Annette Briley - Academia.edu (original) (raw)

Papers by Annette Briley

Research Square (Research Square), Jun 13, 2022

BackgroundEach year in the UK, approximately 35,000 women develop gestational diabetes mellitus (... more BackgroundEach year in the UK, approximately 35,000 women develop gestational diabetes mellitus (GDM). The condition increases the risk of obstetric and neonatal complications for mother and child, including pre-eclampsia, preterm birth and large for gestational age babies. Biochemical consequences include maternal hyperglycemia, neonatal hypoglycemia and dyslipidemia. Metformin is the most commonly used first line pharmacological treatment. However, there are concerns about its widespread use during pregnancy, due to its limited efficacy and potential safety concerns. Therefore, there is a need for additional therapies that improve both maternal-fetal glucose and lipid metabolism.Ursodeoxycholic acid (UDCA) is not currently used for treatment for GDM. However, it can improve glucose control in type 2 diabetes, and it improves fetal lipid profiles in gestational cholestasis. Consequentially, it is hypothesized that treatment with UDCA for women with GDM may improve both maternal metabolism and neonatal outcomes. The primary outcome of this trial is to assess the efficacy of UDCA compared with metformin to improve glucose levels in women with GDM.Methods:The trial is a two-armed, open label, multi-center, randomized controlled trial. Women are eligible if they have been diagnosed with GDM by an oral glucose tolerance test between 24+0 to 30+6 weeks’ gestation, and if they require pharmacological intervention. 158 pregnant women will be recruited across seven NHS Trusts in England and Wales. Women who consent will be recruited and randomized to either metformin or UDCA, which will be taken daily until the birth of their baby. Maternal and neonatal blood samples will be taken to evaluate the impact of the treatments on maternal glucose control, and maternal and neonatal lipid metabolism. Maternal and fetal outcomes will be evaluated, and acceptability of UDCA compared with metformin will be assessed.Discussion:This trial has the potential to identify a potential new treatment for women with GDM. If successful, a future large multi-center trial will be designed to investigate where decisions can be personalized to identify which women will respond more effectively to UDCA than alternatives to improve maternal and baby outcomes. Trial registration:Clinicaltrials.gov – Registration number: NCT04407650

Background In Australia, Allied health community services delivered via telehealth rapidly expand... more Background In Australia, Allied health community services delivered via telehealth rapidly expanded during the coronavirus pandemic (COVID-19). A gap exists in the understanding of outcomes and interprofessional collaborative practice in allied health community interdisciplinary telehealth services. The objectives of this study were to evaluate patient/service outcomes, cost-effectiveness and interprofessional collaborative practice in two allied health community services delivered via telehealth. One providing early intervention, and the other intervention for people with chronic conditions. Methods Quantitative data from client records (n = 15) and surveys (n = 16) were analysed descriptively. Qualitative data gained from: semi-structured interviews (n = 7) gathered client perspectives, and focus groups (n = 5) staff perspectives (n = 20), were analysed using Braun and Clarke’s six phases of reflexive thematic analysis. Results There was a non-significant improvement in Quality of...

Clinical & Experimental Allergy, 2021

BackgroundObservational studies suggest an increased risk of eczema in children living in hard ve... more BackgroundObservational studies suggest an increased risk of eczema in children living in hard versus soft water areas, and there is, therefore, an interest in knowing whether softening water may prevent eczema. We evaluated the feasibility of a parallel‐group assessor‐blinded pilot randomized controlled trial to test whether installing a domestic ion‐exchange water softener before birth in hard water areas reduces the risk of eczema in infants with a family history of atopy.MethodsPregnant women living in hard water areas (>250 mg/L calcium carbonate) in and around London UK, were randomized 1:1 antenatally to either have an ion‐exchange water softener installed in their home or not (ie to continue to receive usual domestic hard water). Infants were assessed at birth and followed up for 6 months. The main end‐points were around feasibility, the primary end‐point being the proportion of eligible families screened who were willing and able to be randomized. Clinical end‐points wer...

