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Dr. Fisher Helen
Paediatric Allergy, Department of Women and Children’s Health, School of Life Course Sciences / School of Immunology & Microbial Sciences, Kings College London, London, WC2R 2LS, UK

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0 Eczema
0 Qualitative Research
0 food allergy
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Review
Published: 04 February 2021 in Allergy
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Oral tolerance induction through early introduction of allergenic food has proven effective in randomized controlled trials. This new approach to weaning has beenincorporated into many national and international infants’ feeding guidelines. However, there are questions thatrequire further discussion, such as, which foods should be introduced early, should the intervention be targeted to infants at high risk or to the general population, and what is the ideal timing for early food introduction. This review examines the extent to which recent trials address these critical questions and highlights areas where further research is required.

ACS Style

Marta Krawiec; Helen R. Fisher; George Du Toit; Henry T. Bahnson; Gideon Lack. Overview of oral tolerance induction for prevention of food allergy—Where are we now? Allergy 2021, 1 .

AMA Style

Marta Krawiec, Helen R. Fisher, George Du Toit, Henry T. Bahnson, Gideon Lack. Overview of oral tolerance induction for prevention of food allergy—Where are we now? Allergy. 2021; ():1.

Chicago/Turabian Style

Marta Krawiec; Helen R. Fisher; George Du Toit; Henry T. Bahnson; Gideon Lack. 2021. "Overview of oral tolerance induction for prevention of food allergy—Where are we now?" Allergy , no. : 1.

News and views
Published: 21 December 2020 in Allergy
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Oral Tolerance Induction (OTI) is the only RCT-proven effective intervention for preventing childhood food allergy.(1, 2) OTI to peanut is highly effective in a high-risk population with an 81% relative risk ration (RRR) to peanut allergy .(3) OTI also reduced egg allergy in the general population in a per protocol analysis.(1) These published RCT findings have changed practice and many governmental and allergy societies now recommend introducing peanut in infancy; some suggest that other foods, such as well-cooked egg, are also introduced. Only National Institute of Allergy and Infectious Diseases (NIAID) stratify their recommendations according to food allergy (FA) risk level.

ACS Style

Helen R. Fisher; Gideon Lack; Graham Roberts; Henry T. Bahnson; George Du Toit. Medical algorithm: Early introduction of food allergens in high‐risk populations. Allergy 2020, 76, 1592 -1594.

AMA Style

Helen R. Fisher, Gideon Lack, Graham Roberts, Henry T. Bahnson, George Du Toit. Medical algorithm: Early introduction of food allergens in high‐risk populations. Allergy. 2020; 76 (5):1592-1594.

Chicago/Turabian Style

Helen R. Fisher; Gideon Lack; Graham Roberts; Henry T. Bahnson; George Du Toit. 2020. "Medical algorithm: Early introduction of food allergens in high‐risk populations." Allergy 76, no. 5: 1592-1594.

Journal article
Published: 09 July 2020 in Allergy
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Peanut allergy (PA) is a common, potentially life‐threatening and typically lifelong condition with a significant burden of illness. However, information is lacking on how persons with PA (PwPA) and their caregivers perceive the psychosocial impact of living with PA. The Allergy to Peanuts imPacting Emotions And Life 1 (APPEAL‐1) survey, conducted across Europe, investigated the experience and impact of living with PA. Here, we report data evaluating the psychosocial impact of PA on PwPA and their caregivers. Allergy to Peanuts imPacting Emotions And Life study 1 was an online survey conducted in eight European countries. Representatives of eight patient advocacy groups and five healthcare‐research specialists developed the survey. Eligible respondent groups included the following: adults diagnosed with PA (self‐report); parent/nonparent caregivers (proxy‐report for a child with PA); and parent/nonparent caregivers (self‐report of PA impact on themselves). Of 1846 total study respondents, 419 were adults with PA (self‐report); 546 were parents/caregivers (proxy‐report); and 881 were parents/caregivers (self‐report). Most respondents reported lifestyle restrictions regarding food (84%‐93%) and additional domains including parties and socializing, holiday activities and destinations, and taking public transport (53%‐89%). Approximately 40% rated themselves as “very” frustrated and “very” stressed. Two‐thirds (65%) felt socially isolated; 43% were bullied. Less than half felt confident in knowing when to use an adrenaline autoinjector. Several intercountry differences were observed such as high levels of uncertainty and stress in respondents from Ireland, highest rates of anxiety in respondents from Germany, and social exclusion and isolation most common in respondents from France. Peanut allergy imposes an adverse psychosocial impact on patients and caregivers, leading to frustration, stress and isolation. Attention to the impact of PA is needed in research and clinical practice to improve PA healthcare and public education programmes.

ACS Style

Audrey DunnGalvin; Katharina Blumchen; Frans Timmermans; Lynne Regent; Sabine Schnadt; Marcia Podestà; Angel Sánchez; Pascale Couratier; Mary Feeney; Betina Hjorth; Ram Patel; Tessa Lush; Robert Ryan; Andrea Vereda; Montserrat Fernández‐Rivas; Helen Fisher. APPEAL‐1: A multiple‐country European survey assessing the psychosocial impact of peanut allergy. Allergy 2020, 75, 2899 -2908.

