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  1. Article ; Online: A job task analysis of the authorised firearms officer - counter terrorism (AFO-CT) national role profile.

    Powell, Steven D / Hogan, Joseph / Fallowfield, Joanne L / Brown, Pieter E H / Tsang, Fiona / Fisken, Alison / Rowland, Daniel / Richards, Lana / Allsopp, Adrian J

    Work (Reading, Mass.)

    2024  Volume 77, Issue 4, Page(s) 1223–1234

    Abstract: Background: The Ministry of Defence Police recognised the requirement to develop a Physical Employment Standard (PES) for the Authorised Firearms Officer -Counter Terrorism (AFO-CT) role profile.: Objective: The purpose of this study was to conduct a ...

    Abstract Background: The Ministry of Defence Police recognised the requirement to develop a Physical Employment Standard (PES) for the Authorised Firearms Officer -Counter Terrorism (AFO-CT) role profile.
    Objective: The purpose of this study was to conduct a job task analysis to identify the most critical and physically demanding tasks performed by AFO-CT personnel.
    Methods: A focus group and online survey were undertaken to identify a list of job tasks. The down-selected job tasks were objectively monitored during training events to determine the most physically demanding tasks. Tasks were ranked by physical demand and additional factors (e.g., operational load, primary physical actions). Down-selected tasks were then included in a Subject Matter Experts (SME) task scenario generation workshop. The physiological demands of the resulting standardised scenarios were determined.
    Results: The focus group (n = 11) identified 13 physically demanding and critical role-related tasks. The subsequent survey (n = 907) down-selected eight tasks with a 'moderate' demand or greater. Thirty AFO-CT personnel completed the eight tasks as part of routine training events. From the observed tasks, four tasks were down-selected and combined into two operationally relevant, reasonable worst-case standardised scenarios during a SME workshop. The two scenarios, 'Conduct Armed Search in the Open for an Active Shooter' and 'Victim Focussed Emergency Search' were used in subsequent phases of the research to form the basis of the AFO-CT PES.
    Conclusion: This research elucidated the most physically demanding job tasks within the AFO-CT role profile to inform the development of a MOD armed policing PES.
    MeSH term(s) Humans ; Task Performance and Analysis ; Employment ; Physical Examination ; Police ; Tomography, X-Ray Computed ; Physical Fitness
    Language English
    Publishing date 2024-01-21
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1394194-x
    ISSN 1875-9270 ; 1051-9815
    ISSN (online) 1875-9270
    ISSN 1051-9815
    DOI 10.3233/WOR-230246
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4810: Show issues Location:
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  2. Article ; Online: Improvement in cognitive impairment following the successful treatment of endogenous Cushing's syndrome-a case report and literature review.

    Brzozowska, Malgorzata Monika / Kepreotis, Sacha / Tsang, Fiona / Fuentes-Patarroyo, Sully Xiomara

    BMC endocrine disorders

    2019  Volume 19, Issue 1, Page(s) 68

    Abstract: Background: Endogenous Cushing's syndrome, a rare endocrine disorder, characterised by chronic cortisol hypersecretion, results in neuropsychiatric disturbances and in cognitive deficits, which are only partially reversible after the biochemical ... ...

    Abstract Background: Endogenous Cushing's syndrome, a rare endocrine disorder, characterised by chronic cortisol hypersecretion, results in neuropsychiatric disturbances and in cognitive deficits, which are only partially reversible after the biochemical remission of the disease.
    Case presentation: We report a case of a woman with a profound cognitive deficit and a gradual functional decline caused by Cushing's disease of at least 10 years duration. The neurosurgical resection of her 2 mm adrenocorticotropic hormone (ACTH) secreting pituitary microadenoma resulted in a successful resolution of the patient's hypercortisolism and a significant recovery of her neurocognitive function. The patient's progress was evaluated using serial clinical observations, functional assessments, Mini-Mental Status exams and through the formal neuropsychological report. Furthermore, the patient's recovery of her neurocognitive function was reflected by a sustained improvement in the patient's specific structural brain abnormalities on radiological imaging.
    Conclusions: This report illustrates the importance of early detection and treatment of Cushing's syndrome in order to prevent neurocognitive impairment and neuropsychiatric disorders which are associated with an endogenous cortisol hypersecretion. The long term adverse effects of severe hypercortisolaemia on brain function and the pathophysiological mechanisms responsible for the structural and functional changes in brain anatomy due to glucocorticoid excess are reviewed.
    MeSH term(s) ACTH-Secreting Pituitary Adenoma/diagnostic imaging ; ACTH-Secreting Pituitary Adenoma/surgery ; Brain/diagnostic imaging ; Cognition ; Cushing Syndrome/complications ; Cushing Syndrome/diagnostic imaging ; Cushing Syndrome/surgery ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurocognitive Disorders/complications ; Neurocognitive Disorders/surgery ; Remission Induction ; Time Factors
    Language English
    Publishing date 2019-06-28
    Publishing country England
    Document type Case Reports ; Journal Article ; Review
    ISSN 1472-6823
    ISSN (online) 1472-6823
    DOI 10.1186/s12902-019-0401-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: The Modified Crescenteric Anterior Intercostal Perforator Flap.

