A5078769179- Geriatric Care and Nursing Homes
- Intensive Care Unit Cognitive Disorders
- Frailty in Older Adults
- Health Systems, Economic Evaluations, Quality of Life
- Dementia and Cognitive Impairment Research
- Mental Health and Patient Involvement
- Healthcare innovation and challenges
- Healthcare Policy and Management
- Health disparities and outcomes
- Intergenerational Family Dynamics and Caregiving
- Palliative Care and End-of-Life Issues
- Interprofessional Education and Collaboration
- Stroke Rehabilitation and Recovery
- Health Policy Implementation Science
- Breastfeeding Practices and Influences
- Cancer survivorship and care
- Aging and Gerontology Research
- Complementary and Alternative Medicine Studies
- Aging, Elder Care, and Social Issues
- Acupuncture Treatment Research Studies
- Primary Care and Health Outcomes
- Healthcare Systems and Practices
- Physical Activity and Health
- Pain Management and Opioid Use
- Anesthesia and Sedative Agents
Children's National
2022-2023
University of Leeds
2013-2022
Bradford Teaching Hospitals NHS Foundation Trust
2014-2021
University of Bradford
2019
Bradford Royal Infirmary
2013-2019
Drexel University
2018
Vanderbilt University
2015
Nuffield Health
1999-2007
British Library
1978
Princess of Wales Community Hospital
1978
Delirium affects > 15% of hospitalised patients but is grossly underdetected, contributing to poor care. The 4 'A's Test (4AT, www.the4AT.com ) a short delirium assessment tool designed for routine use without special training. primary objective was assess the accuracy 4AT detection. secondary compare with another commonly used tool, Confusion Assessment Method (CAM).This prospective diagnostic test study set in emergency departments or acute medical wards involving aged ≥ 70. All those...
Critical appraisal of research studies forms a central role within the application and uptake evidence‐based approaches health social care. While there are established checklists for evaluating quantitative research, this is not case qualitative research. This article outlines process developing an evaluative tool studies, reflecting uniqueness associated paradigm, illustrates its use by reference to three papers appraised systematic review community‐based rehabilitation services. At centre...
Delirium is a common and serious neuropsychiatric syndrome, usually triggered by illness or drugs. It remains underdetected. One reason for this lack of brief, pragmatic assessment tools. The 4 'A's test (Arousal, Attention, Abbreviated Mental Test - 4, Acute change) (4AT) screening tool designed routine use. This project evaluated its usability, diagnostic accuracy cost.Phase 1 the usability 4AT in practice was measured with two surveys qualitative studies health-care professionals, review...
Medical Research Council (MRC) guidance identifies implementation as a key element of the development and evaluation process for complex healthcare interventions. Implementation is itself involving mobilization human, material, organizational resources to change practice within settings that have pre-existing structures, historical patterns relationships, routinized ways working. Process evaluations enable researchers clinicians understand how proceeds what factors impact on intended program...
Abstract Background Delirium is a frequent complication of hospital admission among older people. Multicomponent interventions which can reduce incident delirium by ≈one-third are recommended the National Institute Health and Care Excellence. Currently, standardised prevention system care suitable for adoption in UK Service does not exist. The Prevention (POD) theory informed, multicomponent intervention systematic implementation process includes role volunteers. We report POD delivery...
Delirium is a common complication for older people in hospital. Evidence suggests that delirium incidence hospital may be reduced by about third through multi-component intervention targeted at known modifiable risk factors. We describe the research design and conceptual framework underpinning it informed development of novel prevention system care acute wards. Particular focus study was on developing an implementation process aimed embedding practice change within routine delivery. adopted...
Objective To evaluate the process of implementation modified London Stroke Carers Training Course (LSCTC) in Caregivers After (TRACS) cluster randomised trial and contribute to interpretation TRACS results. The LSCTC was a structured competency-based training programme designed help develop knowledge skills (eg, patient handling or transfer skills) essential for day-to-day management disabled survivors stroke. comprised 14 components, 6 were mandatory (and delivered all) 8 non-mandatory, be...
Introduction Delirium is a severe neuropsychiatric syndrome of rapid onset, commonly precipitated by acute illness. It common in older people the emergency department (ED) and hospital, but greatly under-recognised these other settings. forms cognitive impairment, particularly dementia, coexist. There need for delirium screening tool that can be administered range professional-level healthcare staff to patients with sensory or functional impairments busy clinical environment, which also...