AMA Style

Audrey DunnGalvin, Katharina Blumchen, Frans Timmermans, Lynne Regent, Sabine Schnadt, Marcia Podestà, Angel Sánchez, Pascale Couratier, Mary Feeney, Betina Hjorth, Ram Patel, Tessa Lush, Robert Ryan, Andrea Vereda, Montserrat Fernández‐Rivas, Helen Fisher. APPEAL‐1: A multiple‐country European survey assessing the psychosocial impact of peanut allergy. Allergy. 2020; 75 (11):2899-2908.

Chicago/Turabian Style

Audrey DunnGalvin; Katharina Blumchen; Frans Timmermans; Lynne Regent; Sabine Schnadt; Marcia Podestà; Angel Sánchez; Pascale Couratier; Mary Feeney; Betina Hjorth; Ram Patel; Tessa Lush; Robert Ryan; Andrea Vereda; Montserrat Fernández‐Rivas; Helen Fisher. 2020. "APPEAL‐1: A multiple‐country European survey assessing the psychosocial impact of peanut allergy." Allergy 75, no. 11: 2899-2908.

Original article
Published: 21 May 2020 in Allergy
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Background Peanut allergy (PA) is associated with marked quality‐of‐life (QoL) impairment. However, data are lacking on the experience and impact of living with PA from the perspectives of persons with PA (PwPA) and their caregivers. A llergy to P eanuts imP acting E motions A nd L ife study 1 (APPEAL‐1) was a pan‐European survey investigating these perspectives. This first of two articles reports clinical characteristics of PwPA and PA management practices. Methods APPEAL‐1 was a quantitative, online survey conducted in eight European countries, developed by eight representatives of patient advocacy groups and five healthcare professionals and researchers. Eligible participants included adults with PA and parents/caregivers of PwPA who responded by self‐report and provided proxy‐report for the PwPA under their care. Data were summarised using nonweighted descriptive statistics. Results Of 1846 completed/analysed questionnaires, 528 were from adults with PA (self‐report); 437 by proxy for children with PA (34 aged 0‐3 years, 287 aged 4‐12 years, 116 aged 13‐17 years); 881 from parents/caregivers (self‐report). Of PwPA (N=965), 95% reported diagnosis by healthcare professionals, mostly by clinical history and peanut‐specific allergy testing. Rates of allergic rhinitis, asthma, and other food allergies in PwPA were 50%, 42%, and 79%, respectively. Only 31% of PwPA received HCP advice/support following their worst allergic reaction, and 28% had not been prescribed an adrenaline auto‐injector. Results were similar by country but varied by age group. Conclusions The APPEAL‐1 findings contribute to greater understanding of PA impact on PwPA, caregivers, and family members and the need for improved PA management across Europe.

ACS Style

Katharina Blumchen; Audrey DunnGalvin; Frans Timmermans; Lynne Regent; Sabine Schnadt; Marcia Podestà; Angel Sánchez; Pascale Couratier; Mary Feeney; Betina Hjorth; Ram Patel; Tessa Lush; Robert Ryan; Andrea Vereda; Helen Fisher; Montserrat Fernández‐Rivas. APPEAL‐1: A pan‐European survey of patient/caregiver perceptions of peanut allergy management. Allergy 2020, 75, 2920 -2935.

AMA Style

Katharina Blumchen, Audrey DunnGalvin, Frans Timmermans, Lynne Regent, Sabine Schnadt, Marcia Podestà, Angel Sánchez, Pascale Couratier, Mary Feeney, Betina Hjorth, Ram Patel, Tessa Lush, Robert Ryan, Andrea Vereda, Helen Fisher, Montserrat Fernández‐Rivas. APPEAL‐1: A pan‐European survey of patient/caregiver perceptions of peanut allergy management. Allergy. 2020; 75 (11):2920-2935.

Chicago/Turabian Style

Katharina Blumchen; Audrey DunnGalvin; Frans Timmermans; Lynne Regent; Sabine Schnadt; Marcia Podestà; Angel Sánchez; Pascale Couratier; Mary Feeney; Betina Hjorth; Ram Patel; Tessa Lush; Robert Ryan; Andrea Vereda; Helen Fisher; Montserrat Fernández‐Rivas. 2020. "APPEAL‐1: A pan‐European survey of patient/caregiver perceptions of peanut allergy management." Allergy 75, no. 11: 2920-2935.

Journal article
Published: 22 February 2019 in Annals of Allergy, Asthma & Immunology
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ACS Style

Helen R. Fisher; Gideon Lack; George Du Toit. Solid foods should be introduced into susceptible infants' diets in early life-PRO. Annals of Allergy, Asthma & Immunology 2019, 122, 583 -585.

AMA Style

Helen R. Fisher, Gideon Lack, George Du Toit. Solid foods should be introduced into susceptible infants' diets in early life-PRO. Annals of Allergy, Asthma & Immunology. 2019; 122 (6):583-585.

Chicago/Turabian Style

Helen R. Fisher; Gideon Lack; George Du Toit. 2019. "Solid foods should be introduced into susceptible infants' diets in early life-PRO." Annals of Allergy, Asthma & Immunology 122, no. 6: 583-585.

