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  1. Article ; Online: Abortion rates in UK servicewomen.

    Kinkaid, Victoria Elizabeth / Guest, Ruth / Appleyard, Tracy-Louise

    BMJ sexual & reproductive health

    2024  

    Language English
    Publishing date 2024-04-03
    Publishing country England
    Document type Letter
    ISSN 2515-2009
    ISSN (online) 2515-2009
    DOI 10.1136/bmjsrh-2024-202288
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Anogenital injury following sexual assault and consensual sexual intercourse: a systematic review and meta-analysis.

    Naumann, David N / Morris, Louise / Bowley, Douglas M / Appleyard, Tracy-Louise / Cumming, Julie / Wardle, Deborah

    EClinicalMedicine

    2023  Volume 65, Page(s) 102266

    Abstract: Background: Sexual violence is a grave human rights violation and a serious global public health challenge. Rates of reporting of sexual violence and subsequent passage of cases through the criminal justice system are poor all over the world. The ... ...

    Abstract Background: Sexual violence is a grave human rights violation and a serious global public health challenge. Rates of reporting of sexual violence and subsequent passage of cases through the criminal justice system are poor all over the world. The presence or absence of anogenital injury following sexual assault may influence survivors in their willingness to report a crime, and law enforcement officers and jurors in their decision making regarding the laying of charges and/or conviction of offenders. The aim of this systematic review was to compare rates of identification of anogenital injury (AGI) in women following sexual assault and consensual sexual intercourse using the same examination techniques.
    Methods: In this systematic review and meta-analysis, Medline, Embase and Google Scholar were searched for relevant studies (in any language, with no age or sex criteria) published between February 25, 1993, and February 25, 2023, that directly compared AGI between individuals after either sexual assault or consensual sexual intercourse. Abstracts, conference proceedings, and case reports were excluded. The primary outcome of interest was any form of detected AGI. The Mantel-Haenszel method was used for meta-analysis using random effects modelling to determine the risk ratio (RR) of AGI between sexual assault and consensual sexual intercourse. Quality assessment was undertaken using the Newcastle-Ottawa scale tool. The
    Findings: We included 10 studies, accounting for 3165 study participants. All participants were female. AGI was detected in 901 (48%) of 1874 participants following sexual assault and 394 (31%) of 1291 participants following consensual sexual intercourse. Meta-analysis of all included studies demonstrated that the presence of AGI was significantly more likely for participants following sexual assault than consensual sexual intercourse (RR 1.59 (95% CI 1.21, 2.09);
    Interpretation: Although AGI was significantly more likely to be detected after sexual assault than consensual sexual intercourse, more than half of survivors of sexual assault have no detectable injuries. The presence of AGI, therefore, does not prove there has been sexual violence and absence of injury does not refute that sexual assault has occurred.
    Funding: The University of Birmingham.
    Language English
    Publishing date 2023-10-05
    Publishing country England
    Document type Journal Article
    ISSN 2589-5370
    ISSN (online) 2589-5370
    DOI 10.1016/j.eclinm.2023.102266
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The training value of a low-fidelity cervical biopsy workshop.

    Manley, Kristyn M / Park, Claire H / Medland, Victoria L / Appleyard, Tracy-Louise

    Simulation in healthcare : journal of the Society for Simulation in Healthcare

    2015  Volume 10, Issue 2, Page(s) 116–121

    Abstract: Introduction: Cervical biopsy increases diagnostic yield compared with cytology and reduces time between presentation with and diagnosis of cervical cancer. Procedural training however needs to evolve in line with legislated working time restrictions ... ...

    Abstract Introduction: Cervical biopsy increases diagnostic yield compared with cytology and reduces time between presentation with and diagnosis of cervical cancer. Procedural training however needs to evolve in line with legislated working time restrictions and patient safety concerns. This makes gynecologic procedures ideal for simulation training. To date, no studies have looked at the use of low-fidelity simulation models to teach cervical punch biopsy.
    Methods: A cervical punch biopsy model was created using home and departmental waste products. The simulation model was tested by expert colposcopists and used during a gynecology trainee cervical study day. Twenty-one trainees attended a lecture that showed photographs of normal and abnormal cervices and a workshop where colposcopists demonstrated the technique before direct hands-on training with the simulator. Participants were asked to complete a survey, using a 5-point Likert scale, outlining the educational value of the workshop.
    Results: Five low-fidelity cervical biopsy simulation models were created, these cost nothing, took an hour to make, and were easily transported. Of the different "cervix" materials tested, sponge provided the most realistic traction and the least fragmented biopsies (3-5 mm). Eighteen trainees completed the survey of whom all strongly agreed that learning was enhanced compared with didactics alone. The mean score for the value of the simulation in preparing trainees to perform future cervical biopsies was 4.7 (SD = 0.42) (95% confidence interval, 4.49-4.90).
    Conclusions: Our low-fidelity cervical biopsy models are easy to make, portable, and low cost. Trainees have reported the significant educational value of this simulation model in teaching an outpatient gynecologic/colposcopy procedure in a nonclinical environment.
    MeSH term(s) Biopsy ; Cervix Uteri ; Colposcopy ; Education, Medical/methods ; Female ; Gynecology/education ; Humans ; Models, Biological
    Language English
    Publishing date 2015-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2223429-9
    ISSN 1559-713X ; 1559-2332
    ISSN (online) 1559-713X
    ISSN 1559-2332
    DOI 10.1097/SIH.0000000000000065
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Implementation of laparoscopic virtual-reality simulation training in gynaecology: a mixed-methods design.

