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Harris M, Wilson JC, Holmes S, Radford DR. Perceived stress and well-being among dental hygiene and dental therapy students. Br Dent J 2018; 222:101-106. [PMID: 28127002 DOI: 10.1038/sj.bdj.2017.76] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2016] [Indexed: 11/09/2022]
Abstract
Aims To explore dental hygiene and dental therapy students' (DHDTS') perception of stress and well-being during their undergraduate education and establish base-line data for further studies of this group of dental professionals.Subjects and methods A questionnaire was distributed to Years 1, 2 and 3 DHDTS and final year outreach dental students (DS) (as a comparison group), at the University of Portsmouth Dental Academy (UPDA), during summer 2015. Data were collected on students' perception of levels of stress and well-being. Statistical analyses were undertaken using SPSS software. Mann-Whitney U tests with Bonferroni corrections were used and the level for a statistically significant difference was set at p <0.002.Results A response rate of 81% (DHDTS) and 85% (DS) was achieved. Clinical factors and academic work were perceived as stressful for both DHDTS and DS, with no significant difference between the groups. The majority of respondents reported levels of depression, anxiety, and stress to be within the normal range. All students reported high levels of positive well-being, with DHDTS scoring significantly higher than DS in the dimensions of personal growth, purpose in life, self-acceptance and positive relations with others (p <0.002).Conclusions DHDTS and DS identified sources of stress within their undergraduate education, but also perceived themselves as positively-functioning individuals.
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James N, Holmes S, Skorupinska I, Germain L, Sud R, Hanna M, Matthews E. Pilot study to explore the frequency and severity of pain in skeletal muscle channelopathies. Neuromuscul Disord 2018. [DOI: 10.1016/s0960-8966(18)30374-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ramdharry G, Jones F, Holmes S, James N, Booth S, Reilly M, Hanna M. Neuro-muscular bridges: development of an evidence based selfmanagement resource for people with neuro-muscular diseases. Neuromuscul Disord 2018. [DOI: 10.1016/s0960-8966(18)30412-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Woolhouse I, Bishop L, Darlison L, De Fonseka D, Edey A, Edwards J, Faivre-Finn C, Fennell DA, Holmes S, Kerr KM, Nakas A, Peel T, Rahman NM, Slade M, Steele J, Tsim S, Maskell NA. British Thoracic Society Guideline for the investigation and management of malignant pleural mesothelioma. Thorax 2018; 73:i1-i30. [PMID: 29444986 DOI: 10.1136/thoraxjnl-2017-211321] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Holmes S. Alopecia: the questions we need to answer. Br J Dermatol 2018; 178:330-331. [PMID: 29441547 DOI: 10.1111/bjd.16158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Woolhouse I, Bishop L, Darlison L, de Fonseka D, Edey A, Edwards J, Faivre-Finn C, Fennell DA, Holmes S, Kerr KM, Nakas A, Peel T, Rahman NM, Slade M, Steele J, Tsim S, Maskell NA. BTS guideline for the investigation and management of malignant pleural mesothelioma. BMJ Open Respir Res 2018; 5:e000266. [PMID: 29531746 PMCID: PMC5844375 DOI: 10.1136/bmjresp-2017-000266] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 11/21/2022] Open
Abstract
The full guideline for the investigation and management of malignant pleural mesothelioma is published in Thorax. The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline.