Journal article
Published: 01 February 2019 in Journal of Allergy and Clinical Immunology
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ACS Style

Audrey DunnGalvin; Montserrat Fernandez Rivas; Helen R. Fisher; Mary Feeney; Frans Timmermans; Lynne Regent; Sabine Schnadt; Marcia Podestà; Ángel Sánchez; Pascale Couratier; Betina Hjorth; Fiona Kenna; Ram Patel; Andrea Vereda; Tessa Lush; Katharina Blümchen. APPEAL (Allergy to Peanuts ImPacting Emotions and Life): Pan-European Results on Peanut Allergy Impact on Allergic Individuals, Parents and Caregivers. Journal of Allergy and Clinical Immunology 2019, 143, AB54 .

AMA Style

Audrey DunnGalvin, Montserrat Fernandez Rivas, Helen R. Fisher, Mary Feeney, Frans Timmermans, Lynne Regent, Sabine Schnadt, Marcia Podestà, Ángel Sánchez, Pascale Couratier, Betina Hjorth, Fiona Kenna, Ram Patel, Andrea Vereda, Tessa Lush, Katharina Blümchen. APPEAL (Allergy to Peanuts ImPacting Emotions and Life): Pan-European Results on Peanut Allergy Impact on Allergic Individuals, Parents and Caregivers. Journal of Allergy and Clinical Immunology. 2019; 143 (2):AB54.

Chicago/Turabian Style

Audrey DunnGalvin; Montserrat Fernandez Rivas; Helen R. Fisher; Mary Feeney; Frans Timmermans; Lynne Regent; Sabine Schnadt; Marcia Podestà; Ángel Sánchez; Pascale Couratier; Betina Hjorth; Fiona Kenna; Ram Patel; Andrea Vereda; Tessa Lush; Katharina Blümchen. 2019. "APPEAL (Allergy to Peanuts ImPacting Emotions and Life): Pan-European Results on Peanut Allergy Impact on Allergic Individuals, Parents and Caregivers." Journal of Allergy and Clinical Immunology 143, no. 2: AB54.

Review article
Published: 01 February 2019 in The Journal of Allergy and Clinical Immunology: In Practice
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Peanut allergy affects 1% to 3% of the Western world, usually begins in early childhood, is rarely outgrown, and has no currently approved treatment. The identification and application of prevention strategies is therefore essential. In 2015, the Learning Early About Peanuts study findings found that early consumption of peanut protein was effective in preventing peanut allergy in high-risk children as compared with peanut avoidance. These findings resulted in changes to allergy prevention guidelines and policy across the world. There are country-specific variations to guidelines, but, within these variations, feeding peanut to children in infancy is a common theme. There are numerous logistical challenges surrounding the implementation of contemporary guidelines at a population level. In the United States, guidelines advise according to risk level with prescreening recommended for high-risk children (mod/severe eczema, egg allergy). Even though high-risk children represent the minority of the childhood population, there are still significant challenges associated with identifying and screening such infants. The need for conducting allergy testing before first giving peanut protein to high-risk infants is debated; although adopting this approach promotes safety, it is financially and logistically challenging. Clinical trials that explore the real-life application of these guidelines are needed as is an assessment of guidelines (Australia, for example) that do not adopt the approach of screening.

ACS Style

Helen Fisher; Corinne A. Keet; Gideon Lack; George du Toit. Preventing Peanut Allergy: Where Are We Now? The Journal of Allergy and Clinical Immunology: In Practice 2019, 7, 367 -373.

AMA Style

Helen Fisher, Corinne A. Keet, Gideon Lack, George du Toit. Preventing Peanut Allergy: Where Are We Now? The Journal of Allergy and Clinical Immunology: In Practice. 2019; 7 (2):367-373.

Chicago/Turabian Style

Helen Fisher; Corinne A. Keet; Gideon Lack; George du Toit. 2019. "Preventing Peanut Allergy: Where Are We Now?" The Journal of Allergy and Clinical Immunology: In Practice 7, no. 2: 367-373.

Review
Published: 14 June 2018 in Annals of Allergy, Asthma & Immunology
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To highlight challenges associated with this novel preventive strategy. The Learning Early About Peanuts (LEAP) and Enquiring About Tolerance (EAT) Studies, with reference to other oral tolerance induction studies. Randomized clinial trials seeking to prevent food allergy through allergen introduction in infancy. Oral tolerance induction programs that use a regimen of consumption of 2 g/week of protein are effective in preventing peanut and egg allergy. LEAP findings suggest oral tolerance induction is allergen specific. Adding peanut and other common food allergens (egg, fish, sesame, milk) to the infant diet has no adverse nutritional or growth effects and does not increase rates of food allergy. Breastfeeding rates are not adversely affected by these interventions. In the Western world, nonwhite children have the highest risk of food allergy, but their families are the least likely to participate in oral tolerance induction programs. Many challenges must be overcome to implement successful food allergy prevention strategies. Allergy testing of high-risk infants (those with moderate to severe eczema and/or egg allergy) before commencing oral tolerance induction is desirable, but access is not universal. Dietary interventions would ideally be implemented in infancy before allergic sensitization and allergy occur, using a program that provides protection against multiple common allergens. Further research and consensus with regard to food preparations, target populations, dosing regimens, and preparations and clearly defined adherence are now required.

