Maureen Twiddy

University of Hull · Hull York Medical School (HYMS)

Treatment for childhood obesity is characterised by high attrition rates and failure to achieve weight maintenance. It is therefore important to develop more effective programmes. The aim of the present qualitative study was to explore the views of parents, children and health trainers to identify issues which can inform the development of more eff...

Continuity of care is widely acknowledged as important for patients with multi-morbidity but simple, service-orientated indices cannot capture the full impact of continuity in complex care delivery systems. The patient’s perspective is important to assess outcomes fully and this is challenging because generic measures of patient-perceived continuit...

Introduction Provide evidence to support evolving management strategies for high-risk (B3) breast lesions by assessing risk of carcinoma in subgroups of B3 lesions using systematic review and meta-analysis. Methods Databases identified observational studies between 1980 and 2015 that reported on underestimation of malignancy following B3 lesion di...

Background: Approximately 30 000 people undergo major emergency abdominal gastrointestinal surgery annually, and 36 per cent of these procedures (around 10 800) are carried out for emergency colorectal pathology. Some 14 per cent of all patients requiring emergency surgery have a laparoscopic procedure. The aims of the LaCeS (laparoscopic versus o...

Background Microplastics (MPs) are omnipresent in the environment, including the human food chain; a likely important contributor to human exposure is drinking water. Objective To undertake a systematic review of MP contamination of drinking water and estimate quantitative exposures. Methods The protocol for the systematic review employed has bee...

Introduction MicroUS is a new imaging technique that may have potential to reliably monitor prostate disease and therefore release capacity in MRI departments. Firstly, however, it is essential to identify which healthcare staff may be suitable to learn to use this modality. Based on previous evidence, UK sonographers may be well placed to harness...

Emerging evidence suggests that extracorporeal shockwave therapy (ESWT) may improve time to DFU healing. The aim of this review was to appraise the evidence on role of ESWT in DFU healing and impact of different ESWT doses. Databases were searched for trials comparing ESWT plus standard care to standard care alone in participants with DFUs. Search...

OBJECTIVE: In England, Electronic Palliative Care Coordination Systems (EPaCCS) were introduced in 2008 to support care coordination and delivery in accordance with patient preferences. Despite policy supporting their implementation, there has been a lack of rigorous evaluation of EPaCCS and it is not clear how they have been translated into practi...

As the effects of climate change become more visible, extreme weather events are becoming more common. The effects of flooding on health are understood but the long-term impact on the well-being of those affected need to be considered. This mixed methods secondary analysis of a cross-sectional survey examined the extent to which being flooded in th...

Introduction Admissions for ArLD continue to rise across the NHS in England. It is estimated up to 60% are in need of specialist interventions on discharge. The interventions often delivered in the community include behavioural, psychological and pharmacological treatments to support alcohol reduction/cessation with the goal of abstinence. National...

Introduction Delirium is a complex condition in which altered mental state and cognition causes severe distress and poor clinical outcomes for patients and families, anxiety and stress for the health professionals and support staff providing care, and higher care costs. Hospice patients are at high risk of developing delirium, but there is signific...

Objectives Men living with prostate cancer have supportive and palliative needs. However, few studies detail unmet needs (vs quality of life measurement) or include data from those with advanced disease. We aimed to identify unmet needs of people living with prostate cancer (men, family carers), including those with advanced disease. Methods Mixed...

Background: Diabetes and vascular disease are the leading causes of lower limb amputation. Currently, 463 million adults are living with diabetes, and 202 million with peripheral vascular disease, worldwide. When a lower limb amputation is considered, preservation of the knee in a below-knee amputation allows for superior functional recovery when...

Humans are exposed to microplastics (MPs) daily via ingestion and inhalation. It is not known whether this results in adverse health effects and, if so, at what levels of exposure. Without epidemiological studies, human cell in vitro MP toxicological studies provide an alternative approach to this question. This review systematically synthesised al...

Objective The objective of this study is to explore the specific information and communication needs of men affected by prostate cancer to inform the development of educational materials for clinicians. Methods This is a qualitative descriptive study. A purposive sampling strategy was used to identify men at different cancer stages and with experi...

Background Incremental haemodialysis/haemodiafiltration (HD) may help reduce early mortality rates in patients starting HD. This mixed-method feasibility study aims to test the acceptability, tolerance and safety of a novel incremental HD regime, and to study its impact on parameters of patient wellbeing. Method We aim to enrol 20 patients who...

Background and Aims Mortality rates are high in patients starting haemodialysis/haemodiafiltration (HD) therapy. Incremental HD may help reduce this risk by reducing the burden of early treatment whilst patients are still adapting to long-term HD therapy. A feasibility study (ENDURE study – Clinical trials ID: NCT04268264) is being conducted with t...

Background The use of multiparametric magnetic resonance imaging (mpMRI) within active surveillance of prostate cancer programmes is identified by the UK National Institute for Health and Care Excellence (NICE guideline NG 131 2019) as having a role for monitoring disease. The widespread demands on mpMRI capacity may limit its use in surveillance....

