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Article ; Online: Neoadjuvant chemotherapy for ovarian cancer: Avoiding 'needless hurt'?

Morrison, Jo

BJOG : an international journal of obstetrics and gynaecology

2023 Volume 130, Issue 13, Page(s) 1589–1590

MeSH term(s)	Humans ; Female ; Neoadjuvant Therapy ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/pathology ; Carcinoma, Ovarian Epithelial/drug therapy ; Cytoreduction Surgical Procedures ; Neoplasm Staging
Language	English
Publishing date	2023-07-30
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	2000931-8
ISSN	1471-0528 ; 0306-5456 ; 1470-0328
ISSN (online)	1471-0528
ISSN	0306-5456 ; 1470-0328
DOI	10.1111/1471-0528.17627
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Article ; Online: Endometrial cancer follow up; finding the confidence to let go?

Morrison, Jo

BJOG : an international journal of obstetrics and gynaecology

2018 Volume 125, Issue 13, Page(s) 1715

MeSH term(s)	Endometrial Neoplasms ; Endometrium ; Fear ; Female ; Follow-Up Studies ; Humans ; Neoplasm Recurrence, Local
Language	English
Publishing date	2018-08-07
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	2000931-8
ISSN	1471-0528 ; 0306-5456 ; 1470-0328
ISSN (online)	1471-0528
ISSN	0306-5456 ; 1470-0328
DOI	10.1111/1471-0528.15395
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Article ; Online: Mixed methods study of attitudes on location of gynaecological oncology outpatient care: a patient and healthcare professional questionnaire.

Newhouse, Rebecca / Cullimore, Victoria / Hotton, Emily / Maxwell, Hilary / Jones, Eleanor / Morrison, Jo

BMJ open quality

2024 Volume 13, Issue 1

Abstract: Objective: Gynaecological oncology place of care is often based on evolution of services, along historical professional boundaries, rather than user needs or preferences. We aimed to assess existing evidence, gather views of patients in the UK on their ... ...

Abstract	Objective: Gynaecological oncology place of care is often based on evolution of services, along historical professional boundaries, rather than user needs or preferences. We aimed to assess existing evidence, gather views of patients in the UK on their preferred place of outpatient care for gynaecological malignancies and evaluate alignment with preferences of healthcare professionals (HCP). Methods: We performed a mixed methods study, including a scoping review, a patient survey and a healthcare practitioner questionnaire. We collected quantitative and qualitative data, performing content analysis to determine current practice and impact on patients. Results: No studies were identified in our scoping review. We received responses from 159 patients and 54 gynaecological oncology HCPs. There was a strong preference for a dedicated gynaecological oncology setting (89% somewhat or very happy) (p<0.0001). Fifty-three percent of patients were somewhat or very unhappy to have care colocated with general obstetrics and gynaecology services. Specifically, two key themes were identified through content analysis of qualitative data from patients: 'environment and getting this right is vital'; and 'our cancer should be the priority'. HCPs underestimated the strong patient preference to be seen in dedicated units. Of those who see patients within general obstetrics and gynaecology, only 50% said patients were seen at separate times/locations from obstetric patients. Conclusion: This study demonstrates the significant impact of place of care on gynaecological oncology patients, which may be underestimated by HCPs.
MeSH term(s)	Female ; Pregnancy ; Humans ; Genital Neoplasms, Female/therapy ; Gynecology/methods ; Surveys and Questionnaires ; Ambulatory Care ; Delivery of Health Care
Language	English
Publishing date	2024-01-17
Publishing country	England
Document type	Review ; Journal Article
ISSN	2399-6641
ISSN (online)	2399-6641
DOI	10.1136/bmjoq-2023-002539
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Article ; Online: Observational study of survival outcomes of people referred for 'fast-track' end-of-life care funding in a district general hospital: too little too late?

Morrison, Jo / Choudhary, Cherry / Beazley, Ryan / Richards, James / Davis, Charlie

BMJ open quality

2023 Volume 12, Issue 2

Abstract: Background: End-of-life care requires support for people to die where they feel safe and well-cared for. End-of-life care may require funding to support dying outside of hospital. In England, funding is procured through Continuing Healthcare Fast-Track ... ...