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Holmes S, Harries M. Re: Frontal Fibrosing Alopecia Severity Index (
FFASI
): a call for a more inclusive and globally relevant severity index for frontal fibrosing alopecia: reply from the authors. Br J Dermatol 2017; 177:884. [DOI: 10.1111/bjd.15796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Bhatti N, Ali S, Holmes S. New and cost-effective way of retracting orbital contents during repair of the orbital floor. Br J Oral Maxillofac Surg 2017; 55:e43-e44. [PMID: 28668482 DOI: 10.1016/j.bjoms.2017.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 06/05/2017] [Indexed: 10/19/2022]
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Sweeney J, Silk PJ, Rhainds M, MacKay W, Hughes C, Van Rooyen K, MacKinnon W, Leclair G, Holmes S, Kettela EG. First Report of Mating Disruption With an Aggregation Pheromone: A Case Study With Tetropium fuscum (Coleoptera: Cerambycidae). JOURNAL OF ECONOMIC ENTOMOLOGY 2017; 110:1078-1086. [PMID: 28334411 DOI: 10.1093/jee/tow308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Indexed: 06/06/2023]
Abstract
Tetropium fuscum (F.), native to Europe and established in Nova Scotia, Canada, since at least 1990, is considered a low-to-moderate threat to spruce (Picea spp.) forests in North America and regulated as a quarantine pest by the Canadian Food Inspection Agency. We tested broadcast applications of the aggregation pheromone racemic (5E)-6,10-dimethyl-5,9-undecadien-2-ol (fuscumol), formulated at 10% concentration in Hercon Bio-Flakes (Hercon International, Emigsville, PA), for efficacy in disrupting T. fuscum mating and suppressing populations. Two applications of 2.5-2.75 kg Bio-Flakes (250-275 g a.i.) per ha per season significantly reduced trap catches and mating success (2009, 2010, 2012): about 30% of females trapped in treated plots had mated compared with 60% of females trapped in untreated plots. Similar reductions in mating success were observed in 2011 with one or two 4.5 kg/ha applications of Bio-Flakes. Mean densities of T. fuscum colonizing sentinel bait logs or girdled trees were 36% lower in pheromone-treated plots than in untreated plots, but the difference was not statistically significant. Lack of population suppression may have been because mated females immigrated into treated plots or because populations were so high that despite a 50% reduction in mating success, absolute numbers of mated females were sufficient to infest our bait logs or trees. This is the first demonstration of insect mating disruption via broadcast application of an aggregation pheromone. Pheromone-mediated mating disruption has potential to slow the spread of invasive cerambycids by targeting low-density outlier populations near or beyond the leading edge of an infestation.
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Debroy Kidambi A, Dobson K, Holmes S, Carauna D, Del Marmol V, Vujovic A, Kaur M, Takwale A, Farrant P, Champagne C, Harries M, Messenger A. Frontal fibrosing alopecia in men: an association with facial moisturizers and sunscreens. Br J Dermatol 2017; 177:260-261. [DOI: 10.1111/bjd.15311] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Ahmad Z, Mohamedbhai H, Bajalan M, Holmes S. ZS maxillofacial trauma app: a two-year review of an iPhone app intended to aid assessment of maxillofacial trauma. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Holmes S, Male A, Ramdharry G, Quinlivan R, Bugiardini E, Poole O, James N, Hanna M. Service evaluation exploring the incidence of vestibular and balance dysfunction in people with mitochondrial disease. Neuromuscul Disord 2017. [DOI: 10.1016/s0960-8966(17)30284-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Stacy NI, Field CL, Staggs L, MacLean RA, Stacy BA, Keene J, Cacela D, Pelton C, Cray C, Kelley M, Holmes S, Innis CJ. Clinicopathological findings in sea turtles assessed during the Deepwater Horizon oil spill response. ENDANGER SPECIES RES 2017. [DOI: 10.3354/esr00769] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Halpin DMG, Holmes S, Calvert J, McInerney D. Case finding for chronic obstructive pulmonary disease in people attending long-term condition clinics in primary care. Chron Respir Dis 2016; 13:337-343. [PMID: 27072019 PMCID: PMC5734801 DOI: 10.1177/1479972316643011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Despite increased interest and awareness of chronic obstructive pulmonary disease (COPD), nearly half of the people with COPD remain undiagnosed. Inviting people at risk for screening is unlikely to be effective as many will not attend. Co-morbidities are common in people with COPD but COPD is also a comorbidity of other long-term conditions and people with these conditions are under regular review in primary care clinics. This study aimed to develop a pilot programme to case find people with COPD among patients attending other long-term clinics in primary care. Twenty-three general practices were recruited to participate in South West England. All current or ex-smokers aged ≥35 attending a long-term condition clinic who were not known to have COPD were asked to complete a questionnaire designed to help identify people with COPD and to perform microspirometry. Practices were asked to collect data on up to 100 patients. One thousand three hundred and thirty-three patients were assessed. Four hundred and ten people (31%) were current smokers. Six hundred and thirteen (46%) had high questionnaire scores and 287 (22%) of these also had a forced expiratory volume in 1 second (FEV1) below the lower limit of normal (LLN). The mean FEV1 in these patients was 59.0% of predicted (range 22-79.0%). Two hundred and twenty-four had an FEV1 between 50% and 80% of predicted, 50 had an FEV1 between 30% and 50% of predicted. One hundred and sixteen (40%) of the people with an FEV1 below the LLN were still smoking and 55 accepted referral to cessation services. A total of 56% of the other smokers assessed but not thought to have COPD also accepted referral. Assessing symptoms and performing microspirometry in people attending long-term condition clinics in primary care is feasible and has a high yield of identifying people likely to have previously undiagnosed COPD.