Poor participant engagement threatens the potential impact and cost-effectiveness of public health programmes preventing meaningful evaluation and wider application. Although barriers and levers to engagement with public health programmes are well documented, there is a lack of proven strategies in the literature addressing these. This paper detail...

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of through‐knee amputation compared to above‐knee amputation on clinical and rehabilitation outcomes and complication rates in all patients undergoing vascular and non‐vascular major lower limb amputations.

Background: Microplastics (MPs) have contaminated all compartments of the marine environment including biota such as seafood; ingestion from such sources is one of the two major uptake routes identified for human exposure. Objectives: The objectives were to conduct a systematic review and meta-analysis of the levels of MP contamination in seafoo...

PURPOSE High-grade nonmuscle invasive bladder cancer (HRNMIBC) is a heterogeneous disease. Treatments include intravesical maintenance Bacillus Calmette-Guerin (mBCG) and radical cystectomy (RC). We wanted to understand whether a randomized trial comparing these options was possible. MATERIALS AND METHODS We conducted a two-arm, prospective multic...

Microplastics (MPs) are an emerging contaminant ubiquitous in the environment. There is growing concern regarding potential human health effects, a major human exposure route being dietary uptake. We have undertaken a systematic review (SR) and meta-analysis to identify all relevant research on MP contamination of salt intended for human consumptio...

Choice modelling techniques have established themselves as a key analysis tool in health economics and have been used to understand patient and practitioner preferences across a wide variety of settings. A key interest in recent years has been the incorporation of ever more flexible levels of heterogeneity in preferences across individual decision...

Background: Realist methodologies are increasingly being used to evaluate complex interventions in health and social care. Programme theory (ideas and assumptions of how a particular intervention works) development is the first step in a realist evaluation or a realist synthesis, with literature reviews providing important evidence to support this...

Colorectal cancer is one of the most commonly occurring cancers in the world, and colonoscopy is the most sensitive procedure to detect it. Colonoscopy success depends on the quality of bowel preparation, but the way information is designed and communicated to patients does not meet their needs. This study investigates the advantage of visualized i...

Introduction The first-line recommended treatment for patients with intermittent claudication (IC) is a supervised exercise programme (SEP), which includes a minimum of 2-hours of exercise per week over a 12-week period. However, provision, uptake and adherence rates for these SEP programmes are poor, with time constraints cited as a common partici...

Background Realist methodologies are increasingly being used to evaluate complex interventions in health and social care. Programme theory development (ideas and assumptions of how a particular intervention works) is a key initial step in realist methodology, with literature reviews providing important evidence to support this. Deciding how to sear...

Background Realist methodologies are increasingly being used to evaluate complex interventions in health and social care. Programme theory (ideas and assumptions of how a particular intervention works) development is the first step in a realist evaluation or a realist synthesis, with literature reviews providing important evidence to support this....

Background Poor participant engagement threatens the potential impact and cost effectiveness of public health programmes preventing meaningful evaluation and wider application. Although barriers and levers to participant engagement with public health programmes are well documented, there is a lack of proven strategies in the literature addressing t...

Background Although surgical resection has been considered the only curative option for colorectal liver metastases, thermal ablation has recently been suggested as an alternative curative treatment. There have been no adequately powered trials comparing surgery with thermal ablation. Objectives Main objective – to compare the clinical effectivene...

Introduction Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive lung disease that causes breathlessness and cough that worsen over time, limiting daily activities and negatively impacting quality of life. Although treatments are now available that slow the rate of lung function decline, trials of these treatments have failed to show i...

Introduction Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive lung disease that causes breathlessness and cough that worsen over time, limiting daily activities and negatively impacting quality of life. Although treatments are now available that slow the rate of lung function decline, trials of these treatments have failed to show i...

Background: Children's centres in the UK provide a setting for public health programmes; offering support to families living in the most disadvantaged areas where obesity prevalence is at its highest. Health, Exercise and Nutrition in the Really Young (HENRY) is an eight-week obesity prevention programme currently delivered in children's centres a...

Objectives Patient and public involvement (PPI) is argued to lead to higher quality health research, which is more relatable to and helps empower the public. We synthesised the evidence to look for examples of PPI in health research in low/middle-income countries (LMICs), looking at levels of involvement and impact. Additionally, we considered the...

Background Chronic breathlessness is common in cardiorespiratory conditions and is frequently associated with emergency department (ED) presentation when the patient experiences acute-on-chronic breathlessness. Breathing Space is a concept combining patient coping, help-seeking and clinician responsiveness to breathlessness in addition to disease-m...

Background: Parenting programmes are recommended for conduct disorders in 5-11 year olds, but ineffective for 25-33%. A feasibility trial was needed to determine whether a confirmatory trial of second-line, manualised short-term psychoanalytic child psychotherapy (mPCP) versus treatment as usual (TaU) is practicable. Method: This was a two-arm,...

Background Protein biomarkers with associations with the activity and outcomes of diseases are being identified by modern proteomic technologies. They may be simple, accessible, cheap and safe tests that can inform diagnosis, prognosis, treatment selection, monitoring of disease activity and therapy and may substitute for complex, invasive and expe...

