Imperial College London

MrsHeatherHanna

Faculty of MedicineDepartment of Infectious Disease

Teaching Fellow
 
 
 
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Contact

 

+44 (0)20 7594 7214h.hanna CV

 
 
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Location

 

250Medical SchoolSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
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13 results found

Barker S, Daniels L, Chang Y-S, Chikovani T, DunnGalvin A, Gerdts JD, Gerth Van Wijk R, Gibbs T, Villarreal Gonzalez RV, Guzman-Avilan RI, Hanna H, Hossny E, Kolotilina A, Ortega Martell JA, Pacharn P, de Lira Quezada CE, Sibanda E, Stukus D, Tham EH, Venter C, Gonzalez-Diaz SN, Levin ME, Martin B, Warner JO, Munblit Det al., 2021, Allergy education and training for physicians., World Allergy Organ J, Vol: 14, Pages: 1-12, ISSN: 1939-4551

The increasing prevalence of allergic diseases has placed a significant burden on global healthcare and society as whole. This has necessitated a rapid development of "allergy" as a specialist area. However, as allergy is so common and, for most, relatively easy to diagnose and control, all clinicians need to have basic knowledge and competence  to manage  mild disease and recognize when referral is required. The allergology specialty has not yet been recognized in many countries and even where allergy is fully recognized as a specialty, the approach to training in allergy differs significantly. In the light of recent developments in allergy diagnosis and management, there is an urgent need to harmonize core competences for physicians, as well as the standardization of core principles for medical education and post-graduate training in allergy. All physicians and allied health professionals must appreciate the multidisciplinary team (MDT) approach to allergy, which is key to achieving the highest standards in holistic care. Due to worldwide variation in resources and personnel, some MDT roles will need to be absorbed by the treating physician or other healthcare professionals. We draw particular attention to the role of psychological input for all allergy patients, dietetic input in the case of food allergy and patient education to support all patients in the supported self-management of their condition on a daily basis. A strong appreciation of these multidisciplinary aspects will help physicians provide quality patient-centered care. We consider that harmonization of allergy components within undergraduate curricula is crucial to ensure all physicians develop the appropriate allergy-related knowledge and skills, particularly in light of inconsistencies seen in the primary care management of allergy. This review from the World Allergy Organization (WAO) Education and Training Committee also outlines allergy-related competences required

Journal article

Daniels L, Barker S, Chang Y-S, Chikovani T, DunnGalvin A, Gerdts JD, Gerth Van Wijk R, Gibbs T, Villarreal-Gonzalez RV, Guzman-Avilan RI, Hanna H, Hossny E, Kolotilina A, Ortega Martell JA, Pacharn P, de Lira Quezada CE, Sibanda E, Stukus D, Tham EH, Venter C, Gonzalez-Diaz SN, Levin ME, Martin B, Munblit D, Warner JOet al., 2021, Harmonizing allergy care–integrated care pathways and multidisciplinary approaches, World Allergy Organization Journal, Vol: 14, ISSN: 1939-4551

There is a wide time gap between the publication of evidence and the application of new knowledge into routine clinical practice. The consequence is sub-optimal outcomes, particularly concerning for long-term relapsing/remitting conditions such as allergic diseases. In response, there has been a proliferation of published guidelines which systematically review evidence for the gold-standard management of most allergic disorders. However, this has not necessarily been followed by improved outcomes, partly due to a lack of coordination across the patient pathway. This has become known as the "second translational gap". A proposed solution is the development and implementation of integrated care pathways (ICPs) to optimize patient outcomes, with the notion that evidence-based medicine requires evidence-based implementation. ICP implementation is shown to improve short-term outcomes for acute conditions and routine surgery, including reduced length of hospital stay, improved documentation and improved patient safety. However, this improvement is not reflected in patient experience or patient-centered functional outcomes. The implementation of life-long, cost-effective interventions within comprehensive pathways requires a deep appreciation for complexity within allergy care.We promote an evidence-based methodology for the implementation of ICPs for allergic disorders in which all stakeholders in allergy care are positioned equally and encouraged to contribute, particularly patients and their caregivers. This evidence-based process commences with scoping the unmet needs, followed by stakeholder mapping. All stakeholders are invited to meetings to develop a common vision and mission through the generation of action/effect diagrams which helps build concordance across the agencies. Dividing the interventions into achievable steps and reviewing with plan/do/study/act cycles will gradually modify the pathway to achieve the best outcomes. While the management guidel