Abstract	Background: End-of-life care requires support for people to die where they feel safe and well-cared for. End-of-life care may require funding to support dying outside of hospital. In England, funding is procured through Continuing Healthcare Fast-Track funding, requiring assessment to determine eligibility. Anecdotal evidence suggested that Fast-Track funding applications were deferred where clinicians thought this inappropriate due to limited life-expectancy. Aim: To evaluate overall survival after Fast-Track funding application. Design: Prospective evaluation of Fast-Track funding application outcomes and survival. Setting/participants: All people in 2021 who had a Fast-Track funding application from a medium-sized district general hospital in Southwest England. Results: 439 people were referred for Fast-Track funding with a median age of 80 years (range 31-100 years). 413/439 (94.1%) died during follow-up, with a median survival of 15 days (range 0-436 days). Median survival for people with Fast-Track funding approved or deferred was 18 days and 25 days, respectively (p=0.0013). 129 people (29.4%) died before discharge (median survival 4 days) and only 7.5% were still alive 90 days after referral for Fast-Track funding. Conclusions: Fast-Track funding applications were deferred for those with very limited life-expectancy, with minimal clinical difference in survival (7 days) compared with those who had applications approved. This is likely to delay discharge to the preferred place of death and reduce quality of end-of-life care. A blanket acceptance of Fast-Track funding applications, with review for those still alive after 60 days, may improve end-of-life care and be more efficient for the healthcare system.
MeSH term(s)	Humans ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Hospitals, General ; Terminal Care ; Hospice Care ; Patient Discharge ; England
Language	English
Publishing date	2023-06-08
Publishing country	England
Document type	Observational Study ; Journal Article
ISSN	2399-6641
ISSN (online)	2399-6641
DOI	10.1136/bmjoq-2023-002279
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Article ; Online: Patient-initiated follow-up after treatment for low risk endometrial cancer: a prospective audit of outcomes and cost benefits.

Coleridge, Sarah / Morrison, Jo

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

2020 Volume 30, Issue 8, Page(s) 1177–1182

Abstract: Objective: Recurrence of low-risk endometrioid endometrial cancer is rare, and traditional hospital follow-up has a cost to both the patient and the healthcare system, without evidence of benefit. We examined the uptake of patient-initiated follow-up, ... ...

Abstract	Objective: Recurrence of low-risk endometrioid endometrial cancer is rare, and traditional hospital follow-up has a cost to both the patient and the healthcare system, without evidence of benefit. We examined the uptake of patient-initiated follow-up, pattern of recurrences, and survival for women following surgical treatment of low-risk endometrial cancer and compared estimated costs with hospital follow-up. Methods: This study was a prospective audit of outcomes following implementation of a patient-initiated follow-up policy in a UK-based gynecological cancer center for women with low-risk endometrial cancer treated surgically (International Federation of Gynecology and Obstetrics (FIGO) stage 1A, G1-2) from January 2010 to December 2015. Women were identified following multidisciplinary team meetings and data were collected from the electronic cancer register, paper, and electronic clinical records. Health service costs were calculated based on standard tariffs for follow-up appointments; patient costs were estimated from mileage traveled from home postcode and parking charges. Progression-free survival and overall survival were assessed. Estimated financial costs to the health service and patients of hospital follow-up were compared with actual patient-initiated follow-up costs. Results: A total of 129 women were offered patient-initiated follow-up (declined by four; accepted by another 11 after hospital follow-up for 6 months to 3.5 years) with median follow-up of 60.7 months (range 1.4-109.1 months). Ten women recurred: four vaginal vault recurrences (all salvaged), three pelvic recurrences (all salvaged), and three distant metastatic disease (all died). Five-year disease-specific survival was 97.3%. Ten women in the cohort died: three from endometrial cancer and seven from unrelated causes. The cost saving to the health service of patient-initiated follow-up compared with a traditional hospital follow-up regimen was £116 403 (median £988.60 per patient,range £0-£1071). Patients saved an estimated £7122 in transport and parking costs (median £57.22 per patient,range £4.98-£147.70). Conclusion: Patient-initiated follow-up for low risk endometrial cancer has cost benefits to both health service and patients. Those with pelvic or vault recurrence had salvageable disease, despite patient-initiated follow-up.
MeSH term(s)	Adult ; Aftercare/economics ; Aged ; Aged, 80 and over ; Cost Savings ; Cost-Benefit Analysis ; Endometrial Neoplasms/economics ; Endometrial Neoplasms/pathology ; Endometrial Neoplasms/surgery ; Female ; Follow-Up Studies ; Health Care Costs ; Humans ; Middle Aged ; Neoplasm Recurrence, Local/economics ; Neoplasm Recurrence, Local/therapy ; Nurse's Role ; Patient Participation/economics ; Progression-Free Survival ; Prospective Studies ; Risk Factors ; Survival Rate ; Transportation/economics
Language	English
Publishing date	2020-05-05
Publishing country	England
Document type	Journal Article
ZDB-ID	1070385-8
ISSN	1525-1438 ; 1048-891X
ISSN (online)	1525-1438
ISSN	1048-891X
DOI	10.1136/ijgc-2020-001263
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Zs.A 3198: Show issues

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Article ; Online: Antimicrobial use practices in canine and feline dental procedures performed in primary care veterinary practices in the United States.

