ORCID Profile
0000-0002-7252-9515
Current Organisation
University of Southampton
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Publisher: SAGE Publications
Date: 15-06-2022
DOI: 10.1177/1742271X211023800
Abstract: The Achilles tendon is the most frequently ruptured tendon. Prompt diagnosis of this injury ensures optimal management decisions are instituted early ensuring the best outcome and patient experience, at minimal cost to the United Kingdom National Health Service. Despite this, regional and national variations to diagnosis and management exist, with anecdotal evidence of inefficiencies in the local patient pathway. To explore this further, a retrospective departmental audit of timescales from presentation to ultrasound diagnosis and definitive treatment decision was undertaken. All suspected Achilles tendon ruptures in 2018 were identified through electronic and written patient records, and information on timescales involved in the diagnosis and management of each compiled. Descriptive statistics were used to map each step of the pathway and timescales involved, with performance assessed against local departmental standards and the Swansea Morriston Achilles Rupture Treatment (SMART) protocol. In total, 119 patients were identified, of which 113 received an ultrasound examination. Local departmental standards were met in the majority of cases, with 78% (n = 88) diagnosed by ultrasound within one week of the request and 83% (n = 91) given a treatment decision within two weeks of presentation. However, this was suboptimal when compared with timeframes utilised for developing the SMART protocol, with only 7% (n = 8) scanned within 48 hours of presentation. Key areas of the patient pathway were identified for quality service improvement and redesign, with multidisciplinary discussion resulting in the development of a revised patient pathway which expedites diagnosis and treatment for these injuries.
Publisher: Springer Science and Business Media LLC
Date: 12-2013
Publisher: Public Library of Science (PLoS)
Date: 30-04-2018
Publisher: Springer Science and Business Media LLC
Date: 08-2018
Publisher: Wiley
Date: 29-06-2023
DOI: 10.1002/ACR.25186
Abstract: Objective. Adults with foot symptoms (i.e., pain, aching, or stiffness) may be at increased risk of reduced time to all‐cause mortality. The purpose of this study was to evaluate whether foot symptoms are independently associated with all‐cause mortality in older adults. Methods. We analyzed longitudinal data from 2613 participants from the Johnston County Osteoarthritis Project (JoCoOA), a longitudinal population‐based cohort of adults 45 years of age and older. Participants completed questionnaires at baseline to determine presence of foot symptoms and covariable status. Baseline walking speed was measured via an 8‐foot walk test. To examine the association of foot symptoms with time to mortality, hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox regression models, adjusted for potential confounders. Results. We observed 813 deaths over 4 to 14.5 years of follow‐up. At baseline, 37% of participants had foot symptoms, mean age was 63 years, mean BMI was approximately 31 kg/m 2 , 65% were women, and 33% were Black. Moderate to severe foot symptoms were associated with reduced time to mortality after adjustment for demographics, comorbidities, physical activity, and knee and hip symptoms (HR=1.30, 95%CI=1.09‐1.54). Importantly, this association was not modified by walking speed or diabetes. Conclusion. In iduals with foot symptoms had an increased hazard of all‐cause mortality compared to those with no foot symptoms. These effects were independent of key confounders and were not moderated by walking speed. Effective interventions to identify and manage at least moderate foot symptoms may reduce the risk of decreased time to mortality. This article is protected by copyright. All rights reserved.
Publisher: Springer Science and Business Media LLC
Date: 25-01-2022
DOI: 10.1186/S13047-022-00511-0
Abstract: Currently, wound management decisions are based largely on visual observations such as photographs, descriptors or measurements which can lack detail and do not always capture the sub-wound area. A previous case series suggests that there is benefit in using ultrasound imaging (USI) to evaluate diabetic foot ulcers (DFU) at point-of-care, however no guidance exists to inform its use. This scoping exercise explores the capacity of podiatrists with experience in interpreting musculoskeletal structures using USI to interpret sonographic images of DFU. Following a short briefing session, podiatrists with previous musculoskeletal (MSK) USI training were asked to review and report on previously recorded static sonographic images ( n = 8) of active DFU. Content analysis was utilised to identify recurring keywords within the podiatrists’ reports which were coded and assigned to categories to gain context to the data. Seven podiatrists participated in the study. Four categories were constructed for the purposes of analysis: Frequency of reporting, 2) Language used in reporting, 3) Observations, 4) Clinical impression Frequently, the reported findings between podiatrists were found to be similar, especially those related to bone morphology. However greater variability was seen in the reporting of wound specific soft-tissue observations. This scoping exercise has shown that podiatrists can translate their existing USI skills to make rudimentary reports on clinical findings in DFU. All participants were consistently able to identify and describe characteristics associated with DFU from a single b mode static wound ultrasound image. Findings from this investigation can be used as a foundation for further work to establish accuracy and reliability to validate DFU sonography. In conjunction the development of protocols and training materials will enable the adoption of USI to assess DFU in clinical practice. This will in turn, contribute to improved patient care and establish a new paradigm for wound surveillance which is translatable to other wound types.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.JOCA.2022.02.603
Abstract: To summarise the available evidence relating to the diagnosis, epidemiology, burden, outcome assessment and treatment of foot and ankle osteoarthritis (OA) and to develop an agenda to guide future research. Members of the International Foot and Ankle Osteoarthritis Consortium compiled a narrative summary of the literature which formed the basis of an interactive discussion at the Osteoarthritis Research Society International World Congress in 2021, during which a list of 24 research agenda items were generated. Following the meeting, delegates were asked to rank the research agenda items on a 0 to 100 visual analogue rating scale (0 = not at all important to 100 = extremely important). Items scoring a mean of 70 or above were selected for inclusion. Of the 45 delegates who attended the meeting, 31 contributed to the agenda item scoring. Nineteen research agenda items met the required threshold: three related to diagnosis, four to epidemiology, four to burden, three to outcome assessment and five to treatment. Key knowledge gaps related to foot and ankle OA were identified, and a comprehensive agenda to guide future research planning was developed. Implementation of this agenda will assist in improving the understanding and clinical management of this common and disabling, yet relatively overlooked condition.
Publisher: Wiley
Date: 25-04-2019
DOI: 10.1002/ACR.23829
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Catherine Bowen.