Journal article

Boix-Amorós A, Collado MC, Van't Land B, Calvert A, Le Doare K, Garssen J, Hanna H, Khaleva E, Peroni DG, Geddes DT, Kozyrskyj AL, Warner JO, Munblit Det al., 2019, Reviewing the evidence on breast milk composition and immunological outcomes., Nutr Rev

A large number of biologically active components have been found in human milk (HM), and in both human and animal models, studies have provided some evidence suggesting that HM composition can be altered by maternal exposures, subsequently influencing health outcomes for the breastfed child. Evidence varies from the research studies on whether breastfeeding protects the offspring from noncommunicable diseases, including those associated with immunological dysfunction. It has been hypothesized that the conflicting evidence results from HM composition variations, which contain many immune active molecules, oligosaccharides, lactoferrin, and lysozyme in differing concentrations, along with a diverse microbiome. Determining the components that influence infant health outcomes in terms of both short- and long-term sequelae is complicated by a lack of understanding of the environmental factors that modify HM constituents and thereby offspring outcomes. Variations in HM immune and microbial composition (and the differing infantile responses) may in part explain the controversies that are evidenced in studies that aim to evaluate the prevalence of allergy by prolonged and exclusive breastfeeding. HM is a "mixture" of immune active factors, oligosaccharides, and microbes, which all may influence early immunological outcomes. This comprehensive review provides an in-depth overview of existing evidence on the studied relationships between maternal exposures, HM composition, vaccine responses, and immunological outcomes.

Journal article

Boyle RJ, Umasunthar T, Smith JG, Hanna H, Procktor A, Phillips K, Pinto C, Gore C, Cox HE, Warner JO, Vickers B, Hodes Met al., 2017, A brief psychological intervention for mothers of children with food allergy can change risk perception and reduce anxiety: Outcomes of a randomized controlled trial, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 47, Pages: 1309-1317, ISSN: 0954-7894

Journal article

Munblit D, Korsunskiy I, Asmanov A, Hanna Het al., 2017, THE ROLE OF BREASTFEEDING AND WEANING PRACTICES IN ALLERGIC DISEASE DEVELOPMENT, CURRENT ALLERGY & CLINICAL IMMUNOLOGY, Vol: 30, Pages: 76-81, ISSN: 1609-3607

Journal article

Boyle RJ, hanna H, 2016, Community healthcare professionals overestimate the risk of fatal anaphylaxis for food allergic children, Clinical and Experimental Allergy, ISSN: 1365-2222

Journal article

Hanna HJS, Boyle R, Emmanuel J, Naim S, Umasuntharet al., 2016, Community healthcare professionals overestimate the risk of fatal anaphylaxis for food allergic children, Clinical and Experimental Allergy, Vol: 46, Pages: 1501-1503, ISSN: 1365-2222

Journal article

Umasunthar T, Procktor A, Hodes M, Smith JG, Gore C, Cox HE, Marrs T, Hanna H, Phillips K, Pinto C, Turner PJ, Warner JO, Boyle RJet al., 2015, Patients' ability to treat anaphylaxis using adrenaline autoinjectors: a randomized controlled trial, ALLERGY, Vol: 70, Pages: 855-863, ISSN: 0105-4538

Journal article

Boyle R, Procktor A, Phillips K, Pinto C, Hanna H, Umasunthar Tet al., 2015, Ability to successfully use an epinephrine auto‐injector after switching to a different device, Clinical and Translational Allergy, Vol: 5, ISSN: 2045-7022

Journal article

Gore RB, Boyle RJ, Gore C, Custovic A, Hanna H, Svensson P, Warner JOet al., 2015, Effect of a novel temperature-controlled laminar airflow device on personal breathing zone aeroallergen exposure, INDOOR AIR, Vol: 25, Pages: 36-44, ISSN: 0905-6947

Journal article

Lau G-Y, Patel N, Umasunthar T, Gore C, Warner JO, Hanna H, Phillips K, Zaki AM, Hodes M, Boyle RJet al., 2014, Anxiety and stress in mothers of food-allergic children, PEDIATRIC ALLERGY AND IMMUNOLOGY, Vol: 25, Pages: 236-242, ISSN: 0905-6157

Journal article

Gore R, Boyle R, Hanna H, Custovic A, Gore C, Svensson P, Warner Jet al., 2010, Effect of a novel temperature-controlled laminar airflow device on personal breathing zone cat allergen exposure, 29th Congress of the European-Academy-of-Allergy-and-Clinical-Immunology (EAACI), Publisher: WILEY-BLACKWELL, Pages: 686-686, ISSN: 0105-4538

Conference paper

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