ACS Style

Helen Fisher; George Du Toit; Henry T. Bahnson; Gideon Lack. The challenges of preventing food allergy. Annals of Allergy, Asthma & Immunology 2018, 121, 313 -319.

AMA Style

Helen Fisher, George Du Toit, Henry T. Bahnson, Gideon Lack. The challenges of preventing food allergy. Annals of Allergy, Asthma & Immunology. 2018; 121 (3):313-319.

Chicago/Turabian Style

Helen Fisher; George Du Toit; Henry T. Bahnson; Gideon Lack. 2018. "The challenges of preventing food allergy." Annals of Allergy, Asthma & Immunology 121, no. 3: 313-319.

Randomized controlled trial
Published: 01 April 2018 in Journal of Allergy and Clinical Immunology
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Early introduction of dietary peanut in high-risk infants with severe eczema and/or egg allergy prevented peanut allergy at 5 years of age in the LEAP Study; the protective effect persisted after 12 months of avoiding peanuts in the LEAP-On Study. It is unclear whether this benefit is allergen and allergic-disease specific.To assess the impact of early introduction of peanut on the development of allergic disease, food sensitization and aeroallergen sensitization.Asthma, eczema and rhinoconjunctivitis were diagnosed by clinical assessment. Reported allergic reactions and consumption of tree nuts and sesame were recorded by questionnaire. Sensitization to food and aeroallergens was determined by skin prick testing and specific IgE measurement.A high and increasing burden of food and aeroallergen sensitization and allergic disease was noted across study time points; 76% of LEAP participants had at least one allergic disease at 60 months of age. There were no differences in allergic disease between LEAP groups. There were small differences in sensitization and reported allergic reactions for select tree nuts; levels were higher in the LEAP consumption group. Significant resolution of eczema and sensitization to egg and milk occurred in LEAP participants; this was not affected by peanut consumption.Early consumption of peanut in infants at high risk of peanut allergy is allergen-specific and does not prevent the development of other allergic disease, sensitization to other foods and aeroallergens, or reported allergic reactions to tree nuts and sesame. Furthermore, peanut consumption does not hasten the resolution of eczema or egg allergy.

ACS Style

George du Toit; Peter H. Sayre; Graham Roberts; Kaitie Lawson; Michelle L. Sever; Henry T. Bahnson; Helen Fisher; Mary Feeney; Suzana Radulovic; Monica Basting; Marshall Plaut; Gideon Lack; Susan Chan; Adam Fox; Mable Abraham; Muhsinah Adam; Louise Coverdale; Claire Duncan; Amy Nixon; Una O’Dwyer-Leeson; Victoria Offord; Aine Sheridan; Fiona Watson; Natalie Witham; Kathryn Cockerell; Gail Harland; Tiffany Miller; Charlotte Stedman; Catherine Clarke; Richard Cleaver; Gemma Deutsch; Alicia Parr; Natalia Becares; Matthew Crossley; Natalia Do Couto Francisco; Kerry Richards; Ewa Pietraszewicz; Alick Stephens; Asha Sudra; Rianne Wester; Alastair Wilson; Celine Wu; Jenna Heath; Kathryn Hersee; Devi Patkunam; Adam Asare; Eduard Chani; Judith Evind; Noha Lim; Audrey Plough; Margarita Gomez Lorenzo; Joy Laurienzo Panza; Jackie Johnson; Jack Hu; Travis Mason. Allergen specificity of early peanut consumption and effect on development of allergic disease in the Learning Early About Peanut Allergy study cohort. Journal of Allergy and Clinical Immunology 2018, 141, 1343 -1353.

AMA Style

George du Toit, Peter H. Sayre, Graham Roberts, Kaitie Lawson, Michelle L. Sever, Henry T. Bahnson, Helen Fisher, Mary Feeney, Suzana Radulovic, Monica Basting, Marshall Plaut, Gideon Lack, Susan Chan, Adam Fox, Mable Abraham, Muhsinah Adam, Louise Coverdale, Claire Duncan, Amy Nixon, Una O’Dwyer-Leeson, Victoria Offord, Aine Sheridan, Fiona Watson, Natalie Witham, Kathryn Cockerell, Gail Harland, Tiffany Miller, Charlotte Stedman, Catherine Clarke, Richard Cleaver, Gemma Deutsch, Alicia Parr, Natalia Becares, Matthew Crossley, Natalia Do Couto Francisco, Kerry Richards, Ewa Pietraszewicz, Alick Stephens, Asha Sudra, Rianne Wester, Alastair Wilson, Celine Wu, Jenna Heath, Kathryn Hersee, Devi Patkunam, Adam Asare, Eduard Chani, Judith Evind, Noha Lim, Audrey Plough, Margarita Gomez Lorenzo, Joy Laurienzo Panza, Jackie Johnson, Jack Hu, Travis Mason. Allergen specificity of early peanut consumption and effect on development of allergic disease in the Learning Early About Peanut Allergy study cohort. Journal of Allergy and Clinical Immunology. 2018; 141 (4):1343-1353.

