A5033176888- Frailty in Older Adults
- Cardiac pacing and defibrillation studies
- Heart Failure Treatment and Management
- Emergency and Acute Care Studies
- Pneumonia and Respiratory Infections
- Nutrition and Health in Aging
- Intensive Care Unit Cognitive Disorders
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare Systems and Technology
- Cardiovascular and exercise physiology
- Anesthesia and Neurotoxicity Research
- Geriatric Care and Nursing Homes
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Hip and Femur Fractures
- ECG Monitoring and Analysis
- Physical Activity and Health
- HIV/AIDS drug development and treatment
- Innovations in Medical Education
- Cardiovascular Function and Risk Factors
- Eosinophilic Esophagitis
- Nosocomial Infections in ICU
- Telemedicine and Telehealth Implementation
- HIV Research and Treatment
- HIV/AIDS Research and Interventions
- Inflammatory Bowel Disease
Medical Defence Union
2023-2025
University of Manchester
1976-2024
Manchester Academic Health Science Centre
2019-2024
Manchester University
2024
Northern Health
2023
University of Birmingham
2021-2023
Pennine Acute Hospitals NHS Trust
2021
Manchester University NHS Foundation Trust
2017-2021
The Royal Wolverhampton NHS Trust
2021
Greater Manchester Mental Health NHS Foundation Trust
2018-2021
Background. The recently introduced concept of health care–associated pneumonia (HCAP), referring to patients with frequent healthcare contacts and at higher risk contracting resistant pathogens, is controversial.
Abstract Introduction Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty unclear. Methods This multi-centre cohort study involved patients aged 18 years and hospitalised COVID-19, using routinely collected data. We used Cox regression analysis to assess impact age, delirium on risk inpatient mortality, adjusting for sex, illness severity, inflammation co-morbidities. ordinal logistic Clinical Frailty Scale (CFS)...
Background. The 2007 Infectious Disease Society of America/American Thoracic (IDSA/ATS) guidelines for community-acquired pneumonia (CAP) recommended new criteria to guide admission the intensive care unit (ICU) patients with this condition. Although major (requirement mechanical ventilation or septic shock requiring vasopressor support) are well established, value minor alone have not been fully validated.
<b>Objective</b> To study the association of clarithromycin with cardiovascular events in setting acute exacerbations chronic obstructive pulmonary disease and community acquired pneumonia. <b>Design</b> Analysis two prospectively collected datasets. <b>Setting</b> Chronic dataset including patients admitted to one 12 hospitals around United Kingdom between 2009 2011; Edinburgh pneumonia cohort NHS Lothian Hospitals 2005 2009. <b>Population</b> 1343 hospital 1631 <b>Main outcome measures</b>...
ABSTRACT Background: There are still substantial uncertainties over best practice in delirium care. The European Delirium Association (EDA) conducted a survey of its members and other interested parties on various aspects Methods: invitation to participate the online was distributed among EDA membership. covered assessment, treatment hyperactive hypoactive delirium, organizational management. Results: A total 200 responses were collected (United Kingdom 28.6%, Netherlands 25.3%, Italy 15%,...
Background: Online access to all or part of their health records is widely demanded by patients and, where provided in form patient portals, has been substantially used at least subgroups patients, particularly those with chronic disease. However, little reported regarding the longer-term use patient-accessible electronic record services, which important allocating resources. Renal PatientView (RPV) an established system that gives kidney disease live test results and information about...
Abstract Aims Remote monitoring of patients with physiological data derived from cardiac implanted electronic devices (CIEDs) offers potential to reconfigure clinical services. The ‘Heart Failure Risk Score' (HFRS) uses input integrated device risk‐stratify as low‐risk, medium‐risk, or high‐risk a heart failure event in the next 30 days. This study aimed evaluate novel pathway utilizing combination CIED risk‐stratification and telephone triage identify worsening (WHF). Methods results A...