Weese, J Scott / Battersby, Ian / Morrison, JoAnn / Spofford, Nathaniel / Soltero-Rivera, Maria

PloS one

2023 Volume 18, Issue 12, Page(s) e0295070

Abstract: This study examined the utilization of antimicrobials in canines and felines receiving dental treatments in veterinary clinics in the United States, retrospectively. A total of 818,150 animals (713,901 procedures in dogs and 104,249 procedures in cats) ... ...

Abstract	This study examined the utilization of antimicrobials in canines and felines receiving dental treatments in veterinary clinics in the United States, retrospectively. A total of 818,150 animals (713,901 procedures in dogs and 104,249 procedures in cats) underwent dental procedures under general anesthesia in 2020. These included dental prophylaxis and extractions. Patient demographic data, antimicrobial treatment, treatment duration, dose, periodontal disease score, whether tooth extractions were performed and how many extractions were performed was recorded. Our results showed that local or systemic antimicrobials were used in 116,723/713,901 (16.4%) procedures in dogs and 14,264/104,249 (14%) procedures in cats. Age, weight, extraction of one or more teeth and diagnosis of periodontal disease (any stage) were associated with increased likelihood of antimicrobial administration using univariable analysis (all P<0.001) and in the multivariable model. Clindamycin, amoxicillin-clavulanate and amoxicillin were the most common oral antimicrobials used in dogs and cats. Drugs classified as highest priority clinically important antibiotics (HPCIA) were administered to 30,960/116,723 (26.5%) of dogs and 7,469/14,264 (52%) of treated cats. The results obtained can inform interventions to optimize patient care and promote prudent use of antimicrobials during dental procedures in canine and feline patients.
MeSH term(s)	Humans ; Dogs ; Cats ; Animals ; United States ; Cat Diseases/drug therapy ; Retrospective Studies ; Dog Diseases/drug therapy ; Anti-Infective Agents/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Amoxicillin/therapeutic use ; Periodontal Diseases/drug therapy ; Tooth Extraction ; Primary Health Care
Chemical Substances	Anti-Infective Agents ; Anti-Bacterial Agents ; Amoxicillin (804826J2HU)
Language	English
Publishing date	2023-12-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0295070
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Small cell neuroendocrine tumour of the cervix in pregnancy: the importance of multidisciplinary management.

Bain, Esme / Coleridge, Sarah Louise / Morrison, Jo

BMJ case reports

2021 Volume 14, Issue 9

Abstract: A woman in her mid-20s presented with bleeding at 18 weeks gestation from a cervical 'polyp'. Histopathology demonstrated a rare small cell neuroendocrine of the cervix. There were only 18 cases of neuroendocrine tumours of the cervix in and around ... ...

Abstract	A woman in her mid-20s presented with bleeding at 18 weeks gestation from a cervical 'polyp'. Histopathology demonstrated a rare small cell neuroendocrine of the cervix. There were only 18 cases of neuroendocrine tumours of the cervix in and around pregnancy in the literature, so the evidence base for treatment was scarce. She was treated with neoadjuvant chemotherapy, using a regimen used for small cell neuroendocrine tumours of the lung, to allow for fetal lung maturity. Disease initially responded, then progressed and she was delivered at 32 weeks by caesarean radical hysterectomy. Adjuvant treatment included further chemotherapy and radical pelvic radiotherapy. The woman and her child are doing well over 6 years after treatment, although the woman has significant side effects of both radical surgery and radiotherapy. This case emphasises the need for excellent communication between multidisciplinary professionals, patients and their families and using external colleagues to help with rare clinical problems.
MeSH term(s)	Adult ; Female ; Humans ; Hysterectomy ; Neoadjuvant Therapy ; Neuroendocrine Tumors ; Pregnancy ; Uterine Cervical Neoplasms/surgery
Language	English
Publishing date	2021-09-13
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2020-237058
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Article ; Online: Breed, smaller weight, and multiple injections are associated with increased adverse event reports within three days following canine vaccine administration.

Moore, George E / Morrison, JoAnn / Saito, Emi K / Spofford, Nathaniel / Yang, Mike

Journal of the American Veterinary Medical Association

2023 Volume 261, Issue 11, Page(s) 1653–1659

Abstract: Objective: To evaluate patient and vaccine factors associated with adverse events (AEs) recorded within 3 days of vaccine administration in a large cohort of dogs.: Animals: 4,654,187 dogs vaccinated in 16,087,455 office visits in a 5-year period at ... ...