Introduction Acute colorectal surgery forms a significant proportion of emergency admissions within the National Health Service. There is limited evidence to suggest minimally invasive surgery may be associated with improved clinical outcomes in this cohort of patients. Consequently, there is a need to assess the clinical effectiveness and cost-eff...

Background Although surgical resection has been considered the only curative option for colorectal liver metastases (CLM), thermal ablation has recently been suggested as an alternative curative treatment. A prospective randomised trial is required to define the efficacy of resection vs ablation for the treatment of colorectal liver metastases. Met...

Objective Outpatient parenteral antimicrobial therapy (OPAT) provides opportunities for improved cost savings, but in the UK, implementation is patchy and a variety of service models are in use. The slow uptake in the UK and Europe is due to a number of clinical, financial and logistical issues, including concern about patient safety. The measureme...

Background The National Institute for Health and Care Excellence (NICE) recommends evidence-based parenting programmes as a first-line intervention for conduct disorders (CD) in children aged 5–11 years. As these are not effective in 25–33% of cases, NICE has requested research into second-line interventions. Child and Adolescent Psychotherapists (...

Purpose Bladder cancer (BC) is a common disease with disparate treatment options and variable outcomes. Despite the disease’s high prevalence, little is known of the lived experience of affected patients. National patient experience surveys suggest that those with BC have poorer experiences than those with other common cancers. The aim of this revi...

Introduction High-risk non-muscle invasive bladder cancer (HRNMIBC) is a heterogeneous disease that can be difficult to predict. While around 25% of cancers progress to invasion and metastases, the remaining majority of tumours remain within the bladder. It is uncertain whether patients with HRNMIBC are better treated with intravesical maintenance...

Objectives: In the UK, patients who require intravenous antimicrobial (IVA) treatment may receive this in the community through outpatient parenteral antimicrobial therapy (OPAT) services. Services include: IVA administration at a hospital outpatient clinic (HO); IVA administration at home by a general nurse (GN) or a specialist nurse (SN); or pat...

Objective Evaluate evidence of the efficacy, safety, acceptability and cost-effectiveness of outpatient parenteral antimicrobial therapy (OPAT) models. Design A systematic review. Data sources MEDLINE, EMBASE, CINAHL, Cochrane Library, National Health Service (NHS) Economic Evaluation Database (EED), Research Papers in Economics (RePEc), Tufts Co...

Background Outpatient parenteral antimicrobial therapy (OPAT) is widely used in most developed countries, providing considerable opportunities for improved cost savings. However, it is implemented only partially in the UK, using a variety of service models. Objectives The aims of this research were to (1) establish the extent of OPAT service model...

Introduction: This qualitative study was conducted to explore the motivations and experience of oocyte donors donating to women known to them. Methods: Three women who donated oocytes to a close relative were interviewed and data were analysed using an Interpretative Phenomenological Analysis approach. Results: The two key elements noted were ?moti...

Introduction In 2013 a BTS survey showed substantial variability in the advice that patients with obstructive sleep apnoea syndrome (OSAS) would be likely to receive from clinicians with regard to whether they were fit to drive or not. Since then the BTS has issued guidance and the DVLA changed its emphasis to sleepiness “likely to impair safe driv...

Staging and restaging for distant metastatic disease in breast cancer: has anything changed in the last four years? Since 2012 there has been recognition by many professional bodies that whole body screening for distant metastatic disease in early stage breast cancer is a fruitless and costly exercise, that generates excessive numbers of supplemen...

Introduction: Outpatient parenteral antimicrobial therapy (OPAT) is used to treat a wide range of infections, and is common practice in countries such as the USA and Australia. In the UK, national guidelines (standards of care) for OPAT services have been developed to act as a benchmark for clinical monitoring and quality. However, the availabilit...

Background Trigeminal Neuralgia (TN) is a serious health problem, causing brief, recurrent episodes of stabbing or burning facial pain, which patients describe as feeling like an electric shock. The consequences of living with the condition are severe. There is currently no cure for TN and management of the condition can be complex, often delayed b...

We evaluated clinicians' current practice for giving advice to patients with obstructive sleep apnoea syndrome. Clinicians were invited to complete a web-based survey and indicate the advice they would give to patients in a number of scenarios about driving; they were also asked what they considered to be residual drowsiness and adequate compliance...

Introduction Clinicians are often asked to complete forms about patients with OSAS by the DVLA. We evaluated the current practice of assessing residual drowsiness, CPAP compliance and whether objective testing is undertaken by clinicians to assess an individual’s fitness for driving. Methods Clinicians who complete the DVLA medical forms (SL1 and S...

Introduction Advice about driving is a key component of the management of OSAS patients. No objective tests have been shown to predict reliably whether an individual is safe to drive or not and therefore the advice given will depend upon the opinion of clinicians. We evaluated the current practice of advice given regarding fitness to drive in OSAS...

It is good practice for the public to be involved in developing health research. Resources should be available for researchers to fund the involvement of the public in the development of their grants. To describe a funding award scheme to support public involvement in grant development, managed by an NIHR Research Design Service (RDS). Case example...