A5047577489- Health Systems, Economic Evaluations, Quality of Life
- Healthcare Decision-Making and Restraints
- Palliative Care and End-of-Life Issues
- Adolescent and Pediatric Healthcare
- Obesity, Physical Activity, Diet
- Psychiatric care and mental health services
- Schizophrenia research and treatment
- Obesity and Health Practices
- Geriatric Care and Nursing Homes
- Nerve Injury and Rehabilitation
- Childhood Cancer Survivors' Quality of Life
- Grief, Bereavement, and Mental Health
- Child and Adolescent Health
- Cancer Treatment and Pharmacology
- Shoulder Injury and Treatment
- Physical Activity and Health
- Healthcare cost, quality, practices
- Family Support in Illness
- Cancer survivorship and care
- Health disparities and outcomes
- Patient Satisfaction in Healthcare
- Primary Care and Health Outcomes
- Emergency and Acute Care Studies
- Child Nutrition and Feeding Issues
- Healthcare Policy and Management
University of Warwick
2016-2023
University of Birmingham
2012-2019
<h3>Abstract</h3> <h3>Objective</h3> To assess the effectiveness of a school and family based healthy lifestyle programme (WAVES intervention) compared with usual practice, in preventing childhood obesity. <h3>Design</h3> Cluster randomised controlled trial. <h3>Setting</h3> UK primary schools from West Midlands. <h3>Participants</h3> 200 were randomly selected all state run within 35 miles study centre (n=980), oversampling those high minority ethnic populations. These ordered sequentially...
Abstract Objective To evaluate whether a structured exercise programme improved functional and health related quality of life outcomes compared with usual care for women at high risk upper limb disability after breast cancer surgery. Design Multicentre, pragmatic, superiority, randomised controlled trial economic evaluation. Setting 17 UK National Health Service centres. Participants 392 undergoing surgery, postoperative morbidity, (1:1) to (n=196) or alone (n=196). Interventions Usual...
Disruption of care during transition from child and adolescent mental health services (CAMHS) to adult may adversely affect the well-being service users. The MILESTONE (Managing Link Strengthening Transition Child Adult Mental Healthcare) study evaluates longitudinal course outcomes adolescents approaching boundary (TB) their CAMHS determines effectiveness model managed in improving outcomes, compared with usual care.
End-of-life care affects both the patient and those close to them. Typically, are not considered within economic evaluation, which may lead omission of important benefits resulting from end-of-life care.To develop an outcome measure suitable for use in evaluation that captures dying.To descriptive system measure, in-depth qualitative interviews were conducted with participants constant comparative analysis methods used a measure.Twenty-seven individuals bereaved last 2 years or close-person...
Abstract The paediatric-adult split in mental health care necessitates young people to make a transition between services when they reach the upper end of child and adolescent (CAMHS). However, we know that this is often poor, not all who require ongoing support are able continue adult (AMHS). These said have fallen through gap services. This research aimed explore reasons why fall CAMHS AMHS, what effect has had on them their families. Narrative interviews were conducted with 15 parents,...
Poor transition planning contributes to discontinuity of care at the child-adult mental health service boundary (SB), adversely affecting outcomes in young people (YP). The aim study was determine whether managed (MT) improves YP reaching child/adolescent (CAMHS) compared with usual (UC).A two-arm cluster-randomised trial (ISRCTN83240263 and NCT03013595) clusters allocated 1:2 between MT UC. Recruitment took place 40 CAMHS (eight European countries) October 2015 December 2016. Eligible...
Background Upper limb problems are common after breast cancer treatment. Objectives To investigate the clinical effectiveness and cost-effectiveness of a structured exercise programme compared with usual care on upper function, health-related outcomes costs in women undergoing surgery. Design This was two-arm, pragmatic, randomised controlled trial embedded qualitative research, process evaluation parallel economic analysis; unit randomisation individual (allocated ratio 1 : 1). Setting...
Systematic reviews suggest that school-based interventions can be effective in preventing childhood obesity, but better-designed trials are needed consider costs, process, equity, potential harms and longer-term outcomes.To assess the clinical effectiveness cost-effectiveness of WAVES (West Midlands ActiVe lifestyle healthy Eating School children) study intervention, compared with usual practice, obesity among primary school children.A cluster randomised controlled trial, split across two...
Background Childhood obesity is a serious public health challenge and schools have been identified as an ideal place to implement prevention interventions. The aim of this study was measure the cost-effectiveness multi-faceted school-based intervention targeting children aged 6–7 years when compared 'usual activities'. Methods A cluster randomised controlled trial in 54 across West Midlands (UK) conducted. 12-month aimed increase physical activity by 30 minutes per day encourage healthy...
