A5005959314- Palliative Care and End-of-Life Issues
- Geriatric Care and Nursing Homes
- Cancer survivorship and care
- Primate Behavior and Ecology
- Child and Animal Learning Development
- Liver Disease and Transplantation
- Grief, Bereavement, and Mental Health
- Childhood Cancer Survivors' Quality of Life
- Homelessness and Social Issues
- Mindfulness and Compassion Interventions
- Complementary and Alternative Medicine Studies
- Ethics in medical practice
- Liver Disease Diagnosis and Treatment
- Organ Transplantation Techniques and Outcomes
- Patient Satisfaction in Healthcare
- Dementia and Cognitive Impairment Research
- Neuroendocrine regulation and behavior
- Cancer-related cognitive impairment studies
- Language, Metaphor, and Cognition
- Animal Behavior and Reproduction
- Team Dynamics and Performance
- Bone health and treatments
- Memory and Neural Mechanisms
- Pharmacovigilance and Adverse Drug Reactions
- Interprofessional Education and Collaboration
University of South Carolina
2023
University College London
2012-2022
Marie Curie
2012-2022
University of St Andrews
2016-2022
Nottingham University Hospitals NHS Trust
2021
Newcastle upon Tyne Hospitals NHS Foundation Trust
2019
Atrium Medical Cente
2019
University College Lahore
2017
The University of Texas MD Anderson Cancer Center
2016-2017
Royal Brisbane and Women's Hospital
2017
The process of generating 'signals' possible unrecognized hazards from spontaneous adverse drug reaction reporting data has been likened to looking for a needle in haystack. However, statistical approaches the have under-utilised.Using UK Yellow Card database, we developed and evaluated aid signal generation called Proportional Reporting Ratio (PRR). proportion all reactions which are particular medical condition interest is compared same drugs 2 x table. We investigated group newly-marketed...
Background: Increasing number of people are dying with advanced dementia. Comfort and quality life key goals care. Aims: To describe (1) physical psychological symptoms, (2) health social care service utilisation (3) at end in Design: 9-month prospective cohort study. Setting participants: Greater London, England, dementia (Functional Assessment Staging Scale 6e above) from 14 nursing homes or their own homes. Main outcome measures: At study entry monthly: prescriptions, Charlson Comorbidity...
Inherited retinal degenerations are a common cause of untreatable blindness worldwide, with retinitis pigmentosa and cone dystrophy affecting approximately 1 in 3500 10,000 individuals, respectively. A major limitation to the development effective therapies is lack availability animal models that fully replicate human condition. Particularly for disorders, rodent, canine, feline no true macula have substantive limitations. By contrast, cone-rich nonhuman primate (NHP) closely mirrors retina....
Aim To investigate how distributed leadership via the Shared Governance programme influences employee engagement, empowerment, job satisfaction and turnover intentions among direct care nursing staff in a large UK hospital. Background Increasing rates shortages of health has called for interventions to improve engagement satisfaction. Methods 116 were sampled mixed-methods explanatory sequential design. A maximum variance sample 15 participants subsequently interviewed gain deeper...
Background: Being homeless or vulnerably housed is associated with death at a young age, frequently related to medical problems complicated by drug alcohol dependence. Homeless people experience high symptom burden the end of life, yet palliative care service use limited. Aim: To explore views and experiences current formerly people, frontline homelessness staff (from hostels, day centres outreach teams) health- social-care providers, regarding challenges supporting advanced ill health, make...
A vital prerequisite for cumulative culture, a phenomenon often asserted to be unique humans, is the ability modify behaviour and flexibly switch more productive or efficient alternatives. Here, we first established an inefficient solution foraging task in five captive chimpanzee groups (N = 19). Three subsequently witnessed conspecific using alternative, efficient, solution. When participants could successfully forage with their behaviours, most individuals did not this technique; however,...
Many people with dementia die in nursing homes, but quality of care may be suboptimal. We developed the theory-driven 'Compassion Intervention' to enhance end-of-life advanced dementia.To (1) understand how Intervention operated homes different health economies; (2) collect preliminary outcome data and costs an interdisciplinary leader (ICL) facilitate Intervention; (3) check caused no harm.A naturalistic feasibility study implementation for 6 months.Two northern London, UK.Thirty residents...