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Bhatti N, Kanzaria A, Huxham-Owen N, Bridle C, Holmes S. Management of complex orbital fractures. Br J Oral Maxillofac Surg 2016; 54:719-23. [DOI: 10.1016/j.bjoms.2016.04.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 04/27/2016] [Indexed: 11/17/2022]
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Holmes S, Harries M. Reply to ‘Frontal Fibrosing Alopecia Severity Index (FFASI): a validated scoring system for assessing frontal fibrosing alopecia’: reply from the authors. Br J Dermatol 2016; 175:648-9. [DOI: 10.1111/bjd.14859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Radford DR, Holmes S, Dunne SM, Woolford MJ. Outreach clinical dental education: the Portsmouth experience - a 4-year follow-up study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2016; 20:148-155. [PMID: 26037502 DOI: 10.1111/eje.12153] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/05/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND The Portsmouth Dental Academy (UPDA) was opened in September 2010 and was a development from the highly successful School of Professionals Complementary to Dentistry (2004-2010). The aim of the Academy was to provide integrated team education for all dental professionals in a primary care setting. The dental students are on outreach from King's College London, and the dental care professional students are registered at the University of Portsmouth. OBJECTIVES To evaluate the dental students response to the residential outreach educational experience at the UPDA. METHODS A 49-item questionnaire divided into nine domains that provided both qualitative data and quantitative data were administered at the end of the longitudinal 10-week placement, to four successive cohorts of students in 2010-2014. RESULTS A 95% return rate was achieved. Students valued highly the quality of the clinical teaching. Through their experience, they felt they understood fully the role of the dentist in care planning in primary care and felt well prepared for dental foundation training. This educational success is unpinned with successful maintenance factors including a well-organised induction period and giving the students a sense of belongingness, empowerment and autonomy for their personal development as new graduates. CONCLUSION Within the limitations of the questionnaire study over the 4-year period, the students were very positive about all the aspects of this residential outreach education at the UPDA but particularly valued the immersion in clinical dentistry and the bridging from dental school to their dental foundation training.
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Holmes S. Frontal Fibrosing Alopecia. SKIN THERAPY LETTER 2016; 21:5-7. [PMID: 27388531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Frontal fibrosing alopecia, described just over 20 years ago, has become one of the most frequently seen causes of scarring alopecia at many specialist hair clinics. Considered a clinical variant of lichen planopilaris (LPP), it has distinctive features and associations which distinguish it from LPP. Although largely affecting postmenopausal women, a small but increasing number of men and premenopausal women are affected. The spectrum of the disease has expanded from involvement of the frontal hairline and eyebrows, to potentially affecting the entire hairline, facial and body hair. Genetic and environmental factors have been implicated but the aetiology remains uncertain. A range of treatments have been used in management of the condition, but clinical trials are required to establish effectiveness.
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Dixon LC, Ward DJ, Smith J, Holmes S, Mahadeva R. New and emerging technologies for the diagnosis and monitoring of chronic obstructive pulmonary disease: A horizon scanning review. Chron Respir Dis 2016; 13:321-336. [PMID: 26968787 PMCID: PMC5084418 DOI: 10.1177/1479972316636994] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
There is a need for straightforward, novel diagnostic and monitoring technologies to enable the early diagnosis of COPD and its differentiation from other respiratory diseases, to establish the cause of acute exacerbations and to monitor disease progression. We sought to establish whether technologies already in development could potentially address these needs. A systematic horizon scanning review was undertaken to identify technologies in development from a wide range of commercial and non-commercial sources. Technologies were restricted to those likely to be available within 18 months, and then evaluated for degree of innovation, potential for impact, acceptability to users and likelihood of adoption by clinicians and patients with COPD. Eighty technologies were identified, of which 25 were considered particularly promising. Biomarker tests, particularly those using sputum or saliva samples and/or available at the point of care, were positively evaluated, with many offering novel approaches to early diagnosis and to determining the cause for acute exacerbations. Several wrist-worn devices and smartphone-based spirometers offering the facility for self-monitoring and early detection of exacerbations were also considered promising. The most promising identified technologies have the potential to improve COPD care and patient outcomes. Further research and evaluation activities should be focused on these technologies.
