A5087649946- Fetal and Pediatric Neurological Disorders
- Prenatal Screening and Diagnostics
- Health Systems, Economic Evaluations, Quality of Life
- Neonatal and fetal brain pathology
- Cystic Fibrosis Research Advances
- Family and Disability Support Research
- Autism Spectrum Disorder Research
- Parvovirus B19 Infection Studies
- Geriatric Care and Nursing Homes
- Child Development and Digital Technology
- Stroke Rehabilitation and Recovery
- Medication Adherence and Compliance
- Pharmaceutical Practices and Patient Outcomes
- Research on Leishmaniasis Studies
- Statistical Methods and Bayesian Inference
- Adolescent and Pediatric Healthcare
- Health and Medical Studies
- Frailty in Older Adults
- Mental Health and Patient Involvement
- Child and Adolescent Psychosocial and Emotional Development
- Telemedicine and Telehealth Implementation
- Statistical Methods in Clinical Trials
- Dementia and Cognitive Impairment Research
- Simulation Techniques and Applications
- Infant Development and Preterm Care
University of York
2020-2025
University of Sheffield
2015-2021
Royal Hallamshire Hospital
2019
Post-kala-azar dermal leishmaniasis (PKDL) is a chronic, stigmatizing skin condition occurring frequently after apparent clinical cure from visceral leishmaniasis. Given an urgent need for new treatments, we conducted phase IIa safety and immunogenicity trial of ChAd63-KH vaccine in Sudanese patients with persistent PKDL. LEISH2a (ClinicalTrials.gov: NCT02894008) was open-label three-phase involving sixteen adult eight adolescent PKDL (median duration, 30 months; range, 6–180 months)....
Recurrent pulmonary exacerbations lead to progressive lung damage in cystic fibrosis (CF). Inhaled medications (mucoactive agents and antibiotics) help prevent exacerbations, but objectively measured adherence is low. We investigated whether a multi-component (complex) self-management intervention support would reduce exacerbation rates over 12 months.Between October 2017 May 2018, adults with CF (aged ≥16 years; 19 UK centres) were randomised the (data-logging nebulisers, digital platform...
ABSTRACT Objective To assess the contribution of fetal magnetic resonance imaging (MRI) in fetuses MERIDIAN cohort diagnosed with ventriculomegaly (VM) as only abnormal intracranial finding on antenatal ultrasound. Methods This was a subgroup analysis study VM ultrasound women who had subsequent MRI examination within 2 weeks and for whom outcome reference data were available. The diagnostic accuracy reported relation to severity VM. difference measurements trigone size two methods clinical...
In individually randomised trials we might expect interventions delivered in groups or by care providers to result clustering of outcomes for participants treated the same group provider. partially nested controlled (pnRCTs) this only occurs one trial arm, commonly intervention arm. It is important measure and account between-cluster variability design analysis. We compare analysis approaches pnRCTs with continuous outcomes, investigating impact on statistical inference cluster sizes, coding...
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...
Background Ultrasonography has been the mainstay of antenatal screening programmes in UK for many years. Technical factors and physical limitations may result suboptimal images that can lead to incorrect diagnoses inaccurate counselling prognostic information being given parents. Previous studies suggest addition utero magnetic resonance imaging (iuMRI) improve diagnostic accuracy fetal brain abnormalities. These have limitations, including a lack an outcome reference diagnosis (ORD), which...
Introduction Type 2 diabetes mellitus (T2DM) is two to three times more common in people with severe mental illness (SMI) than the general population. Supporting self-management fundamental improving clinical outcomes. The DIAMONDS trial aims evaluate and cost effectiveness of a novel, codesigned, supported programme for T2DM SMI. Methods analysis This multicentre, two-armed, parallel, individually randomised controlled will be conducted National Health Service health trusts across England....
Preventative medication reduces hospitalisations in people with cystic fibrosis (PWCF) but adherence is poor. We assessed the feasibility of a randomised controlled trial complex intervention, which combines display real time data and behaviour change techniques.
BackgroundIn utero MRI (iuMRI) detects fetal brain abnormalities more accurately than ultrasonography and provides additional clinical information in around half of pregnancies. We aimed to study whether postnatal neuroimaging after age 6 months changes the diagnostic accuracy iuMRI its ability predict developmental outcome.MethodsFamilies enrolled MERIDIAN whose child survived 3 years were invited have a case note review assessment outcome with Bayley Scales Infant Toddler Development, Ages...
ABSTRACT Objective To assess the contribution of fetal magnetic resonance imaging (MRI) in fetuses MERIDIAN cohort diagnosed with either agenesis or hypogenesis corpus callosum (referred to collectively as failed commissuration) on antenatal ultrasound. Methods This was a subgroup analysis study commissuration (with without ventriculomegaly) ultrasound women who had MRI assessment within 2 weeks and for whom outcome reference data were available. The diagnostic accuracy studied, well...