    Denning, Max / Hayes, Philippa / Tsang, Fiona / Leff, Daniel / Thiruchelvam, Paul / Hadjiminas, Dimitri

    Plastic and reconstructive surgery. Global open

    2020  Volume 8, Issue 5, Page(s) e2785

    Abstract: Lower pole breast cancers are challenging to manage because conventional wide local excision may produce a "bird's beak" deformity. In an era of oncoplastic surgery, techniques that balance oncological results with cosmetic outcomes such as local flaps ... ...

    Abstract Lower pole breast cancers are challenging to manage because conventional wide local excision may produce a "bird's beak" deformity. In an era of oncoplastic surgery, techniques that balance oncological results with cosmetic outcomes such as local flaps have extended the role of breast-conserving surgery. Local flaps are particularly useful for partial breast reconstruction due to the relative simplicity of the surgical procedure and reduced morbidity. Intercostal artery perforator flaps have a shorter duration of surgery than free flaps and do not require microsurgical anastomoses. Anterior intercostal artery perforator (AICAP) flaps provide excellent cosmesis, yet traditional crescenteric harvest yields limited volume for reconstruction. We describe a modification to an established reconstructive technique for lower pole breast defects. The technique is based on 3 extensions of tissue, providing a larger volume of tissue replacement compared with traditional AICAP flaps. The technique is particularly suitable for small- and medium-sized non-ptotic breasts, with lower pole tumors. The modified crescenteric AICAP technique can be used to increase the available tissue when performing lower pole reconstructions.
    Language English
    Publishing date 2020-05-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2851682-5
    ISSN 2169-7574 ; 2169-7574
    ISSN (online) 2169-7574
    ISSN 2169-7574
    DOI 10.1097/GOX.0000000000002785
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 7091: Show issues Location:
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  4. Article ; Online: Patient Safety Education 20 Years After the Institute of Medicine Report: Results From a Cross-sectional National Survey.

    Arora, Sonal / Tsang, Fiona / Kekecs, Zoltan / Shah, Nisha / Archer, Stephanie / Smith, Jason / Darzi, Ara

    Journal of patient safety

    2019  Volume 17, Issue 8, Page(s) e1884–e1888

    Abstract: Objectives: Educating healthcare professionals in patient safety is essential to achieving sustainable improvements in care. This study aimed to identify the key constituents of patient safety education alongside its facilitators and barriers from a ... ...

    Abstract Objectives: Educating healthcare professionals in patient safety is essential to achieving sustainable improvements in care. This study aimed to identify the key constituents of patient safety education alongside its facilitators and barriers from a frontline perspective.
    Methods: An electronic survey was sent to 592 healthcare professionals and educators in patient safety education in the United Kingdom. Two independent reviewers conducted a thematic analysis of the free-text data. Themes focused on effective content, learning practices and facilitators and barriers to patient safety education.
    Results: Of 592 individuals completing the survey, 545 (92%) submitted analyzable responses. Interrater reliability of coding was high with Cohen k value of 0.86. Participants endorsed experiential and interactive learning as ideal modalities for delivery and expressed a need for content to be based on real clinical cases and tailored to the needs of the learners. The most commonly mentioned facilitators were standardization of methods and assessment (49%), dedicated funding (21%), and culture of openness (20%). Staffing problems and high workload (41%) and lack of accessibility of training (23%) were identified as primary barriers of efficacy and uptake.
    Conclusions: This study identified key factors to the success of patient safety education in terms of content and delivery alongside facilitators and barriers. Future curricula developers and interventions should improve standardization, funding, culture, and access so as to optimize education programs to enhance patient safety.
    MeSH term(s) Cross-Sectional Studies ; Health Personnel ; Humans ; National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division ; Patient Safety ; Reproducibility of Results ; United States
    Language English
    Publishing date 2019-09-30
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2394324-5
    ISSN 1549-8425 ; 1549-8417
    ISSN (online) 1549-8425
    ISSN 1549-8417
    DOI 10.1097/PTS.0000000000000676
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6583: Show issues Location:
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  5. Article ; Online: Obstructive sleep apnoea and 12-month weight loss in adults with class 3 obesity attending a multidisciplinary weight management program.

