A5041602186- Lipoproteins and Cardiovascular Health
- Health Systems, Economic Evaluations, Quality of Life
- Cultural Competency in Health Care
- Uterine Myomas and Treatments
- Endometriosis Research and Treatment
- Childhood Cancer Survivors' Quality of Life
- Primary Care and Health Outcomes
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Prenatal Screening and Diagnostics
- Palliative Care and End-of-Life Issues
- BRCA gene mutations in cancer
- Hemoglobinopathies and Related Disorders
- Obesity and Health Practices
- Migration, Health and Trauma
- Interpreting and Communication in Healthcare
- Mental Health Treatment and Access
- Genomics and Rare Diseases
- Emergency and Acute Care Studies
- Iron Metabolism and Disorders
- Chronic Disease Management Strategies
- Gynecological conditions and treatments
- Global Health Workforce Issues
- Obesity, Physical Activity, Diet
- Digital Mental Health Interventions
- Health Promotion and Cardiovascular Prevention
University of Nottingham
2016-2025
Nottingham Biomedical Research Centre
2013-2025
City University of Hong Kong
2024
Jiangsu University
2024
NIHR Clinical Research Network
2023
NIHR MindTech MedTech Co-operative
2023
Northamptonshire Healthcare NHS Foundation Trust
2023
Institute of Mental Health
2023
National Institute for Health Research
2013-2023
University College London
2009-2023
Current approaches to predict cardiovascular risk fail identify many people who would benefit from preventive treatment, while others receive unnecessary intervention. Machine-learning offers opportunity improve accuracy by exploiting complex interactions between factors. We assessed whether machine-learning can prediction.
Background Heavy menstrual bleeding (HMB) is a common problem, yet evidence to inform decisions about initial medical treatment limited. Objectives To assess the clinical effectiveness and cost-effectiveness of levonorgestrel-releasing intrauterine system (LNG-IUS) (Mirena ® , Bayer) compared with usual treatment, exploration women’s perspectives on treatment. Design A pragmatic, multicentre randomised trial an economic evaluation longitudinal qualitative study. Setting Women who presented...
<h3>Abstract</h3> <b>Objective</b>: To identify and explore parents9 concerns when young children become acutely ill. <b>Design</b>: Qualitative study making use of semi-structured one to group interviews with parents preschool children. <b>Setting</b>: Disadvantaged inner city community. <b>Subjects</b>: 95 <b>Results</b>: Fever, cough, the possibility meningitis were primary their became Parents9 reflected lay beliefs, interpretation medical knowledge, fears that child might die or be...
<h3>Abstract</h3> <b>Objectives</b>: To identify and explore difficulties parents experience with acute illness in young children the information they seek to help them. <b>Design</b>: Qualitative study using semistructured one group interviews of preschool children. <b>Setting</b>: Disadvantaged inner city community. <b>Subjects</b>: 95 <b>Results</b>: Parents felt disempowered when dealing their because making sense illness. Central parents9 were experiences inadequate sharing by general...
While ethnic disparities in health and care are increasing, evidence on how to enhance quality of reduce inequalities remains limited. Despite growth the scope application guidelines "cultural competence," remarkably little is known about practising professionals experience perceive their work with patients from diverse communities. Using cancer as a clinical context, we aimed explore this range inform interventions care.We conducted qualitative study involving 18 focus groups purposeful...
Menorrhagia is a common problem, yet evidence to inform decisions about therapy limited. In pragmatic, multicenter, randomized trial, we compared the levonorgestrel-releasing intrauterine system (levonorgestrel-IUS) with usual medical treatment in women menorrhagia who presented their primary care providers.We randomly assigned 571 levonorgestrel-IUS or (tranexamic acid, mefenamic combined estrogen-progestogen, progesterone alone). The outcome was patient-reported score on Multi-Attribute...
Background Prognostic modelling using standard methods is well-established, particularly for predicting risk of single diseases. Machine-learning may offer potential to explore outcomes even greater complexity, such as premature death. This study aimed develop novel prediction algorithms machine-learning, in addition survival modelling, predict all-cause mortality. Methods A prospective population cohort 502,628 participants aged 40–69 years were recruited the UK Biobank from 2006–2010 and...
Objective To assess low-density lipoprotein cholesterol (LDL-C) response in patients after initiation of statins, and future risk cardiovascular disease (CVD). Methods Prospective cohort study 165 411 primary care patients, from the UK Clinical Practice Research Datalink, who were free CVD before statin initiation, had at least one pre-treatment LDL-C within 12 months before, post-treatment 24 after, initiation. Based on current national guidelines, <40% reduction baseline was classified...
Background. People of South Asian origin have higher mortality and morbidity from coronary heart disease (CHD) diabetes than those European origin. However, physical activity, established value in primary secondary prevention, appears lower among Asians. Objective. To explore influences on, attitudes towards, activity women with CHD to inform prevention strategies. Methods. Exploratory qualitative study aged 26–70 years varying ethnicity, religion socio-economic background and/or...
