A5075660648- Airway Management and Intubation Techniques
- Pelvic floor disorders treatments
- Respiratory and Cough-Related Research
- Retinal Imaging and Analysis
- Cardiac Arrest and Resuscitation
- Cardiac, Anesthesia and Surgical Outcomes
- Retinal Diseases and Treatments
- Health Systems, Economic Evaluations, Quality of Life
- Urinary Bladder and Prostate Research
- Pneumonia and Respiratory Infections
- Dermatology and Skin Diseases
- Health and Medical Research Impacts
- Retinal and Optic Conditions
- Antibiotic Use and Resistance
- Ear Surgery and Otitis Media
- Trauma and Emergency Care Studies
- Contact Dermatitis and Allergies
- Trauma Management and Diagnosis
- Respiratory Support and Mechanisms
- Emergency and Acute Care Studies
- Meta-analysis and systematic reviews
- Infection Control and Ventilation
- Dialysis and Renal Disease Management
- Food Allergy and Anaphylaxis Research
- Obesity, Physical Activity, Diet
University of Bristol
2016-2025
Institute of Population and Public Health
2021-2024
Mount Sinai Hospital
2024
At Bristol
2019-2023
University of Glasgow
2023
University of North Carolina at Chapel Hill
2023
University of Birmingham
2023
Hull Royal Infirmary
2017
Bristol Royal Infirmary
2015
Queen's University
1999
<h3>Importance</h3> The optimal approach to airway management during out-of-hospital cardiac arrest is unknown. <h3>Objective</h3> To determine whether a supraglottic device (SGA) superior tracheal intubation (TI) as the initial advanced strategy in adults with nontraumatic arrest. <h3>Design, Setting, and Participants</h3> Multicenter, cluster randomized clinical trial of paramedics from 4 ambulance services England responding emergencies for approximately 21 million people. Patients aged...
Background Bevacizumab (Avastin ® , Roche), which is used in cancer therapy, the ‘parent’ molecule from ranibizumab (Lucentis Novartis) was derived for treatment of neovascular age-related macular degeneration (nAMD). There were reports literature on effectiveness bevacizumab treating nAMD, but no trials. The cost per dose about 5–10% that ranibizumab. This trial a head-to-head comparison these two drugs. Objective To compare clinical and cost-effectiveness bevacizumab, regimens, nAMD....
To our knowledge, there are no trials comparing emollients commonly used for childhood eczema. We aimed to compare the clinical effectiveness and safety of four main emollient types: lotions, creams, gels, ointments.We did a pragmatic, individually randomised, parallel group, phase 4 superiority trial in 77 general practice surgeries England. Children aged between 6 months 12 years with eczema (Patient Orientated Eczema Measure [POEM] score >2) were randomly assigned (1:1:1:1; stratified by...
BackgroundDrugs modifying angiotensin II signalling could reduce Alzheimer's disease pathology, thus decreasing the rate of progression. We investigated whether receptor antagonist losartan, compared with placebo, brain volume loss, as a measure progression, in clinically diagnosed mild-to-moderate disease.MethodsIn this double-blind, multicentre, randomised controlled trial, eligible patients aged 55 years or older, previously untreated drugs and (National Institute Neurological...
Abstract Background More than a third of the 65,000 people living with kidney failure in UK attend dialysis unit 2–5 times week to have their blood cleaned for 3–5 h. In haemodialysis (HD), toxins are removed by diffusion, which can be enhanced using high-flux dialyser. This augmented convection, as occurs haemodiafiltration (HDF), and improved outcomes been reported who able achieve high volumes convection. study compares clinical- cost-effectiveness high-volume HDF compared HD treatment...
Abstract Background While patient and public involvement (PPI) in clinical trials is beneficial mandated by some funders, formal guidance on how to implement PPI limited challenges have been reported. We aimed investigate approached within a UK Clinical Trials Unit (CTU)’s portfolio of randomised controlled trials, perceived barriers to/facilitators its successful implementation, perspectives the CTU’s role PPI. Methods A mixed-methods study design, involving (1) an online survey 26 trial...
To assess whether an easy-to-use multifaceted intervention for children presenting to primary care with respiratory tract infections would reduce antibiotic dispensing, without increasing hospital admissions infection.
Abstract Background Antibiotics are prescribed for over 50% of RTIs in primary care, despite good evidence most patients do not benefit. Rapid multiplex microbiological point-of-care-tests (POCTRM) determine the presence/ absence respiratory pathogens 15 min. Whether POCTRM reduce antibiotic prescribing without worsening patient outcomes is known. Objectives To investigate whether can (i) same-day children and adults presenting to care with RTIs; (ii) change symptom severity on Days 2 4....
Abstract Background Respiratory tract infections (RTIs) are common in people care homes. Transmission can be through direct contact or airborne particles. Portable high-efficiency-particulate-air (HEPA) filtration units remove microbial particles, but it is unclear if this sufficient to reduce infections. Objectives To investigate the effectiveness of portable HEPA RTIs home residents. Methods Ninety residential homes were randomized communal rooms and private bedrooms usual care. Primary...