    Burden, Christy / Appleyard, Tracy-Louise / Angouri, Jo / Draycott, Timothy J / McDermott, Leanne / Fox, Robert

    European journal of obstetrics, gynecology, and reproductive biology

    2013  Volume 170, Issue 2, Page(s) 474–479

    Abstract: Objectives: Virtual-reality (VR) training has been demonstrated to improve laparoscopic surgical skills in the operating theatre. The incorporation of laparoscopic VR simulation into surgical training in gynaecology remains a significant educational ... ...

    Abstract Objectives: Virtual-reality (VR) training has been demonstrated to improve laparoscopic surgical skills in the operating theatre. The incorporation of laparoscopic VR simulation into surgical training in gynaecology remains a significant educational challenge. We undertook a pilot study to assess the feasibility of the implementation of a laparoscopic VR simulation programme into a single unit.
    Study design: An observational study with qualitative analysis of semi-structured group interviews. Trainees in gynaecology (n=9) were scheduled to undertake a pre-validated structured training programme on a laparoscopic VR simulator (LapSim(®)) over six months. The main outcome measure was the trainees' progress through the training modules in six months. Trainees' perceptions of the feasibility and barriers to the implementation of laparoscopic VR training were assessed in focus groups after training.
    Results: Sixty-six percent of participants completed six of ten modules. Overall, feedback from the focus groups was positive; trainees felt training improved their dexterity, hand-eye co-ordination and confidence in theatre. Negative aspects included lack of haptic feedback, and facility for laparoscopic port placement training. Time restriction emerged as the main barrier to training.
    Conclusions: Despite positive perceptions of training, no trainee completed more than two-thirds of the modules of a self-directed laparoscopic VR training programme. Suggested improvements to the integration of future laparoscopic VR training include an additional theoretical component with a fuller understanding of benefits of VR training, and scheduled supervision. Ultimately, the success of a laparoscopic VR simulation training programme might only be improved if it is a mandatory component of the curriculum, together with dedicated time for training. Future multi-centred implementation studies of validated laparoscopic VR curricula are required.
    MeSH term(s) Adult ; Female ; Gynecologic Surgical Procedures/education ; Gynecologic Surgical Procedures/methods ; Gynecology/education ; Gynecology/methods ; Humans ; Laparoscopy/education ; Laparoscopy/methods ; User-Computer Interface
    Language English
    Publishing date 2013-10
    Publishing country Ireland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 190605-7
    ISSN 1872-7654 ; 0301-2115 ; 0028-2243
    ISSN (online) 1872-7654
    ISSN 0301-2115 ; 0028-2243
    DOI 10.1016/j.ejogrb.2013.07.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Diagnostic accuracy of tests for lymph node status in primary cervical cancer: a systematic review and meta-analysis.

    Selman, Tara J / Mann, Christopher / Zamora, Javier / Appleyard, Tracy-Louise / Khan, Khalid

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2008  Volume 178, Issue 7, Page(s) 855–862

    Abstract: Background: Lymph node status is the key to determining the prognosis and treatment of cervical cancer. However, it cannot be assessed clinically, and testing for nodal metastasis is controversial. We sought to systematically review the diagnostic ... ...

    Abstract Background: Lymph node status is the key to determining the prognosis and treatment of cervical cancer. However, it cannot be assessed clinically, and testing for nodal metastasis is controversial. We sought to systematically review the diagnostic accuracy literature on sentinel node biopsy, positron emission tomography, magnetic resonance imaging and computed tomography to evaluate the accuracy of each index test in determining lymph node status in patients with cervical cancer.
    Methods: We searched MEDLINE (1966-2006), EMBASE (1980-2006), Medion (1980-2006) and the Cochrane library (Issue 2, 2006) for relevant articles. We also manually searched the reference lists from primary articles and reviews, and we contacted experts in the field for conference abstracts and unpublished studies. We performed random-effects meta-analysis of accuracy indices, and we performed meta-regression analysis to test the effect of study quality on diagnostic accuracy and to identify other sources of heterogeneity.
    Results: We included 72 relevant primary studies, involving a total of 5042 women, in our analysis. We found that, in determining lymph node status, sentinel node biopsy had a pooled positive likelihood ratio of 40.8 (95% confidence interval [CI] 24.6-67.6) and a pooled negative likelihood ratio of 0.18 (95% CI 0.14-0.24). The pooled positive likelihood ratios (and 95% CI) were 15.3 (7.9-29.6) for positron emission tomography, 6.4 (4.9-8.3) for magnetic resonance imaging and 4.3 (3.0-6.2) for computed tomography. The pooled negative likelihood ratios (and 95% CIs) were 0.27 (0.11-0.66) for positron emission tomography, 0.50 (0.39-0.64) for magnetic resonance imaging and 0.58 (0.48-0.70) for computed tomography. Using a 27% pretest probability of lymph node metastasis among all cases (regardless of stage), we found that a positive sentinel node biopsy result increased post-test probability to 94% (95% CI 90%-96%), whereas a positive finding on positron emission tomography increased it to 85% (75%-92%).
    Interpretation: Sentinel node biopsy has greater accuracy in determining lymph node status among women with primary cervical cancer than current commonly used imaging methods.
    MeSH term(s) Diagnostic Imaging ; Female ; Humans ; Likelihood Functions ; Lymph Nodes/pathology ; Lymphatic Metastasis/diagnosis ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy ; Uterine Cervical Neoplasms/pathology
    Language English
    Publishing date 2008-03-24
    Publishing country Canada
    Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.071124
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    Ua VI Zs.136: Show issues Location:
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