    Kobuch, Sophie / Tsang, Fiona / Chimoriya, Ritesh / Gossayn, Daniel / O'Brien, Sarah / Jamal, Javeria / Laks, Leon / Tahrani, Abd / Kormas, Nic / Piya, Milan K

    BMC endocrine disorders

    2021  Volume 21, Issue 1, Page(s) 227

    Abstract: Background: Although there is a strong association between obesity and obstructive sleep apnoea (OSA), the effects of OSA and CPAP therapy on weight loss are less well known. The aim of this study in adults with class 3 obesity attending a ... ...

    Abstract Background: Although there is a strong association between obesity and obstructive sleep apnoea (OSA), the effects of OSA and CPAP therapy on weight loss are less well known. The aim of this study in adults with class 3 obesity attending a multidisciplinary weight management program was to assess the relationship between OSA and CPAP usage, and 12-month weight change.
    Methods: A retrospective cohort study of all patients commencing an intensive multidisciplinary publicly funded weight management program in Sydney, Australia, between March 2018 and March 2019. OSA was diagnosed using laboratory overnight sleep studies. Demographic and clinical data, and use of CPAP therapy was collected at baseline and 12 months. CPAP use was confirmed if used ≥4 h on average per night on download.
    Results: Of the 178 patients who joined the program, 111 (62.4 %) completed 12 months in the program. At baseline, 63.1 % (n=70) of patients had OSA, of whom 54.3 % (n=38) were using CPAP. The non-OSA group had more females compared to the OSA with CPAP group and OSA without CPAP group (90.2 % vs. 57.9 % and 62.5 %, respectively; p=0.003), but there were no significant baseline differences in BMI (50.4±9.3 vs. 52.1±8.7 and 50.3±9.5 kg/m
    Conclusions: This multidisciplinary weight management program resulted in significant weight loss at 12 months, regardless of OSA diagnosis or CPAP use in adults with class 3 obesity. Larger studies are needed to further investigate the effects of severity of OSA status and CPAP use in weight management programs. Until completed, this study suggests that the focus should remain on implementing lifestyle changes and weight management regardless of OSA status.
    MeSH term(s) Adult ; Aged ; Case-Control Studies ; Cholesterol/metabolism ; Continuous Positive Airway Pressure/methods ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/metabolism ; Female ; Humans ; Hypoglycemic Agents/therapeutic use ; Lipoproteins, HDL/metabolism ; Lipoproteins, LDL/metabolism ; Male ; Middle Aged ; Obesity, Morbid/complications ; Obesity, Morbid/metabolism ; Obesity, Morbid/therapy ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/therapy ; Triglycerides/metabolism ; Weight Loss ; Weight Reduction Programs/methods
    Chemical Substances Hypoglycemic Agents ; Lipoproteins, HDL ; Lipoproteins, LDL ; Triglycerides ; Cholesterol (97C5T2UQ7J)
    Language English
    Publishing date 2021-11-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 2091323-0
    ISSN 1472-6823 ; 1472-6823
    ISSN (online) 1472-6823
    ISSN 1472-6823
    DOI 10.1186/s12902-021-00887-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Synchronous Orbital and Gastrointestinal Metastases from Breast Cancer: A Case Report and Review of Literature.

    Soobrah, Ramawad / Tsang, Fiona / Grassi, Veronica / Hirji, Hassan / Mallappa, Sreelakshmi / Reichert, Robert

    Case reports in oncological medicine

    2015  Volume 2015, Page(s) 282790

    Abstract: Breast cancer is the most common malignancy among women and is a significant cause of morbidity and mortality worldwide. With the advent of improved imaging techniques and screening programmes, only a small proportion of women present with metastatic ... ...

    Abstract Breast cancer is the most common malignancy among women and is a significant cause of morbidity and mortality worldwide. With the advent of improved imaging techniques and screening programmes, only a small proportion of women present with metastatic disease. Metastases involving the gastrointestinal (GI) tract and orbit are rare occurrences. We describe the case of a woman with simultaneous GI and orbital metastases from breast cancer who initially presented with abdominal pain and blurred vision and also summarise a review of the literature.
    Language English
    Publishing date 2015-05-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2629911-2
    ISSN 2090-6714 ; 2090-6706
    ISSN (online) 2090-6714
    ISSN 2090-6706
    DOI 10.1155/2015/282790
    Database MEDical Literature Analysis and Retrieval System OnLINE

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