Chicago/Turabian Style

George du Toit; Peter H. Sayre; Graham Roberts; Kaitie Lawson; Michelle L. Sever; Henry T. Bahnson; Helen Fisher; Mary Feeney; Suzana Radulovic; Monica Basting; Marshall Plaut; Gideon Lack; Susan Chan; Adam Fox; Mable Abraham; Muhsinah Adam; Louise Coverdale; Claire Duncan; Amy Nixon; Una O’Dwyer-Leeson; Victoria Offord; Aine Sheridan; Fiona Watson; Natalie Witham; Kathryn Cockerell; Gail Harland; Tiffany Miller; Charlotte Stedman; Catherine Clarke; Richard Cleaver; Gemma Deutsch; Alicia Parr; Natalia Becares; Matthew Crossley; Natalia Do Couto Francisco; Kerry Richards; Ewa Pietraszewicz; Alick Stephens; Asha Sudra; Rianne Wester; Alastair Wilson; Celine Wu; Jenna Heath; Kathryn Hersee; Devi Patkunam; Adam Asare; Eduard Chani; Judith Evind; Noha Lim; Audrey Plough; Margarita Gomez Lorenzo; Joy Laurienzo Panza; Jackie Johnson; Jack Hu; Travis Mason. 2018. "Allergen specificity of early peanut consumption and effect on development of allergic disease in the Learning Early About Peanut Allergy study cohort." Journal of Allergy and Clinical Immunology 141, no. 4: 1343-1353.

Review
Published: 04 August 2016 in PLOS ONE
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Translational research is central to international health policy, research and funding initiatives. Despite increasing use of the term, the translation of basic science discoveries into clinical practice is not straightforward. This systematic search and narrative synthesis aimed to examine factors enabling or hindering translational research from the perspective of basic and clinician scientists, a key stakeholder group in translational research, and to draw policy-relevant implications for organisations seeking to optimise translational research opportunities. We searched SCOPUS and Web of Science from inception until April 2015 for papers reporting scientists’ views of the factors they perceive as enabling or hindering the conduct of translational research. We screened 8,295 papers from electronic database searches and 20 papers from hand searches and citation tracking, identifying 26 studies of qualitative, quantitative or mixed method designs. We used a narrative synthesis approach and identified the following themes: 1) differing concepts of translational research 2) research processes as a barrier to translational research; 3) perceived cultural divide between research and clinical care; 4) interdisciplinary collaboration as enabling translation research, but dependent on the quality of prior and current social relationships; 5) translational research as entrepreneurial science. Across all five themes, factors enabling or hindering translational research were largely shaped by wider social, organisational, and structural factors. To optimise translational research, policy could consider refining translational research models to better reflect scientists’ experiences, fostering greater collaboration and buy in from all types of scientists. Organisations could foster cultural change, ensuring that organisational practices and systems keep pace with the change in knowledge production brought about by the translational research agenda.

ACS Style

Nina Fudge; Euan Sadler; Helen Fisher; John Maher; Charles D. A. Wolfe; Christopher Mckevitt. Optimising Translational Research Opportunities: A Systematic Review and Narrative Synthesis of Basic and Clinician Scientists' Perspectives of Factors Which Enable or Hinder Translational Research. PLOS ONE 2016, 11, e0160475 .

AMA Style

Nina Fudge, Euan Sadler, Helen Fisher, John Maher, Charles D. A. Wolfe, Christopher Mckevitt. Optimising Translational Research Opportunities: A Systematic Review and Narrative Synthesis of Basic and Clinician Scientists' Perspectives of Factors Which Enable or Hinder Translational Research. PLOS ONE. 2016; 11 (8):e0160475.

Chicago/Turabian Style

Nina Fudge; Euan Sadler; Helen Fisher; John Maher; Charles D. A. Wolfe; Christopher Mckevitt. 2016. "Optimising Translational Research Opportunities: A Systematic Review and Narrative Synthesis of Basic and Clinician Scientists' Perspectives of Factors Which Enable or Hinder Translational Research." PLOS ONE 11, no. 8: e0160475.

Research ethics
Published: 08 April 2011 in Journal of Medical Ethics
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Objective Recent legislation mandating the inclusion of children in clinical trials has resulted in an increase in the number of children participating in research. We reviewed the literature regarding the reasons parents chose to accept or decline an invitation to enrol their children in clinical research. Methods We searched for qualitative studies, written in the English language that considered the experiences of parents who had been invited to enrol their children in research. SCOPUS and Web of Knowledge electronic databases and reference lists of retrieved articles and review papers were searched. Retrieved articles were synthesised using the narrative synthesis method. Results 16 qualitative studies exploring the experiences of parents living in five countries whose children had a range of health conditions of varying severity were included. The health status of the child appeared to influence parents' reasons for participation. Parents whose children had life threatening conditions often considered they had no choice but to participate and many welcomed the innovation offered through research participation. Such parents also viewed the risks of research less negatively than those whose children were healthy or in the stable stage of a chronic condition. This raises questions regarding the voluntariness of informed consent by such parents. Conclusions A tailored approach is needed when discussing research participation with parents of eligible children. While parents of healthy children may be more open to discussions of altruism, those whose children have life threatening illnesses should be given adequate information about the alternatives to, and risks of, research participation.

ACS Style

Helen R Fisher; Christopher Mckevitt; Annette Boaz. Why do parents enrol their children in research: a narrative synthesis. Journal of Medical Ethics 2011, 37, 544 -551.

