"If people are hesitant at all, you just want a really big front door": a rapid qualitative interview study on the Luton COVID-19 vaccination outreach clinics.

BACKGROUND: There is a lack of evidence on the usefulness, practicality, and acceptance of vaccination outreach clinics in the community especially during pandemics. In this qualitative study, we explored the experiences, motivations and perceptions of service users, health professionals, strategic staff, volunteers, and community workers involved in the COVID-19 vaccination outreach clinics in Luton. METHODS: Semi structured face to face, telephone, online interviews, and focus groups were conducted with 31 participants including health professionals, strategic staff, volunteers, community workers and service users. The Framework Method was used to analyse the data and generate themes. RESULTS: Service users expressed positivity towards the convenience and familiarity of the location of the vaccination outreach clinics and the flexibility of receiving the vaccination in a local setting. Participants involved in the planning and delivery of the service commented on the worthwhile and rewarding experience but suggested more attention should be given to preparation time, service user recruitment, the working environment, and staff welfare. CONCLUSIONS: The COVID-19 mobile vaccination outreach clinics in Luton tested and developed a different model of service delivery and demonstrated a collaborative way of working: "taking the health service to the patient, not the patient to the health service". Planning and local community engagement were seen as key to successful delivery of a mobile healthcare service.

Reconstruction of the exenterated orbit with osseointegrated implants.

Osseointegrated implant-fixated prostheses are useful for the reconstruction of the exenterated orbit. They provide good cosmesis, and are comfortable and light weight for the patient to wear. A retrospective review was performed of a series of twenty patients who had undergone orbital exenterations from 2003 to 2006, including complex cases with extraorbital and transcranial tumour excisions, nineteen of which were reconstructed with osseointegrated implant-fixated prostheses. For a successful outcome, decisions need to be made regarding the reconstruction of the orbital rim, periorbital soft tissues, indications for socket reconstruction and decisions regarding both one or two stage implantation and radiotherapy planning. Osseointegrated implants provide the optimal cosmetic and functional results in the rehabilitation of the exenterated orbit in our opinion. Close collaborative planning by both the surgeon and the prosthetist from the outset is essential.

Parents' views of community care for children with motor disabilities.

In this study we have ascertained the views of 40 parents of 4-year-old children with motor disabilities, on the health and education services, social service and the availability of respite care. The children with moderate or severe motor disability who were born in 1985, were identified from the Oxford Regional Register of Early Childhood Impairment. Thirty-three (83%) completed a questionnaire taken to the home by the health visitor. Although most parents had access to a range of services, lack of information in the early years, fragmentation of services and limited choices were identified as problems. Parents regarded the breadth of care provided by the pre-school teacher counsellor and the nursery school as very useful, whereas the health service and social services were perceived as less appropriate. This small study suggests that for some families, the objectives of community care as identified in the Griffiths Report (Griffiths 1988) and reiterated in the Children Act (1989) are not yet being met.

Macrocellular silicone foam for mechanically retaining orbital prostheses.

The prosthesis processed with the technique described has a fitting surface that is smooth and glossy, a soft and uniformly compressible foam-filled mass to engage severe undercuts, and a lightweight mass for the completed prosthesis. The technique described increases laboratory time. However, the lightweight prosthesis provides intrinsic mechanical retention that justifies the extra time. Moreover, the controllable uniform compressibility of the foam-filled extension and the improved surface characteristics of the silicone fitting surface minimize the possibility of producing trauma while the prosthesis is inserted, worn, or removed by the patient.

A semi-rigid transparent face mask in the treatment of postburn hypertrophic scars.

Scars, following burns to the face or subsequent skin grafts, can become hypertrophic. The concept of pressure in their treatment is not new. Elastic garments have been popularised and used successfully. However, they have certain limitations. To date, very little reference has been made in the literature to the use of masks. The use of a semi-rigid face mask in the treatment of hypertrophic scars is described. These masks are comfortable to wear, well tolerated and very effective. Case reports are presented and the technique of manufacture detailed.