Abstract	Objective: To evaluate patient and vaccine factors associated with adverse events (AEs) recorded within 3 days of vaccine administration in a large cohort of dogs. Animals: 4,654,187 dogs vaccinated in 16,087,455 office visits in a 5-year period at 1,119 hospitals of a corporate practice. Methods: Electronic medical records of dogs vaccinated between January 1, 2016, and December 31, 2020, were searched for diagnoses of possible AEs recorded within 3 days of administration of vaccines without concurrent injectable heartworm preventative. Patient risk factors (age, sex, breed, and weight) and number and type of vaccine were extracted from records. ORs (and 95% CIs) for risk factors were estimated via multivariable logistic regression mixed models with patient as a random effect. Results: AEs were recorded following 31,197 vaccination visits (0.19%, or 19.4/10,000 visits). Reported AE rates increased from 1 to 4 vaccines administered and among individual vaccines were greatest for rabies vaccine. AE rate was generally inversely related to body weight, with largest rates in dogs ≤ 5 kg. The largest AE rates were noted in French Bulldogs and Dachshunds (ORs > 4 compared to mixed-breed dogs). Clinical relevance: Risk factor information can be used to update vaccination protocols and client communication. Breed differences may indicate genetics as the primary risk factor for adverse vaccine reactions following vaccinations.
MeSH term(s)	Humans ; Dogs ; Animals ; Vaccination/adverse effects ; Vaccination/veterinary ; Vaccines ; Risk Factors ; Drug-Related Side Effects and Adverse Reactions/veterinary ; Dog Diseases/etiology
Chemical Substances	Vaccines
Language	English
Publishing date	2023-07-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	390811-2
ISSN	1943-569X ; 0003-1488
ISSN (online)	1943-569X
ISSN	0003-1488
DOI	10.2460/javma.23.03.0181
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Zs.A 423: Show issues

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Article ; Online: Younger dogs of specific breeds are more likely to experience a rare adverse event after administration of extended-release injectable moxidectin heartworm preventive.

Saito, Emi K / Moore, George E / Morrison, JoAnn / Spofford, Nathaniel / Yang, Mike

Journal of the American Veterinary Medical Association

2023 Volume 261, Issue 11, Page(s) 1666–1672

Abstract: Objective: To estimate the incidence of and identify patient risk factors for an acute adverse event in dogs after administration of a sustained-release injectable heartworm preventive product.: Animals: Canine patients that received the injectable ... ...

Abstract	Objective: To estimate the incidence of and identify patient risk factors for an acute adverse event in dogs after administration of a sustained-release injectable heartworm preventive product. Animals: Canine patients that received the injectable heartworm preventive product during routine preventive care visits. Methods: Retrospective analysis of electronic medical records of canine visits within a large network of primary care veterinary clinics in which the product was administered from January 1, 2016, through December 31, 2020. Visits during which vaccination(s) were also administered were excluded from analysis. Identification of acute adverse events was based on diagnostic entries and other clinical presentations suggestive of an adverse event within 3 days of product administration. Data were analyzed using mixed-effects logistic regression. Results: In the 5-year study period, 1,399,289 visits with 694,030 dogs led to an incidence estimate of approximately 14.3 events/10,000 doses. Regression analysis found younger dogs and 7 breeds (relative to mixed-breed dogs) to have statistically significant greater odds of an event. Clinical relevance: Understanding of incidence and patient risk factors provides veterinary professionals and dog owners more information when deciding on heartworm preventive options for their dog when considering risk for adverse event in dogs of certain ages or breeds.
MeSH term(s)	Humans ; Dogs ; Animals ; Dirofilaria immitis ; Dirofilariasis/prevention & control ; Dirofilariasis/epidemiology ; Retrospective Studies ; Dog Diseases/diagnosis ; Macrolides
Chemical Substances	moxidectin (NGU5H31YO9) ; Macrolides
Language	English
Publishing date	2023-06-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	390811-2
ISSN	1943-569X ; 0003-1488
ISSN (online)	1943-569X
ISSN	0003-1488
DOI	10.2460/javma.23.04.0217
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Article ; Online: Improving outcomes in gynaecological cancer: the benefits of subspecialisation.

Morrison, Jo

The Cochrane database of systematic reviews

2012 , Issue 4, Page(s) ED000040

MeSH term(s)	Centralized Hospital Services ; Female ; Genital Neoplasms, Female/therapy ; Humans
Language	English
Publishing date	2012-03-06
Publishing country	England
Document type	Editorial ; Comment
ISSN	1469-493X
ISSN (online)	1469-493X
DOI	10.1002/14651858.ED000040
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