Intestinal inflammation in Crohn's disease (CD) is caused by mucosal immune system reactivity to luminal antigen and results debilitating symptoms, reduced quality of life, impaired work productivity significant health care costs. Not all patients respond conventional biologic therapies, with chronic ensuing. Although surgical resection may be required, frequently returns surgery not an option, or declined. Case reports suggest potential benefit after haematopoietic stem cell transplant...
ABSTRACT Objective To assess the diagnostic and clinical contribution of fetal magnetic resonance imaging (MRI) in fetuses MERIDIAN cohort diagnosed with abnormalities posterior fossa as only intracranial abnormality recognized on antenatal ultrasound. Methods This was a subgroup analysis study (with or without ventriculomegaly) ultrasound women who had MRI within 2 weeks for whom outcome reference data were available. The accuracy is reported, well indicators confidence effects prognosis...
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...
To refine methods that assess structural brain abnormalities and calculate intracranial volumes in fetuses with congenital heart diseases (CHD) using utero MR (iuMR) imaging. Our secondary objective was to the prevalence of this high-risk cohort compare normative values. We performed iuMR on 16 pregnant women carrying a fetus CHD gestational age ≥ 28-week gestation no abnormality ultrasonography. All cases had fetal echocardiography by pediatric cardiologist. Structural were recorded....
Interpretation of magnetic resonance (MR) imaging the fetal brain in utero is primarily undertaken using 2D images to provide anatomical information about structural abnormalities. It now possible obtain 3D image acquisitions that allow measurement volumes are potentially useful clinically. The aim our current work reference values total obtained from a cohort low risk fetuses with no abnormalities on ante-natal ultrasonography and MR imaging.Images volume 132 were used extract by manual...
Introduction Behavioural and mental disorders have become a public health crisis by 2020 may surpass physical illness as major cause of disability. Early prevention is key. Two Incredible Years (IY) parent programmes that aim to enhance child well-being development, IY Infant Toddler, will be delivered evaluated in proportionate universal intervention model called Enhancing Social-Emotional Health Wellbeing the (E-SEE) Steps. The main research question is: Does E-SEE Steps social emotional...
Background One in 57 children are diagnosed with autism the UK, and estimated cost for supporting these education is substantial. Social Stories™ a promising widely used intervention schools families. It believed that can provide meaningful social information to improve understanding may reduce anxiety. However, no economic evaluation of Stories has been conducted. Aims To assess cost-effectiveness through Autism Spectrum Schools Trial 2, multi-site, pragmatic, cluster-randomised controlled...
Older patients often experience safety issues when transitioning from hospital to home. The 'Your Care Needs You' (YCNY) intervention aims support older people 'know more' and 'do whilst in so that they are better prepared for managing at home.A multi-centre cluster randomised controlled trial (cRCT) will evaluate the effectiveness cost-effectiveness of YCNY intervention. Forty acute wards (clusters) England varying medical specialities be deliver or care-as-usual on a 1:1 basis. primary...
Abstract Background Alcohol interventions are important to the developing public health role of community pharmacies. The Medicines and Consultation (MAC) is a new intervention, co-produced with pharmacists (CPs) patients, which involves CP practice development programme designed integrate discussion alcohol within existing NHS medicine review services. We conducted pilot trial MAC its delivery investigate all study procedures inform progression definitive trial. Methods This cluster RCT was...
To undertake a process evaluation of an adherence support intervention for people with cystic fibrosis (PWCF), to assess its feasibility and acceptability.Two UK (CF) units.Fourteen adult PWCF; three professionals delivering ('interventionists'); five multi-disciplinary CF team members.Nebuliser data recording transfer capability, linked software platform, strategies nebulised treatments facilitated by interventionists over 5 months (± 1 month).Feasibility acceptability the intervention,...
In utero magnetic resonance (iuMR) imaging to diagnose foetal brain abnormalities has been established and is supported by meta-analyses of retrospective prospective studies. this paper we describe classify the iuMR errors made in largest diagnostic accuracy study date (MERIDIAN). We also correlate error rates types with prior experience reporting radiologists order inform how provide a national programme best achievable. The MERIDIAN cohort 570 foetus formed basis included 40 cases...
Background People with cystic fibrosis frequently have low levels of adherence to inhaled medications. Objectives The objectives were develop and evaluate an intervention for adults improve their medication. Design We used agile software methods online platform. mixed a behaviour change delivery by interventionist. These integrated become the CFHealthHub intervention. undertook feasibility study consisting pilot randomised controlled trial process evaluation in two centres. evaluated using...