AMA Style

Helen R Fisher, Christopher Mckevitt, Annette Boaz. Why do parents enrol their children in research: a narrative synthesis. Journal of Medical Ethics. 2011; 37 (9):544-551.

Chicago/Turabian Style

Helen R Fisher; Christopher Mckevitt; Annette Boaz. 2011. "Why do parents enrol their children in research: a narrative synthesis." Journal of Medical Ethics 37, no. 9: 544-551.

Review
Published: 03 June 2010 in Archives of Disease in Childhood
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Objective To determine whether specific oral tolerance induction (SOTI) is more effective than avoidance in inducing tolerance in children aged 0–18 years who have immunoglobulin E (IgE)–mediated food allergy. Data sources MEDLINE (1950 to July 2009), EMBASE (1980 to July 2009) and all EBM Reviews: Cochrane Database of Systematic Reviews, ACP Journal Club, Database of Abstracts of Reviews of Effects, Cochrane Methodology Register, Health Technology Assessment and NHS Economic Evaluation Database (from start date to November 2008). The online table of contents (November 2003 to July 2009) of the Journal of Allergy and Clinical Immunology, Pediatric Allergy and Immunology and Allergy were also searched, and reference lists of retrieved articles were scrutinised for relevant studies. Study selection Randomised controlled trials (RCT) were included providing they enrolled children with IgE-mediated food allergy diagnosed using the criterion standard tool (double-blind placebo-controlled food challenge) before randomisation and also compared posttreatment tolerance between groups using the criterion standard measures. Results Three studies met the inclusion criteria, and two proved a statistically significant reduction in endpoint allergy (determined by oral food challenge) after SOTI compared with the control. The meta-analysis of the included studies found a lower RR of allergy after SOTI, but this did not meet statistical significance (0.606783; 95% CI 0.317733 to 1.158791). Conclusions SOTI cannot yet be recommended in routine practice as a means to induce tolerance in children with IgE-mediated food allergy. Further research is needed using large, high-quality RCT that investigate a variety of food allergens and assesses the long-term efficacy, safety and cost-effectiveness of SOTI.

ACS Style

H. R. Fisher; George Du Toit; Gideon Lack. Specific oral tolerance induction in food allergic children: is oral desensitisation more effective than allergen avoidance?: A meta-analysis of published RCTs. Archives of Disease in Childhood 2010, 96, 259 -264.

AMA Style

H. R. Fisher, George Du Toit, Gideon Lack. Specific oral tolerance induction in food allergic children: is oral desensitisation more effective than allergen avoidance?: A meta-analysis of published RCTs. Archives of Disease in Childhood. 2010; 96 (3):259-264.

Chicago/Turabian Style

H. R. Fisher; George Du Toit; Gideon Lack. 2010. "Specific oral tolerance induction in food allergic children: is oral desensitisation more effective than allergen avoidance?: A meta-analysis of published RCTs." Archives of Disease in Childhood 96, no. 3: 259-264.

Conference abstract
Published: 28 February 2010 in Journal of Allergy and Clinical Immunology
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ACS Style

G. Du Toit; G. Roberts; P. Sayre; V. Turcanu; H.R. Fisher; D. Broide; L. Nirenstein; S. Radulovic; A. Stephens; V. Seyfert-Margolis; N. Nasser; S. Murphy; G. Lack. Induction Of Tolerance Through Early Introduction Of Peanut In High-Risk Children, The LEAP Study. Journal of Allergy and Clinical Immunology 2010, 125, AB22 .

AMA Style

G. Du Toit, G. Roberts, P. Sayre, V. Turcanu, H.R. Fisher, D. Broide, L. Nirenstein, S. Radulovic, A. Stephens, V. Seyfert-Margolis, N. Nasser, S. Murphy, G. Lack. Induction Of Tolerance Through Early Introduction Of Peanut In High-Risk Children, The LEAP Study. Journal of Allergy and Clinical Immunology. 2010; 125 (2):AB22.

Chicago/Turabian Style

G. Du Toit; G. Roberts; P. Sayre; V. Turcanu; H.R. Fisher; D. Broide; L. Nirenstein; S. Radulovic; A. Stephens; V. Seyfert-Margolis; N. Nasser; S. Murphy; G. Lack. 2010. "Induction Of Tolerance Through Early Introduction Of Peanut In High-Risk Children, The LEAP Study." Journal of Allergy and Clinical Immunology 125, no. 2: AB22.

Conference abstract
Published: 28 February 2010 in Journal of Allergy and Clinical Immunology
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ACS Style

G. Roberts; G. Du Toit; P. Sayre; V. Turcanu; H.R. Fisher; D. Broide; L. Nirenstein; S. Radulovic; A. Stephens; V. Seyfert-Margolis; N. Nasser; S. Murphy; G. Lack. Infants with Eczema have High Rates of Sensitization to Food Allergens - results from the Leap Study. Journal of Allergy and Clinical Immunology 2010, 125, AB92 .

AMA Style

G. Roberts, G. Du Toit, P. Sayre, V. Turcanu, H.R. Fisher, D. Broide, L. Nirenstein, S. Radulovic, A. Stephens, V. Seyfert-Margolis, N. Nasser, S. Murphy, G. Lack. Infants with Eczema have High Rates of Sensitization to Food Allergens - results from the Leap Study. Journal of Allergy and Clinical Immunology. 2010; 125 (2):AB92.

