A5042520062- Primary Care and Health Outcomes
- Hormonal Regulation and Hypertension
- Child and Adolescent Health
- Emergency and Acute Care Studies
- Health disparities and outcomes
- Frailty in Older Adults
- COVID-19 and Mental Health
- Heart Failure Treatment and Management
- Healthcare Policy and Management
- Long-Term Effects of COVID-19
- Adrenal and Paraganglionic Tumors
- Chronic Disease Management Strategies
- Data Quality and Management
- Homelessness and Social Issues
- Data-Driven Disease Surveillance
- Migration, Health and Trauma
- Telemedicine and Telehealth Implementation
- Health Policy Implementation Science
- Health, Environment, Cognitive Aging
- Digital Mental Health Interventions
- COVID-19 and healthcare impacts
- Artificial Intelligence in Healthcare and Education
- Healthcare Systems and Technology
- Health Services Management and Policy
- Census and Population Estimation
University of Cambridge
2020-2025
Harvard University
2001-2025
Brigham and Women's Hospital
2023-2025
University College London
2016-2025
Anna Freud Centre
2022-2025
Cambridgeshire and Peterborough NHS Foundation Trust
2020-2024
Midland Regional Hospital at Tullamore
2014-2023
Heartbeat Trust
2021
Fulbourn Hospital
2020
Go2 for Lung Cancer
2019
Abstract Context Primary aldosteronism is a form of low-renin hypertension characterized by dysregulated aldosterone production. Objective To investigate the contributions renin-independent and ACTH-mediated in individuals with phenotype representing entire continuum blood pressure. Design/Participants Human physiology study 348 participants severe and/or resistant hypertension, hypokalemia, elevated pressure stage I/II normal Setting 4 international centers. Interventions/Main Outcome...
BACKGROUND: Primary aldosteronism, an endocrinopathy present in ≥10% to 25% of patients with hypertension, confers excess cardiovascular risk that can be mitigated aldosterone-directed therapy. However, only 2% eligible undergo guideline-recommended screening. This study aimed bypass clinical inertia and identify people primary aldosteronism using pragmatic, direct-to-patient testing. METHODS: Hypertensive adults were recruited via online platforms underwent virtual consent local phlebotomy....
Abstract Aims Developing integrated mental health services focused on the needs of children and young people is a key policy goal in England. The THRIVE Framework its implementation programme, i-THRIVE, are widely used This study examines experiences staff using estimates effectiveness, assesses how local system working relationships influence programme success. Methods evaluation uses quasi-experimental design (10 10 comparison sites.) Measurements included surveys assessment ‘THRIVE-like’...
Atrial natriuretic peptide (ANP) and brain (BNP) are known to be elevated in patients with chronic heart failure at rest. While it is that during exercise the circulating level of ANP increases failure, response BNP these relative control subjects unclear. Ten stable 10 normal performed symptom‐limited respired gas analysis. All had depressed left ventricular ejection fractions (LVEF). Patients lower peak oxygen consumption P V ˙ O 2 ) than group [median (range) 1.18 (0.98–1.76) vs. 1.94...
Abstract Background The i‐THRIVE Programme is a needs‐based model of care, based on the THRIVE Framework, that being implemented across United Kingdom with aim improving outcomes for children and young people's mental health wellbeing. This study aimed to investigate impact this programme has accessibility quality as viewed by key stakeholders. Methods Interviews professionals service users were conducted during implementation Framework in four sites one community provider. Results Three...
Accessible summary What Is Known on the Subject? Mental health care can be delivered remotely through video and telephone consultations. Remote consultations may cheaper more efficient than in person Paper Adds to Existing Knowledge Accessing community mental remote is perceived as not possible or beneficial for all service users. Delivering practical appropriate clinicians teams. are Implications Practice? consultation cannot a ‘one‐size‐fits‐all’ model of care. A flexible approach needed...
The Covid-19 crisis necessitated rapid adoption of remote consultations across National Health Service (NHS) child and adolescent mental health services (CAMHS). This study aimed to understand practitioners' experiences implementation CAMHS in one NHS trust the east England. Data were collected through a brief questionnaire documenting clinicians' following delivery services. began before 'lockdown' focused on assessment (n = 102) as part planned move virtual assessment. As roll-out was...
The National i-THRIVE Programme seeks to evaluate the impact of NHS England-funded whole system transformation on child and adolescent mental health services (CAMHS). This article reports design for a model implementation that has been applied in CAMHS across over 70 areas England using ‘THRIVE’ needs-based principles care. protocol which this model, ‘i-THRIVE’ (implementing-THRIVE), will be used effectiveness THRIVE intervention is reported, together with evaluation process implementation....
Peak oxygen consumption is reduced in patients with symptomatic congestive heart failure, but functional capacity of asymptomatic left ventricular systolic dysfunction has not been assessed by measurement peak attained during graded exercise testing.Peak consumption, that is, aerobic (VO2, mL/kg per minute), was determined treadmill using the modified Naughton protocol 40 (mean ejection fraction ranging from 14% to 35%; mean, 29%) who, while receiving any cardiac medications, were totally...
Utilisation of the Emergency Department (ED) for non-urgent care increases demand services, therefore reducing inappropriate or avoidable attendances is an important area intervention in prevention ED crowding. This study aims to develop a consensus between clinicians across settings about "appropriateness" Ireland.The Better Data, Planning was multi-centre, cross-sectional investigating factors influencing utilisation Ireland. Data compiled patient summary files which were assessed measures...
Background Rates of childhood mental health problems are increasing in the United Kingdom. Early identification is challenging but critical to future psycho-social development children, particularly those with social care contact. Clinical prediction tools could improve these early efforts. Aims Characterise a novel cohort children and develop validate effective Machine Learning (ML) models for problems. Method We used linked, de-identified data from Secure Anonymised Information Linkage...
Abstract Background Extracellular calcium critically regulates physiologic aldosterone production. Moreover, abnormal flux and signaling are involved in the pathogenesis of majority primary aldosteronism cases. Methods We investigated influence saline suppression test (SST) on homeostasis prospectively recruited participants (n = 86). Results During SST, 100% had decreases serum calcium, with 48% developing frank hypocalcemia. Serum declined from 2.30 ± 0.08 mmol/L to 2.13 (P < .001)...
Aims: Developing integrated mental health services that focus on the needs of children and young people is a key policy goal in England. The THRIVE Framework its associated implementation programme, i-THRIVE, are now used areas covering over 65% England's children. This study explores experiences staff involved with i-THRIVE assesses effectiveness, examines how local system working relationships influence programme's success. Methods: programme was evaluated using quasi-experimental among...
BACKGROUND: COVID-19 has affected social interaction and healthcare worldwide.METHODS: We examined changes in presentations referrals to the primary provider of mental health community services Cambridgeshire Peterborough, UK, plus service activity deaths. conducted interrupted time series analyses with respect UK "lockdown". standardized mortality ratio for those without severe illness (SMI).OUTCOMES: Referrals nearly all physical dropped at lockdown, evidence both supply (service...