Lower urinary tract symptoms (LUTS) are a key indication for surgery in older men. The Urodynamics Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM) study evaluated the diagnostic pathway men considering to treat LUTS and reported outcomes at 18 mo. This long-term follow-up reports rates prostate 5 yr. UPSTREAM participants who had consented received postal questionnaires yr after randomisation (October 2019-December 2021). primary outcome was patient-reported...
Health outcomes after out of hospital cardiac arrest (OHCA) are extremely poor, with only 7-9% patients in the United Kingdom (UK) surviving to discharge. Currently emergency medical services (EMS) use either tracheal intubation or newer supraglottic airway devices (SGAs) provide advanced management during OHCA. Equipoise between two techniques has led calls for a well-designed randomised controlled trial. The primary objective AIRWAYS-2 trial is assess whether clinical effectiveness i-gel,...
Background Patients with neovascular age-related macular degeneration (nAMD) usually attend regular reviews, even when the disease is quiescent. Reviews are burdensome to health services, patients and carers. Objectives To compare proportion of correct lesion classifications made by community-based optometrists ophthalmologists from vignettes patients; estimate cost-effectiveness community follow-up compared in Hospital Eye Service (HES); ascertain views patients, their representatives,...
Background Lidocaine patches, applied over rib fractures, may reduce pulmonary complications in older patients. Known barriers to recruiting patients emergency settings necessitate a feasibility trial. We aimed establish whether definitive randomised controlled trial (RCT) evaluating lidocaine patches with fracture(s) was feasible. Methods This multicentre, parallel-group, open-label, RCT seven hospitals England and Scotland. Patients aged ≥65 years, presenting ED traumatic requiring...
Chronic kidney disease (CKD) prevalence is steadily increasing, in part due to increased multimorbidity our aging global population. When progression failure cannot be avoided, people need unbiased information inform decisions about whether start dialysis, if or when indicated, continue with holistic person-centred care without dialysis (conservative management). Comparisons suggest that while there may some survival benefit from over conservative management, aged 80 years and over, multiple...
Background When a cardiac arrest occurs, cardiopulmonary resuscitation should be started immediately. However, there is limited evidence about the best approach to airway management during arrest. Objective The objective was determine whether or not i-gel ® (Intersurgical Ltd, Wokingham, UK) supraglottic superior tracheal intubation as initial advanced strategy in adults with non-traumatic out-of-hospital Design This pragmatic, open, parallel, two-group, multicentre, cluster randomised...
Abstract Background Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to manage anxiety in adults with an autism diagnosis. However, their effectiveness and adverse effect profile the autistic population not well known. This trial aims determine cost-effectiveness of SSRI sertraline reducing symptoms improving quality life a diagnosis compared placebo quantify any effects. Methods STRATA is two-parallel group, multi-centre, pragmatic, double-blind, randomised...
To explore the views of eye health professionals and service users on shared community hospital care for wet or neovascular age-related macular degeneration (nAMD).Using maximum variation sampling, 5 focus groups 10 interviews were conducted with 23 24 from across UK (consisting 8 optometrists, 6 ophthalmologists, commissioners, 2 public representatives clinical advisors to local Clinical Commissioning Groups). Data transcribed verbatim analysed thematically using constant comparative...
Objectives To estimate the cost-effectiveness of a primary care intervention for male lower urinary tract symptoms (LUTS) compared with usual care. Design Economic evaluation alongside cluster randomised controlled trial from UK National Health Service (NHS) perspective 12-month time horizon. Setting Thirty NHS general practice sites in England. Participants 1077 men aged 18 or older identified bothersome LUTS. Interventions A standardised and manualised treatment LUTS was The group (n=524)...
Introduction Traumatic pneumothoraces are present in one of five victims severe trauma. Current guidelines advise chest drain insertion for most traumatic pneumothoraces, although very small can be managed with observation at the treating clinician’s discretion. There remains a large proportion patients whom there is clinical uncertainty as to whether an immediate required, no robust evidence inform practice. Chest drains carry high risk complications such bleeding and infection. The default...
Respiratory tract infections are readily transmitted in care homes. Airborne transmission of pathogens causing respiratory illness is largely unmitigated. Portable high-efficiency-particulate-air (HEPA) filtration units capture microbial particles from the air, but it unclear whether this sufficient to reduce home residents. The Air Filtration prevent symptomatic winter Infections (including COVID-19) homes (AFRI-c) randomized controlled trial will determine using HEPA reduces infection episodes
Atopic dermatitis/eczema affects around 20% of children and is characterised by inflamed, dry, itchy skin. Guidelines recommend 'leave-on' emollients that are applied directly to the skin add or trap moisture used regularly, they can soothe, enhance barrier may prevent disease 'flares'. However, suitability many different varies between people there little evidence help prescribers parents carers decide which type try first. Design: pragmatic, multicentre, individually randomised, parallel...
Abstract Background Falls are a common complication of Parkinson’s disease. There is need for new therapeutic options to target this debilitating aspect the Cholinergic deficit has been shown contribute both gait and cognitive dysfunction seen in condition. Potential benefits using cholinesterase inhibitors were during single centre phase 2 trial. The aim trial evaluate effectiveness inhibitor on fall rate people with idiopathic Methods This multi-centre, double-blind, randomised...