Chicago/Turabian Style

G. Roberts; G. Du Toit; P. Sayre; V. Turcanu; H.R. Fisher; D. Broide; L. Nirenstein; S. Radulovic; A. Stephens; V. Seyfert-Margolis; N. Nasser; S. Murphy; G. Lack. 2010. "Infants with Eczema have High Rates of Sensitization to Food Allergens - results from the Leap Study." Journal of Allergy and Clinical Immunology 125, no. 2: AB92.

Journal article
Published: 30 November 2008 in Journal of Allergy and Clinical Immunology
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Despite guidelines recommending avoidance of peanuts during infancy in the United Kingdom (UK), Australia, and, until recently, North America, peanut allergy (PA) continues to increase in these countries. We sought to determine the prevalence of PA among Israeli and UK Jewish children and evaluate the relationship of PA to infant and maternal peanut consumption. A clinically validated questionnaire determined the prevalence of PA among Jewish schoolchildren (5171 in the UK and 5615 in Israel). A second validated questionnaire assessed peanut consumption and weaning in Jewish infants (77 in the UK and 99 in Israel). The prevalence of PA in the UK was 1.85%, and the prevalence in Israel was 0.17% (P < .001). Despite accounting for atopy, the adjusted risk ratio for PA between countries was 9.8 (95% CI, 3.1-30.5) in primary school children. Peanut is introduced earlier and is eaten more frequently and in larger quantities in Israel than in the UK. The median monthly consumption of peanut in Israeli infants aged 8 to 14 months is 7.1 g of peanut protein, and it is 0 g in the UK (P < .001). The median number of times peanut is eaten per month was 8 in Israel and 0 in the UK (P < .0001). We demonstrate that Jewish children in the UK have a prevalence of PA that is 10-fold higher than that of Jewish children in Israel. This difference is not accounted for by differences in atopy, social class, genetic background, or peanut allergenicity. Israeli infants consume peanut in high quantities in the first year of life, whereas UK infants avoid peanuts. These findings raise the question of whether early introduction of peanut during infancy, rather than avoidance, will prevent the development of PA.

ACS Style

George Du Toit; Yitzhak Katz; Peter Sasieni; David Mesher; Soheila J. Maleki; Helen Fisher; Adam Fox; Victor Turcanu; Tal Amir; Galia Zadik-Mnuhin; Adi Cohen; Irit Livne; Gideon Lack. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. Journal of Allergy and Clinical Immunology 2008, 122, 984 -991.

AMA Style

George Du Toit, Yitzhak Katz, Peter Sasieni, David Mesher, Soheila J. Maleki, Helen Fisher, Adam Fox, Victor Turcanu, Tal Amir, Galia Zadik-Mnuhin, Adi Cohen, Irit Livne, Gideon Lack. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. Journal of Allergy and Clinical Immunology. 2008; 122 (5):984-991.

Chicago/Turabian Style

George Du Toit; Yitzhak Katz; Peter Sasieni; David Mesher; Soheila J. Maleki; Helen Fisher; Adam Fox; Victor Turcanu; Tal Amir; Galia Zadik-Mnuhin; Adi Cohen; Irit Livne; Gideon Lack. 2008. "Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy." Journal of Allergy and Clinical Immunology 122, no. 5: 984-991.

Evaluation study
Published: 06 November 2006 in BMC Medical Informatics and Decision Making
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Background Diagnostic error is a significant problem in specialities characterised by diagnostic uncertainty such as primary care, emergency medicine and paediatrics. Despite wide-spread availability, computerised aids have not been shown to significantly improve diagnostic decision-making in a real world environment, mainly due to the need for prolonged system consultation. In this study performed in the clinical environment, we used a Web-based diagnostic reminder system that provided rapid advice with free text data entry to examine its impact on clinicians' decisions in an acute paediatric setting during assessments characterised by diagnostic uncertainty. Methods Junior doctors working over a 5-month period at four paediatric ambulatory units consulted the Web-based diagnostic aid when they felt the need for diagnostic assistance. Subjects recorded their clinical decisions for patients (differential diagnosis, test-ordering and treatment) before and after system consultation. An expert panel of four paediatric consultants independently suggested clinically significant decisions indicating an appropriate and 'safe' assessment. The primary outcome measure was change in the proportion of 'unsafe' workups by subjects during patient assessment. A more sensitive evaluation of impact was performed using specific validated quality scores. Adverse effects of consultation on decision-making, as well as the additional time spent on system use were examined. Results Subjects attempted to access the diagnostic aid on 595 occasions during the study period (8.6% of all medical assessments); subjects examined diagnostic advice only in 177 episodes (30%). Senior House Officers at hospitals with greater number of available computer workstations in the clinical area were most likely to consult the system, especially out of working hours. Diagnostic workups construed as 'unsafe' occurred in 47/104 cases (45.2%); this reduced to 32.7% following system consultation (McNemar test, p < 0.001). Subjects' mean 'unsafe' workups per case decreased from 0.49 to 0.32 (p < 0.001). System advice prompted the clinician to consider the 'correct' diagnosis (established at discharge) during initial assessment in 3/104 patients. Median usage time was 1 min 38 sec (IQR 50 sec – 3 min 21 sec). Despite a modest increase in the number of diagnostic possibilities entertained by the clinician, no adverse effects were demonstrable on patient management following system use. Numerous technical barriers prevented subjects from accessing the diagnostic aid in the majority of eligible patients in whom they sought diagnostic assistance. Conclusion We have shown that junior doctors used a Web-based diagnostic reminder system during acute paediatric assessments to significantly improve the quality of their diagnostic workup and reduce diagnostic omission errors. These benefits were achieved without any adverse effects on patient management following a quick consultation.