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Holmes S, Ryan T, Young D, Harries M. Frontal Fibrosing Alopecia Severity Index (FFASI): a validated scoring system for assessing frontal fibrosing alopecia. Br J Dermatol 2016; 175:203-7. [PMID: 26847608 DOI: 10.1111/bjd.14445] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Brazier P, Schauer U, Hamelmann E, Holmes S, Pritchard C, Warner JO. Economic analysis of temperature-controlled laminar airflow (TLA) for the treatment of patients with severe persistent allergic asthma. BMJ Open Respir Res 2016; 3:e000117. [PMID: 27026803 PMCID: PMC4809149 DOI: 10.1136/bmjresp-2015-000117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 02/12/2016] [Accepted: 02/14/2016] [Indexed: 11/05/2022] Open
Abstract
Introduction Chronic asthma is a significant burden for individual sufferers, adversely impacting their quality of working and social life, as well as being a major cost to the National Health Service (NHS). Temperature-controlled laminar airflow (TLA) therapy provides asthma patients at BTS/SIGN step 4/5 an add-on treatment option that is non-invasive and has been shown in clinical studies to improve quality of life for patients with poorly controlled allergic asthma. The objective of this study was to quantify the cost-effectiveness of TLA (Airsonett AB) technology as an add-on to standard asthma management drug therapy in the UK. Methods The main performance measure of interest is the incremental cost per quality-adjusted life year (QALY) for patients using TLA in addition to usual care versus usual care alone. The incremental cost of TLA use is based on an observational clinical study monitoring the incidence of exacerbations with treatment valued using NHS cost data. The clinical effectiveness, used to derive the incremental QALY data, is based on a randomised double-blind placebo-controlled clinical trial comprising participants with an equivalent asthma condition. Results For a clinical cohort of asthma patients as a whole, the incremental cost-effectiveness ratio (ICER) is £8998 per QALY gained, that is, within the £20 000/QALY cost-effectiveness benchmark used by the National Institute for Health and Care Excellence (NICE). Sensitivity analysis indicates that ICER values range from £18 883/QALY for the least severe patients through to TLA being dominant, that is, cost saving as well as improving quality of life, for individuals with the most severe and poorly controlled asthma. Conclusions Based on our results, Airsonett TLA is a cost-effective addition to treatment options for stage 4/5 patients. For high-risk individuals with more severe and less well controlled asthma, the use of TLA therapy to reduce incidence of hospitalisation would be a cost saving to the NHS.
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Price K, Wilson N, Holmes S, Bridle C, Heke S, Markides C, Dain V. Implementing a dedicated, embedded psychology service within a Maxillofacial Trauma Outpatient Clinic: preliminary evaluation and findings from the first 4 months. Br J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.bjoms.2015.08.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Stephens J, Evans B, Holmes S. Functional vs anatomical buttresses of the skull base. Br J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.bjoms.2015.08.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lamb RC, Young D, Holmes S. Retrospective review of diphencyprone in the treatment of alopecia areata. Clin Exp Dermatol 2015; 41:352-8. [DOI: 10.1111/ced.12776] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2015] [Indexed: 02/02/2023]
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Stephens JR, Holmes S, Evans BT. Applied anatomy of the anterior cranial fossa: what can fracture patterns tell us? Int J Oral Maxillofac Surg 2015; 45:275-8. [PMID: 26589135 DOI: 10.1016/j.ijom.2015.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 10/01/2015] [Indexed: 11/29/2022]
Abstract
The skull base is uniquely placed to absorb anteriorly directed forces imparted either via the midfacial skeleton or cranial vault. A variety of skull base fracture classifications exist. Less well understood, however, is fracture extension beyond the anterior cranial fossa (ACF) into the middle and posterior cranial fossae. The cases of 81 patients from two UK major trauma centres were studied to examine the distribution of fractures across the skull base and any relationship between the vector of force and extent of skull base injury. It was found that predominantly lateral force to the craniofacial skeleton produced a fracture that propagated beyond the ACF into the middle cranial fossa in 77.4% of cases, significantly more (P<0.001) than for predominantly anterior force (12.0%). Fractures were significantly more likely to propagate into the posterior fossa with a lateral vector of impact compared to an anterior vector (P=0.049). This difference in energy transfer across the skull base may, in part, be explained by the local anatomy. The more delicate central ACF acts as a 'crumple zone' in order to absorb force. Conversely, no collapsible interface exists in the lateral aspect of the ACF, thus the lateral ACF behaves like a 'buttress', resulting in increased energy transfer.
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