Background All NHS providers collect data on patient experience, although there is limited evidence about what to measure or how and use improve services. We studied inpatient mental health services, as these are important, costly often unpopular services within which serious incidents occur. Aims To identify approaches collecting using experience most useful for supporting improvements in care. Design The study comprised five work packages: a systematic review evidence-based themes relevant...
The service configuration with distinct child and adolescent mental health services (CAMHS) adult (AMHS) may be a barrier to continuity of care. Because lack transition policy, CAMHS clinicians have decide whether when young person should AMHS. This study describes which characteristics are associated the clinicians' advice continue treatment at AMHS.Demographic, family, clinical, treatment, service-use MILESTONE cohort 763 people from 39 in Europe were assessed using multi-informant...
Background Young people are at risk of falling through the care gap after leaving child and adolescent mental health services (CAMHS) despite an ongoing need for support. Currently, little is known about predictors transitioning to adult (AMHS), associated healthcare societal costs as young cross transition boundary. Objective To conduct a secondary data analysis exploring or costs. Methods Data were used from longitudinal study, which followed seven European countries 2 years reaching their...
Prehospital analgesia is often required after traumatic injury, currently morphine the strongest parenteral routinely available for use by paramedics in United Kingdom (UK) when treating patients with severe pain. This protocol describes a multi-centre, randomised, double blinded trial comparing clinical and cost-effectiveness of ketamine pain following acute injury. A two arm pragmatic, phase III working large NHS ambulance services, an internal pilot. Participants will be randomised equal...
Abstract Background Acute Day Units (ADUs) exist in some English NHS Trusts as an alternative to psychiatric inpatient admission. However, there is a lack of information about the number, configuration, and functioning such units, extent which additional units might reduce admissions. This cross-sectional survey cluster analysis ADUs aimed identify, categorise, describe England. Methods Mental Health with were identified mapping exercise, questionnaire was distributed ADU managers. Cluster...
The limited literature examining weight status and preference-based health-related quality of life (HRQL) in young children is equivocal. This study aims to examine how the association between HRQL changes as develop ages 6 10 years old. Child Health Utility 9D (CHU-9D) was used determine HRQL. Height data were also collected calculate z-BMI adjusted for age gender. 1467 recruited from 54 schools across West Midlands. Data at four time points over 5 years. Impact on dimensions assessed via...
To assess the cost-effectiveness of an enhanced transtheoretical model behaviour change in conjunction with physiotherapy compared standard care (physiotherapy) patients chronic lower back pain (CLBP).Cost-utility and analyses alongside a multicentre controlled trial from healthcare perspective 1-year time horizon.The was conducted eight centres within Sharon district Israel.220 participants aged between 25 55 years who suffered CLBP for minimum 3 months were recruited.The intervention used...
Background Community treatment orders are widely used in England. It is unclear whether their use varies between patients, places and services, or if they associated with better patient outcomes. Objectives To examine variation the of community associations outcomes health-care costs. Design Secondary analysis using multilevel statistical modelling. Setting England, including 61 NHS mental health provider trusts. Participants A total 69,832 patients eligible to be subject a order. Main...
Abstract Background Supervised cardio-pulmonary rehabilitation may be safe and beneficial for people with pulmonary hypertension (PH) in groups 1 (pulmonary arterial hypertension) 4 (chronic thromboembolic disease), particularly as a hospital in-patient. It has not been tested the most common PH groups; 2 (left heart 3 (lung or 5 (other disorders). Further it evaluated UK National Health Service (NHS) out-patient setting, long-term follow-up. The aim of this randomised controlled trial (RCT)...
Background For people in mental health crisis, acute day units (ADUs) provide daily structured sessions and peer support non-residential settings, often as an addition or alternative to crisis resolution teams (CRTs). There is little recent evidence about outcomes for those using ADUs, particularly compared with receiving CRT care alone. Aims We aimed investigate readmission rates, satisfaction well-being ADUs CRTs. Method conducted a cohort study comparing healthcare during 6-month period...
Supervised community treatment (SCT) for people with serious mental disorders has become accepted practice in many countries around the world. In England, SCT was adopted 2008 form of orders (CTOs). CTOs have been used more than expected, significant variations between and places. There is conflicting evidence about effectiveness SCT; studies based on randomised controlled trials (RCTs) suggested few positive impacts, while those employing observational designs favourable. Robust...