ACS Style

Padmanabhan Ramnarayan; Andrew Winrow; Michael Coren; Vasanta Nanduri; Roger Buchdahl; Benjamin Jacobs; Helen Fisher; Paul M Taylor; Jeremy C Wyatt; Joseph Britto. Diagnostic omission errors in acute paediatric practice: impact of a reminder system on decision-making. BMC Medical Informatics and Decision Making 2006, 6, 37 -37.

AMA Style

Padmanabhan Ramnarayan, Andrew Winrow, Michael Coren, Vasanta Nanduri, Roger Buchdahl, Benjamin Jacobs, Helen Fisher, Paul M Taylor, Jeremy C Wyatt, Joseph Britto. Diagnostic omission errors in acute paediatric practice: impact of a reminder system on decision-making. BMC Medical Informatics and Decision Making. 2006; 6 (1):37-37.

Chicago/Turabian Style

Padmanabhan Ramnarayan; Andrew Winrow; Michael Coren; Vasanta Nanduri; Roger Buchdahl; Benjamin Jacobs; Helen Fisher; Paul M Taylor; Jeremy C Wyatt; Joseph Britto. 2006. "Diagnostic omission errors in acute paediatric practice: impact of a reminder system on decision-making." BMC Medical Informatics and Decision Making 6, no. 1: 37-37.

Conference abstract
Published: 28 February 2006 in Journal of Allergy and Clinical Immunology
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ACS Style

S. Hingley; G. Du Toit; G. Roberts; V. Turcanu; G. Lack; H. Fisher; P. Lau. Peanut Specific IgG4 and its Association with Peanut Allergy. Journal of Allergy and Clinical Immunology 2006, 117, S33 .

AMA Style

S. Hingley, G. Du Toit, G. Roberts, V. Turcanu, G. Lack, H. Fisher, P. Lau. Peanut Specific IgG4 and its Association with Peanut Allergy. Journal of Allergy and Clinical Immunology. 2006; 117 (2):S33.

Chicago/Turabian Style

S. Hingley; G. Du Toit; G. Roberts; V. Turcanu; G. Lack; H. Fisher; P. Lau. 2006. "Peanut Specific IgG4 and its Association with Peanut Allergy." Journal of Allergy and Clinical Immunology 117, no. 2: S33.

Text
Published: 01 September 2003 in Paediatric Care
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Keeping up with clinical evidence is increasingly difficult, particularly in rapidly changing areas such as critical care, but there are computerised tools to help, as Helen Fisher and colleagues explain Healthcare professionals are working in an age when the amount of knowledge they have to remember each day is increasing exponentially (Wyatt 1991), but when information technology is becoming more freely available. In response to this, clinical decision support tools have evolved which aid the dissemination and recollection of this information. Morris (2002) and Hunt et al (1998) believe that computerised decision support tools can aid clinical decision-making and therefore have a favourable impact on patient outcome.

ACS Style

Helen Fisher; Amanda Tomlinson; P Ramnarayan; Joseph Britto. ISABEL: support with clinical decision making. Paediatric Care 2003, 15, 34 -35.

AMA Style

Helen Fisher, Amanda Tomlinson, P Ramnarayan, Joseph Britto. ISABEL: support with clinical decision making. Paediatric Care. 2003; 15 (7):34-35.

Chicago/Turabian Style

Helen Fisher; Amanda Tomlinson; P Ramnarayan; Joseph Britto. 2003. "ISABEL: support with clinical decision making." Paediatric Care 15, no. 7: 34-35.

Review
Published: 01 November 2001 in Journal of Advanced Nursing
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The needs of parents with chronically sick children: a literature review Aims. This paper aims to provide health care professionals with an enhanced knowledge of the needs of parents with chronically sick children. Design. The article takes the form of a critical literature review and examines eight research studies that were carried out from 1987 to 1997, written in the English language and analysing solely the needs or experiences of both parents with at least one chronically sick child. Findings. Appropriately all eight studies were carried out from the naturalistic paradigm and yielded rich data. The synthesis of the results of the papers found three main themes emerging: the need for normality and certainty, the need for information, and the need for partnership. Conclusion. The results of the review serve to emphasize and reiterate the burden of the demands made on these parents, and act as a reminder of the need for empathetic care delivery.

ACS Style

Helen R. Fisher. The needs of parents with chronically sick children: a literature review. Journal of Advanced Nursing 2001, 36, 600 -607.

AMA Style

Helen R. Fisher. The needs of parents with chronically sick children: a literature review. Journal of Advanced Nursing. 2001; 36 (4):600-607.

Chicago/Turabian Style

Helen R. Fisher. 2001. "The needs of parents with chronically sick children: a literature review." Journal of Advanced Nursing 36, no. 4: 600-607.