A5004683639- Global Cancer Incidence and Screening
- Health Systems, Economic Evaluations, Quality of Life
- Breast Cancer Treatment Studies
- Cancer survivorship and care
- Stroke Rehabilitation and Recovery
- Frailty in Older Adults
- Neurobiology of Language and Bilingualism
- Patient-Provider Communication in Healthcare
- Autism Spectrum Disorder Research
- Child and Adolescent Psychosocial and Emotional Development
- Family and Disability Support Research
- Global Maternal and Child Health
- Health, psychology, and well-being
- Dementia and Cognitive Impairment Research
- Palliative Care and End-of-Life Issues
- Women's cancer prevention and management
- Ethics in Clinical Research
- Diabetes Management and Education
- Cancer Risks and Factors
- Reproductive System and Pregnancy
- Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Child Nutrition and Water Access
- Diabetes Management and Research
- Gynecological conditions and treatments
- Health disparities and outcomes
University of Sheffield
2013-2023
University of Liverpool
2022-2023
Post-stroke aphasia might improve over many years with speech and language therapy; however therapy is often less readily available beyond a few months after stroke. We assessed self-managed computerised (CSLT) as means of providing more than patients can access through usual care alone.In this pragmatic, superiority, three-arm, individually randomised, single-blind, parallel group trial, were recruited from 21 departments in the UK. Participants aged 18 or older had been diagnosed...
Risk sharing schemes represent an innovative and important approach to the problems of rationing achieving cost-effectiveness in high cost or controversial health interventions. This study aimed assess feasibility risk schemes, looking at long term clinical outcomes, determine price which treatments would be acceptable NHS. case first NHS scheme, a prospective cohort beta interferon glatiramer acetate multiple sclerosis (MS) patients 71 specialist MS centres UK hospitals, recruited adults...
to test whether an occupation-based lifestyle intervention can sustain and improve the mental well-being of adults aged 65 years or over compared usual care, using individually randomised controlled trial.
Background Speech and language therapy provision for aphasia (a disorder) post stroke has been studied over time through surveys completed by speech therapists. This paper revisits based on what was received 278 patients in 21 UK departments 2014–2016. Aims To explore the community dwelling people with UK. Methods procedures A quantitative content analysis conducted two therapist researchers. Therapy goals recorded were coded into categories subcategories. Descriptive statistics used to...
IntroductionOlder patients with early breast cancer (EBC) derive modest survival benefit from chemotherapy but have increased toxicity risk. Data on the impact of for EBC quality life in older are limited, this is a key determinant treatment acceptance. We aimed to investigate its effect enrolled Bridging Age Gap study.Materials and methodsA prospective, multicentre, observational study ≥70 years old was conducted 2013–2018 at 56 UK hospitals. Demographics, patient, tumour characteristics,...
There is currently insufficient evidence for the clinical effectiveness and cost-effectiveness of psychological therapies post-stroke depression.To evaluate feasibility undertaking a definitive trial to behavioural activation (BA) compared with usual stroke care treating depression.Parallel-group, feasibility, multicentre, randomised controlled nested qualitative research health economic evaluation.Acute community services in three sites England.Community-dwelling adults 3 months 5 years...
BackgroundAge-related breast cancer treatment variance is widespread with many older women having primary endocrine therapy (PET), which may contribute to inferior survival and local control. This propensity-matched study determined if a subgroup of safely be offered PET.MethodsMulticentre, prospective, UK, observational cohort analysis determine optimal allocation surgery plus ET (S+ET) or PET in aged ≥70 cancer. Data on fitness, frailty, stage, grade, biotype, quality life were collected....
Abstract Background Rates of surgery and adjuvant therapy for breast cancer vary widely between units. This may contribute to differences in survival. cluster RCT evaluated the impact decision support interventions (DESIs) older women with cancer, ascertain whether DESIs influenced quality life, survival, quality, treatment choice. Methods A multicentre compared use two against usual care decision-making (aged at least ≥70 years) cancer. Each DESI comprised an online algorithm, booklet,...
Chemotherapy improves outcomes for high risk early breast cancer (EBC) patients but is infrequently offered to older individuals. This study determined if there are fit with high-risk disease who may benefit from chemotherapy.A multicentre, prospective, observational was performed determine chemotherapy (±trastuzumab) usage and survival quality-of-life in EBC aged ≥70 years. Propensity score-matching adjusted variation baseline age, fitness tumour stage.Three thousands four hundred sixteen...
Background Many adults with type 1 diabetes cannot self-manage their effectively and die prematurely diabetic complications as a result of poor glucose control. Following the positive results obtained from randomised controlled trial (RCT) by Dose Adjustment For Normal Eating (DAFNE) group, published in 2002, structured training is recommended for all UK. Aim With evidence that blood control not always improved or sustained, we sought to determine factors explaining why some patients benefit...
Background People with aphasia may improve their communication speech and language therapy many months/years after stroke. However, NHS reduces in availability over time post Objective This trial evaluated the clinical effectiveness cost-effectiveness of self-managed computerised to provide additional therapy. Design A pragmatic, superiority, single-blind, parallel-group, individually randomised (stratified block randomisation, stratified by word-finding severity site) adjunct trial. Setting...