Australian and New Zealand Journal of Obstetrics and Gynaecology, 2014

BackgroundIntrahepatic cholestasis of pregnancy (ICP) is an uncommon obstetric condition characte... more BackgroundIntrahepatic cholestasis of pregnancy (ICP) is an uncommon obstetric condition characterised by intense maternal pruritis and biochemical abnormality. There is a degree of contention regarding the diagnosis and management of ICP, and currently, there are no nationally accepted guidelines.AimsTo conduct a survey of Fellows and Members of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) regarding their diagnosis and management ICP.MethodsAn online survey of currently practising RANZCOG Fellows and Members, utilising Survey Monkey.ResultsThirty percent of those sent the survey responded, comprising approximately 40% of practising obstetricians. Fasting bile acid and serum transaminase elevation in association with the characteristic itch define the disease process for the majority of respondents and also inform management decisions. There was no critical level of bile acid elevation that mandated treatment for the majority of responde...

Maternal and child health journal, Feb 11, 2024

Introduction The number of incarcerated pregnant women is increasing globally. With many having c... more Introduction The number of incarcerated pregnant women is increasing globally. With many having complex health and social backgrounds, incarceration provides opportunities for health interventions, including the chance to have their nutritional needs met. Despite the additional nutritional requirements of pregnancy being well documented, how these are being met within the correctional setting is currently poorly understood. Methods A scoping review of the literature was conducted to identify the literature published between January 2010 and April 2023 related to the provision of nutrition for pregnant women in the international prison systems. Sixteen papers met the criteria for inclusion in the review. The relevant key findings were charted and thematically analysed. Results Two themes were identified: 'the inconsistent reality of food provision' and 'choice, autonomy and food'. There is a clear disparity in the way in which diet is prioritised and provided to pregnant incarcerated women across several countries. Discussion The findings highlight the need for a consistent approach to diet on a macro, global level to ensure the health of women and their infants in context. Significance What is Already Known on This Subject? Whilst the additional nutritional requirements of pregnant women are well known, how these translate into the correctional setting is unknown. What this Study Adds? This scoping review provides a synthesis of the literature related to the provision of diet for incarcerated pregnant women. The findings highlight that prisons housing pregnant and breastfeeding women should ensure that evidence-based policies exist and are enforced to ensure an appropriate diet is provided. Furthermore, flexible access to water and additional snacks between meals should be ensured to meet the women's evolving nutritional needs across the childbearing continuum.

Briley, AL and Holmes, B and Kinnunen, TI and Croker, H and Bell, R and Sanders, T and Wardle, J ... more Briley, AL and Holmes, B and Kinnunen, TI and Croker, H and Bell, R and Sanders, T and Wardle, J and Sandall, J and Robson, S and Sattar, N and Poston, L and Nelson, S and Barr, S (2011) Development of a Complex Intervention To Improve Outcome in Obese Pregnancies; the UPBEAT Protocol. REPROD SCI , 18 (3) 143A - 143A. ... Full text not available from this repository.

EClinicalMedicine, Aug 1, 2022

Nursing Standard, Apr 19, 2021

Anal incontinence is an unpredictable and debilitating condition that can significantly reduce qu... more Anal incontinence is an unpredictable and debilitating condition that can significantly reduce quality of life. Symptoms include the involuntary loss of solid and/or liquid stool, flatus incontinence and rectal urgency. Pregnancy and childbirth are two major factors that increase the risk of anal incontinence in women of reproductive age. Women at high risk of anal incontinence include those with a known history of the condition and those who have experienced severe perineal trauma, particularly after injury to the anal sphincters (third-degree and fourth-degree tears). Routine screening for anal incontinence of women in high-risk groups during pregnancy and after childbirth appears to be limited in clinical practice. This article discusses the potential benefits of screening for anal incontinence, outlines the factors that inhibit and enable screening, describes current bowel screening tools and their limitations, and explores how the identification of anal incontinence in women of reproductive age could be improved.

British Journal of Obstetrics and Gynaecology, 2010

Reproductive Sciences, 2009

Hypertension in Pregnancy, 2008

Journal of The Society for Gynecologic Investigation, 2006