Abstract Background There is limited understanding of the contribution made by older people and their caregivers to acute healthcare in home how this compares hospital inpatient healthcare. Objectives To explore work at time an health event, interface with professionals a (HAH) experiences relate principles underpinning comprehensive geriatric assessment (CGA). Design A qualitative interview study within UK multi-site participant randomised trial geriatrician-led admission avoidance HAH,...
This paper examines older people's contrasting images of people as ‘those like us’ and ‘others’. It draws on data from a qualitative study about the experience ageing that was undertaken in partnership with two local groups England. Whilst informants acknowledged their chronological age, changes appearance physical limitations, most did not describe themselves old. They challenged idea being ‘past it’. Older who personified own values inter-dependence, reciprocity keeping going were seen...
Despite growing interest in the meaning of illness and recovery older age, much research has focused on particular conditions, such as stroke; yet, later life is considerably more diverse. In this article, we examine experience process through interviews with 64 people receiving intermediate care, a form transitional care to support between resumption everyday routines. They describe four trajectories generated from individuals' accounts their perspective recovery: cure restoration,...
There is continuing demand for non-implant prosthodontic treatment and yet there a paucity of high quality Randomised Controlled Trial (RCT) evidence best practice. The aim this research was to provide practice in impressions by comparing two impression materials double-blind, randomised, crossover, controlled, clinical trial.Eighty-five patients were recruited, using published eligibility criteria, the trial at Leeds Dental Institute, UK. Each patient received sets dentures; made either...
Background and objectives: delirium is a distressing but potentially preventable condition common in older people long-term care. It associated with increased morbidity, mortality, functional decline, hospitalization significant healthcare costs. Multicomponent interventions, addressing risk factors, have been shown to reduce by one-third hospitals. not known whether this approach also effective In previous work, we designed bespoke prevention intervention, called 'Stop Delirium!'...
Background Evidence is required to guide the redesign of health care for older people who require hospital admission. Objectives We assessed clinical effectiveness and cost-effectiveness geriatrician-led admission avoidance at home with comprehensive geriatric assessment, experiences their caregivers, how services differed. Design A multisite, randomised, open trial assessment home, compared hospital, using a 2 : 1 (hospital hospital) ratio, parallel economic process evaluation. Participants...
Background Improving the care of people with dementia on acute hospital wards is a policy priority. Person-centred marker quality; delivering such goal service improvement. Objectives The Person, Interactions and Environment (PIE) Programme comprises an observation tool systematic approach to implement embed person-centred in routine for hospitalised patients dementia. study aims were evaluate PIE as method improve older wards, develop insight into what might look like practice this setting....
There is concern that existing models of acute hospital care will become unworkable as the health service admits an increasing number frail older people with complex needs, and there inadequate evidence to guide planning level services. We aim evaluate whether geriatrician-led admission avoidance at home effective alternative admission. are conducting a multi-site randomised open trial home, compared hospital. recruiting markers frailty or prior dependence who have been referred for medical...
The aim of this study was to assess the cost effectiveness silicone and alginate impressions for complete dentures. Cost analyses were undertaken alongside a UK single centre, double blind, controlled, crossover clinical trial. Taking perspective healthcare sector, is measured using EuroQol (EQ-5D-3L) which provides index value health status that may be combined with time produce quality adjusted life years (QALYs); Oral Health Impact Profile (OHIP-EDENT). Incremental ratios are presented...
Delirium is the most frequent complication among older people following hospitalisation. may be prevented in about one-third of patients using a multicomponent intervention. However, United Kingdom, National Health Service has no routine delirium prevention care systems. We have developed Prevention Programme, intervention and implementation process. successfully carried out pilot study to test feasibility acceptability programme. are now undertaking preliminary testing The Study...
The medical profession is dedicated to saving life, which both dramatic and satisfying. Somehow preventing death less apparently much rewarding. Nonetheless, the report of Finland Jones<sup>1</sup>from Boston City Hospital indicated that many lives may be saved in hospitals by controlling staphylococcic infection. They claim not only major minor infections are endemic large but also Staphylococcus a leading cause death. We decided investigate this problem our hospital. asked ourselves...