5%-10% children and young people (CYP) experience specific phobias that impact daily functioning. Cognitive Behaviour Therapy (CBT) is recommended but has limitations. One Session Treatment (OST), a briefer alternative incorporating CBT principles, demonstrated efficacy. The Alleviating Specific Phobias Experienced by Children Trial (ASPECT) investigated the non-inferiority of OST compared to multi-session for treating in CYP.ASPECT was pragmatic, multi-center, randomized controlled trial 26...
<h3>Objective:</h3> The purpose of this work was to investigate the incidence rate for admission and mortality children receiving paediatric intensive care in relation socioeconomic status ethnicity England Wales. <h3>Design:</h3> National cohort sequential hospital admissions. <h3>Setting:</h3> Twenty nine units <h3>Participants:</h3> All aged under 16 years admitted 4 2004–2007. <h3>Main outcome measures:</h3> Incidence rates odds ratios (OR) risk-adjusted by an area based measure...
Growing levels of both obesity and chronic disease in the general population pose a major public health problem. In UK, an innovative 'health weight' cohort trials facility, 'South Yorkshire Cohort', is being built order to provide robust evidence inform policy, commissioning clinical decisions this field. This protocol reports design facility outlines recruitment phase methods. The South Cohort weight study uses multiple randomised controlled trial design. recruits large observational...
Introduction While breast cancer outcomes are improving steadily in younger women due to advances screening and improved therapies, there has been little change among the older age group. It is inevitable that comorbidities/frailty rates higher, which may increase risks of some treatments such as surgery chemotherapy, many healthy benefit from their use. Adjusting treatment regimens appropriately for age/comorbidity/frailty variable largely non-evidence based, specifically with regard...
There is currently insufficient evidence for the clinical and cost-effectiveness of psychological therapies treating post-stroke depression. BEADS a parallel group feasibility multicentre randomised controlled trial with nested qualitative research economic evaluation. The aim to evaluate undertaking full comparing behavioural activation (BA) usual stroke care 4 months patients We recruit 72 depression over 12 at three centres, identified from National Health Service (NHS) community acute...
Research (NIHR), was set up in 1993.It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage provide care NHS.'Health technologies' are broadly defined as all interventions used to promote health, prevent treat disease, improve rehabilitation long-term care.The findings from HTA programme directly influence decision-making bodies such National Institute Health Clinical Excellence (NICE) Screening Committee...
Abstract STUDY QUESTION What is the clinical-effectiveness and safety of endometrial scratch (ES) procedure compared to no ES, prior usual first time in vitro fertilisation (IVF) treatment? SUMMARY ANSWER ES was safe but did not improve pregnancy outcomes when performed mid-luteal phase IVF cycle, with or without intracytoplasmic sperm injection (ICSI). WHAT IS KNOWN ALREADY an ‘add-on’ treatment that available women undergoing a cycle IVF, ICSI, despite lack evidence support its use....
Autism is characterised by keen interests and differences in social interactions communication. Activities that help autistic children young people with skills are commonly used UK schools. LEGO® based therapy a new activity provides interesting fun opportunities for involves building models together. This study looked at the of It was randomised controlled trial, meaning each school randomly chosen (like flipping coin) to either run groups over 12 weeks have usual support from or other...
Recruiting isolated older adults to clinical trials is complex, time-consuming and difficult. Previous studies have suggested querying existing databases identify appropriate potential participants. We aim compare recruitment techniques (general practitioner (GP) mail-outs, community engagement clinician referrals) used in three randomised controlled trial (RCT) assessing the feasibility or effectiveness of two preventative interventions (the Lifestyle Matters Putting Life In Years...
Objectives To assess the cost-effectiveness of LEGO-based therapy compared with usual support. Design Cost-utility analysis alongside randomised control trial. Setting Mainstream primary and secondary schools in UK. Participants 248 children young people (CYP) autism spectrum disorder (ASD) aged 7–15 years. Intervention is a group social skills intervention designed specifically for CYP ASD. Through play, learn to use such as joint attention, sharing, communication problem-solving. arm...
to test the hypothesis that older people and their informal carers are not disadvantaged by home-based rehabilitation (HBR) relative day hospital (DHR).pragmatic randomised controlled trial.four geriatric hospitals four home teams in England.eighty-nine patients referred for multidisciplinary rehabilitation. The target sample size was 460.multidisciplinary either or hospital.the primary outcome measure Nottingham extended activities of daily living scale (NEADL). Secondary measures included...
Healthy, active ageing is strongly associated with good mental wellbeing which in turn helps to prevent illness. However, more investment has been made into research interventions illness than those designed improve wellbeing. This applied programme will provide high quality evidence for an intervention and sustain older adults. study was a multi-centre, pragmatic, two-arm, parallel group, individually randomised controlled trial determine the population benefit of occupational therapy based...
Background Word finding is a common difficulty for people with aphasia. Targeting words that are relevant to the individual could maximise usefulness and impact of word therapy. Aims To provide insights into aphasia perceive be personally relevant. Methods procedures 100 were each asked identify would particularly important them able say. Two speech language therapist researchers conducted quantitative content analysis selected. The coded framework topics subtopics. frequency which different...