To determine if remotely monitored physiological data from cardiac implantable electronic devices (CIEDs) can be used to identify patients at high risk of mortality.This study evaluated whether a score based on CIED (Triage-Heart Failure Risk Status, 'Triage-HFRS', previously validated predict heart failure (HF) events) death. Four hundred and thirty-nine adults with CIEDs were prospectively enrolled. Primary observed outcome was all-cause mortality (median follow-up: 702 days). Several...
Aims In response to the COVID-19 pandemic, UK was placed under strict lockdown measures on 23 March 2020. The aim of this study quantify effects physical activity (PA) levels using data from prospective Triage-HF Plus Evaluation study. Methods This represents a cohort adult patients with implanted cardiac devices capable measuring by embedded accelerometery via remote monitoring platform. Activity were available for 4 weeks pre-implementation and post implementation ‘stay at home’ in form...
Abstract Purpose Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It common, particularly older adults, but poorly recognised. Frailty the accumulation of deficits conferring increased risk adverse outcomes. We set out to determine how severity frailty, as measured using CFS, affected delirium rates, recognition hospitalised people United Kingdom. Methods Adults over 65 years were included observational multi-centre audit...
Abstract Aims This study aims to establish the feasibility, safety, and efficacy of outpatient intravenous (IV) diuretic treatment for management decompensated heart failure (HF) patients enrolled in HeartFailure@Home service. Methods results We retrospectively analysed clinical episodes HF service, managed by ambulatory IV either at home or on a day‐case unit. A control group consisting admitted hospital diuretics (standard‐of‐care) was also evaluated. In total, 203 ( n = 154 patients) were...
We introduced a geographically embedded frailty unit, the comprehensive older person's evaluation 'COPE' zone within our emergency assessment unit (EAU). collated data for all medical patients over 75 years admitted non-electively one month before and after this service change. Significantly more were seen by geriatrician on EAU earlier in their admission 2014 (33.4 vs 19.3%, p<0.001; 11 20 h, p<0.001). More had documented geriatric discussion multidisciplinary team meeting (relative risk...
<h3>ABSTRACT</h3> Despite numerous national campaigns, frailty remains under-recognised in the hospital setting. We performed a survey of hospital-based clinicians across UK to identify barriers identification and best practice management hospital. A total 402 were surveyed range grades, specialties hospitals. Responses highlighted variable awareness personal understanding frailty, particularly among junior doctors non-medical specialties. Although 74% responders agreed assessments should be...
Background Unplanned hospitalizations are common in patients with cardiovascular disease. The "Triage Heart Failure Risk Status" (Triage-HFRS) algorithm cardiac implantable electronic devices uses data from up to 9 device-derived physiological parameters stratify as low/medium/high risk of 30-day heart failure (HF) hospitalization, but its use predict all-cause hospitalization has not been explored. We examined the association between Triage-HFRS and all-cause, cardiovascular, or HF...
Abstract Background There is lack of standardisation in assessment tools used geriatric medicine research, which makes pooling data and cross-study comparisons difficult. Methods We conducted a modified Delphi process to establish measures be included within core extended datasets for research the United Kingdom (UK). This three complete questionnaire rounds, one consensus meeting. Participants were selected from attendance at NIHR Newcastle Biomedical Research Centre meeting, May 2019,...
Objectives This study sets out to ascertain if recognition of delirium impacts on patient outcomes. Design Retrospective cohort study. Setting Unscheduled admissions acute care trust/secondary UK hospitals. Participants Six hundred and fifty-six older adults aged ≥65 years admitted 14 September 2018. Measurements Delirium was ascertained retrospectively from case notes using medical notes. Documented classified as recognised unrecognised delirium. Primary secondary outcome measures measure:...
Relatively little is known about the mating behaviour of hermaphrodite freshwater snails, many which transmit Schistosoma trematodes among humans in developing countries. Knowledge breeding biology these snails could help design schistosome control programmes, as well possibly contributing to our understanding evolution simultaneous hermaphroditism animaL. Here we describe an experiment investigating patterns sexual roles adopted by mansoni-vectot snail, Btmphalaria glabrata. During...