooling; however, this is in the absence of high-quality research evidence.

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Unlabelled: Benign vocal fold lesions cause dysphonia by preventing vocal fold closure, causing irregular vibration and increasing compensatory muscle tension. Voice therapy delivered in addition to phonosurgery may improve voice and quality of life outcomes but the evidence base is lacking and what constitutes voice therapy for this population is not defined. The purpose of this systematic review is to critically evaluate the evidence for pre and post-operative voice therapy to inform the development of an evidence based intervention.

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Purpose: To synthesise the available evidence relating to best practice in training videofluoroscopy and barium swallow analysts.

Method: The review was conducted according to the PRISMA statement and registered in PROSPERO (CRD42017053744). Data were extracted from nine databases.

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Background: Persistent throat symptoms are commonly attributed to 'laryngopharyngeal reflux'. Despite a limited evidence base, these symptoms are increasingly being treated in primary care with proton pump inhibitors.

Objective: To assess the value of proton pump inhibitor therapy in patients with persistent throat symptoms.

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Aims And Objectives: To review interventions and strategies designed to progress UK clinical academic career pathways in nursing and identify barriers and facilitators to aid wider implementation.

Background: For over a decade, the UK political agenda has promoted the entry of nurses into clinical academic roles. Partnerships between the National Health Service and academia are known to increase nursing recruitment, retention and quality of care.

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Objective: To assess the use of proton pump inhibitors (PPIs) to treat persistent throat symptoms.

Design: Pragmatic, double blind, placebo controlled, randomised trial.

Setting: Eight ear, nose, and throat outpatient clinics, United Kingdom.

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Background: The COVID-19 pandemic and the UK government's subsequent coronavirus action plan have fundamentally impacted on every aspect of healthcare. One area that is severely affected is ear, nose and throat (ENT)/laryngology where speech and language therapists (SLTs) engage in a diverse range of practice with patients with a range of conditions, including voice disorders, airway problems, and head and neck cancers (HNCs). A large majority of these patients are in high-risk categories, and many specialized clinical practices are vulnerable.

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Objectives: (1) To describe factors influencing the content, timing, and intensity of pre- and postoperative voice therapy for patients undergoing phonosurgery for benign vocal fold lesions. (2) To understand experts' rationale for decisions made. (3) To critically analyze factors influencing intervention in relation to the wider literature in order to contribute to the development of a complex intervention.

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In the absence of evidence-based guidelines, this study sought to understand current speech-language pathologists' (SLPs) practice when treating drooling in children with a neurodisability. Descriptive research using cross-sectional survey methodology. Online survey methods were used to obtain specific information on Australian SLPs' self-reported assessment and treatment practices relative to working with children with neurodisability who drool.

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Vocal fold nodules present the voice clinic team with a number of clinical dilemmas which are not as simple as previously thought. The definition, aetiology, prevalence and diagnosis are all poorly understood. Furthermore, treatment evidence for both behavioural and surgical approaches is weak.

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Purpose: Patients with throat cancer at later stages often undergo total laryngectomy, a procedure that removes the larynx (voice box) and directly impacts the patient's ability to produce natural voice and communication. This narrative review aimed to explore how changes to communication following laryngectomy may impact quality of life (QoL) for patients.

Methods: Literature searches were conducted using CINAHL, MEDLINE and PsychInfo databases for studies published between 2007 and 2018.

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Aim: To review the evidence for behavioural interventions to reduce drooling in children with neurodisability.

Method: A detailed search in eight databases sought studies that: (1) included participants aged 0 to 18 years with neurodisability and drooling; (2) provided behavioural interventions targeting drooling or a drooling-related behaviour; and (3) used experimental designs. Two reviewers extracted data from full-text papers independently.

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Objectives: Unilateral vocal fold paralysis (UVFP) typically results in marked changes in voice quality and performance and has a significant impact on quality of life. Treatment approaches generally aim to restore glottal closure for phonation and improve vocal function. There are a wide range of voice outcome measures that are available to measure the treatment effect.

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