Many studies have examined the mental health of carers people with dementia. Few their experiences in advanced stages disease and into bereavement. We aimed to understand during dementia exploring links between end life care. Mixed methods longitudinal cohort study. Thirty-five family (6 at home, 29 care homes) were recruited assessed monthly for up nine months or until person died, then two seven Assessments included: Hospital Anxiety Depression Scale, Short Form 12 health–related quality...
To identify the limitations in palliative care provision last year of life for people with liver cirrhosis and potential barriers to enablers care.Mixed methods, including a retrospective case note review, qualitative focus groups individual interviews.A tertiary referral centre south England (UK).Purposively selected notes 30 who attended died during an 18-month period; purposive sample 22 health professionals participated either or interviews.Data collected from included hospital...
Most people with advanced dementia die in nursing homes where families may have to make decisions as death approaches. Discussions about end-of-life care between and home staff are uncommon, despite a range of potential benefits. In this study we aimed examine practices relating discussions family members residing explore strategies for improving practice. An ethnographic two the Compassion Intervention was delivered. The provides model engaging an Interdisciplinary Care Leader promote...
Abstract Objective To understand the feasibility of recruiting people with advanced cancer into a randomised controlled trial acceptance and commitment therapy (ACT) vs standardised talking control (TC) delivering ACT to this population; explore acceptability outcome measures generate normative data. Methods This was two‐arm trial. Participants were attendees at one three hospice‐based day‐therapy units in London, United Kingdom, who demonstrated low scores on Functional Assessment Cancer...
Background With a prevalence of up to 16.5%, depression is one the commonest mental disorders in people with advanced cancer. Depression reduces quality life (QoL) patients and those close them. The National Institute for Health Care Excellence (NICE) guidelines recommend treating using antidepressants and/or psychological treatments, such as cognitive–behavioural therapy (CBT). Although CBT has been shown be effective cancer, it unclear whether or not this case cancer depression. Objectives...
The prevalence of dementia is rising worldwide and many people will die with the disease. Symptoms towards end life may be inadequately managed informal professional carers poorly supported. There are few evidence-based interventions to improve end-of-life care in advanced dementia.To develop an integrated, whole systems, intervention that pragmatic feasible for support those close them.A realist-based approach which qualitative quantitative data assisted development statements. These were...
One-third of people with cancer experience psychological distress and may suppress distressing thoughts, emotions, concerns, leading to further problems. Conventional treatments reduce by problem solving, but in advanced cancer, when ill health is progressive death be approaching, physical difficulties are complex have no simple solutions. Acceptance Commitment Therapy encourages acknowledgement acceptance mental experiences, increasing people's ability work problems that cannot solved....
To determine the knowledge and practice patterns of a UK cohort relevant healthcare professionals (HCPs) about delivering palliative care in cirrhosis, to inform priorities for future research.An on-line questionnaire survey with closed open responses.HCPs identified from mailing list special interest groups hepatology gastroenterology (liver), general specialist (SPC) across UK.Of 6181 potential contacts identified, 517 HCPs responded. Most believed role exists SPC caring people but many...
Background Depression is one of the most common mental disorders in people with advanced cancer. Although cognitive–behavioural therapy (CBT) has been shown to be effective for depression cancer, it unclear whether this case cancer and depression. Aims We sought determine CBT more clinically than treatment as usual (TAU) treating (trial registration number ISRCTN07622709). Method A multi-centre, parallel-group single-blind randomised controlled trial comparing TAU (plus TAU). Participants (...
Objectives To explore the views and experiences of people who are homeless those supporting them regarding conversations approaches to palliative care Setting Data were collected between October 2015 2016 in hostels day centres with staff from primary secondary healthcare providers social services three London boroughs. Participants People experiencing homelessness (n=28), formerly (n=10), health (n=48), hostel (n=30) outreach (n=10 ). Methods In this qualitative descriptive study,...