Heterozygous familial hypercholesterolaemia (FH) is a common autosomal dominant disorder. The vast majority of affected individuals remain undiagnosed, resulting in lost opportunities for preventing premature heart disease. Better use routine primary care data offers an opportunity to enhance detection. We sought develop new predictive algorithm improving identification who could be prioritised further clinical assessment using established diagnostic criteria.Data were analysed 2,975,281...
Aspartate aminotransferase to alanine (AST/ALT) ratio, reflecting liver disease severity, has been associated with increased risk of cardiovascular (CVD). The aim this study was evaluate whether the AST/ALT ratio improves established prediction tools in a primary care population.
Ethnic disparities in use of cancer genetics services raise concerns about equitable opportunity to benefit from familial risk assessment, improved survival and quality life. This paper considers available research explore what may hinder or facilitate minority ethnic access services. We sought inform service development for people South Asian, African Irish origin at breast, ovarian, colorectal prostate cancers the UK. Relevant studies UK, North America Australasia were identified six...
It is challenging to engage repeat users of unscheduled healthcare with severe health anxiety in psychological help and high service costs are incurred. We investigated whether clinical economic outcomes were improved by offering remote cognitive behaviour therapy (RCBT) using videoconferencing or telephone compared treatment as usual (TAU). A single-blind, parallel group, multicentre randomised controlled trial was undertaken primary general hospital care. Participants aged ≥18 years ≥2...
Data about variations in stroke incidence and subsequent major adverse outcomes are essential to inform secondary prevention prioritizing resources those at the greatest risk of end points. We aimed describe age, sex, socioeconomic differences rates first nonfatal outcomes.The cohort study used linked Clinical Practice Research Datalink Hospital Episode Statistics data from United Kingdom. The rate (IR) ratio (composite cardiovascular events, recurrent stroke, disease-related, all-cause...
Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on heart failure, CVD and mortality has not been quantified.This population-based cohort study used routine UK primary care electronic health data linked to secondary death-registry records. We identified adults who were obese, free from had repeated BMI measures. Using group-based trajectory modelling, we examined...
Objective There is a growing interest in developing and offering more systematic preconception healthcare. However, it unclear how this might be regarded by ethnically diverse communities at higher risk of poor maternal child health outcomes. We sought to explore perceptions about care among women from these identify opportunities challenges for intervention development primary care. Design Qualitative study using focus groups semistructured interviews. Setting Ethnically socially...
Evidence concerning the influence of ethnic diversity on clinical encounters in cancer care is sparse. We explored health providers' experiences this context. Focus groups were conducted with a purposeful sample 106 professionals differing disciplines, 18 UK primary and secondary settings. Qualitative data analysed using constant comparison processes for validation. Communication quality information exchanged patients about their treatment was commonly frustrated within interpreter-mediated...
There is substantial evidence that health and health-care experiences vary along ethnic lines the need to understand tackle inequalities has repeatedly been highlighted. Research into ethnicity raises ethical, theoretical methodological issues and, as volume of research in this area grows, so too do concerns regarding its scientific rigour reporting, contribution reducing inequalities. Guidance may be helpful encouraging researchers adopt standard practices design, conduct reporting...
<h3>Objectives</h3> To explore how parents navigate urgent and emergency care (U&EC) services when their child <5 years old has a feverish illness, views of that experience whether are meeting needs triaging in line with national guidance. <h3>Design</h3> Parents febrile contacting any U&EC service three localities during 6-month period were invited to participate telephone questionnaire supplemented by case note review. A subset participated an in-depth interview....
The purpose of this study was to understand clinicians' and parents' perceptions communication within consultations for respiratory tract infections (RTI) in children what influence clinician had on understanding antibiotic treatment.We video recorded 60 primary care aged 3 months 12 years who presented with RTI cough 6 practices England. We then used purposive sampling select 27 parents 13 clinicians semistructured video-elicitation interviews. videos were as prompts investigate...
Universal newborn screening for sickle cell disorders and cystic fibrosis aims to enable the early identification treatment of affected babies. Screening can also identify infants who are healthy carriers, with carrier results being commonest outcome parents professionals discuss in practice. However it is unclear what effect will be on informed their baby's result. Semi-structured face-to-face interviews were conducted a purposeful sample 67 family members (49 mothers, 16 fathers, 2...
Improving care coordination for people with rare conditions may help to reduce burden on patients and carers improve the that receive. We recently developed a taxonomy of different ways coordinating conditions. It is not yet known which models are appropriate in situations. This study aimed to: (1) explore what types be situations, (2) use these findings develop hypothetical
Postnatal depression necessitates timely and effective interventions to mitigate adverse maternal child outcomes in the short term over life course. British south Asian women with are often underserved undertreated due stigma, language barriers, cultural barriers. This trial aimed test clinical efficacy of a culturally adapted, group cognitive behavioural therapy (CBT)-based intervention, Positive Health Programme (PHP), delivered by non-specialist health workers for postnatal women.