A5026184110- Urinary Tract Infections Management
- Antibiotic Use and Resistance
- Bacterial Identification and Susceptibility Testing
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Tuberous Sclerosis Complex Research
- Pain Management and Placebo Effect
- Genetic Neurodegenerative Diseases
- Empathy and Medical Education
- Health Promotion and Cardiovascular Prevention
- Pelvic floor disorders treatments
- COVID-19 Impact on Reproduction
- Global Maternal and Child Health
- Pregnancy and preeclampsia studies
- Neonatal and Maternal Infections
- Sepsis Diagnosis and Treatment
- Dental Erosion and Treatment
- Dental Health and Care Utilization
- Emergency and Acute Care Studies
- Tree-ring climate responses
- Prostate Cancer Diagnosis and Treatment
- Surgical site infection prevention
- Physical Activity and Health
- Delphi Technique in Research
- Asthma and respiratory diseases
- Infectious Diseases and Mycology
Cardiff University
2013-2023
The University of Texas Health Science Center at San Antonio
2018
Point-of-care testing of C-reactive protein (CRP) may be a way to reduce unnecessary use antibiotics without harming patients who have acute exacerbations chronic obstructive pulmonary disease (COPD).
BackgroundNeonatal sepsis is a primary cause of neonatal mortality and an urgent global health concern, especially within low-income middle-income countries (LMICs), where 99% occurs. The aims this study were to determine the incidence associations with all-cause in facility-born neonates LMICs.MethodsThe Burden Antibiotic Resistance Neonates from Developing Societies (BARNARDS) recruited mothers their into prospective observational cohort across 12 clinical sites Bangladesh, Ethiopia,...
To assess perinatal outcomes for pregnancies affected by suspected or confirmed SARS-CoV-2 infection.Prospective, web-based registry. Pregnant women were invited to participate if they had infection between 1st January 2020 and 31st March 2021 the impact of on maternal including miscarriage, stillbirth, fetal growth restriction, pre-term birth transmission infant.Between April 2021, study recruited 8239 participants who SARs-CoV-2 episodes in pregnancy 2021. Maternal death 14/8197 (0.2%)...
Background Regional variations in the presentation of uncomplicated urinary tract infection (UTI) and pathogen sensitivity to antibiotics have been cited as reasons justify differences how infections are managed, which includes prescription broad-spectrum antibiotics. Aim To describe management UTI primary care settings, explore association with patient recovery, taking microbiological findings case mix into account. Design setting Prospective observational study females symptoms presenting...
Fissure sealant (FS) and fluoride varnish (FV) have been shown to be effective in preventing dental caries when tested against a no-treatment control. However, the relative clinical effectiveness cost-effectiveness of these interventions is unknown. To compare FS FV first permanent molars (FPMs) 6- 7-year-olds determine their acceptability. A randomised controlled allocation-blinded trial with two parallel arms. targeted population programme using mobile clinics (MDCs) schools located areas...
Background Most patients presenting with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in primary care are prescribed antibiotics, but these may not be beneficial, and they can cause side effects increase the risk subsequent resistant infections. Point-of-care tests (POCTs) could safely reduce inappropriate antibiotic prescribing antimicrobial resistance. Objective To determine whether or use a C-reactive protein (CRP) POCT to guide decisions for AECOPD reduces...
Urinary tract infections (UTI) are the most frequent bacterial infection affecting women and account for about 15% of antibiotics prescribed in primary care. However, some with a UTI not or wrong antibiotics, while many who do have microbiologically confirmed antibiotics. Inappropriate antibiotic prescribing unnecessarily increases risk side effects development resistance, wastes resources. POETIC is randomised controlled trial Point Of Care Test (POCT) (Flexicult™) guided management...
Background The effectiveness of using point-of-care (POC) urine culture in primary care on appropriate antibiotic use is unknown. Aim To assess whether the Flexicult ™ SSI-Urinary Kit, which quantifies bacterial growth and determines susceptibility at point care, achieves that more often concordant with laboratory results, when compared standard care. Design setting Individually randomised trial females uncomplicated urinary tract infection (UTI) research networks (PCRNs) England,...
Introduction Chronic lung disease of prematurity (CLD), also known as bronchopulmonary dysplasia (BPD), is a cause significant respiratory morbidity in childhood and beyond. Coupled with immaturity, infections (especially by Ureaplasma spp) are implicated the pathogenesis CLD through promotion pulmonary inflammation. Azithromycin, which highly effective against spp has potent anti-inflammatory properties. Thus, azithromycin therapy may improve outcomes targeting infective inflammatory...
Abstract Background Nocebo effects (‘negative placebo’ effects) experienced by clinical trial participants can arise from an underlying condition or through communication about side in the participant information leaflets (or elsewhere). Misattributing nocebo to medicinal intervention lead experiencing harmful and may result distortion of adverse effect reporting. However, little is known how on potential provided participants. There increasing concern that way which trials are described...
Introduction Previous novel COVID-19 pandemics, SARS and middle east respiratory syndrome observed an association of infection in pregnancy with preterm delivery, stillbirth increased maternal mortality. COVID-19, caused by SARS-CoV-2 infection, is the largest pandemic living memory. Rapid accrual robust case data on women their babies affected suspected or confirmed will inform clinical management preventative strategies current future outbreaks. Methods analysis The neonatal outcomes...
Huntington's disease is a progressive neurodegenerative disorder characterized by motor, cognitive and psychiatric symptoms. Currently, no disease-modifying therapies are available to slow or halt progression. relatively focal specific loss of striatal medium spiny neurons, which makes it suitable for cell-replacement therapy, process involving the transplantation donor cells replace those lost due disease. TRIal DEsigns delivery Novel Therapies in neurodegeneration phase I Trial Within...
Most patients presenting with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in primary care are prescribed an antibiotic, which may not always be appropriate and cause harm. C-reactive protein (CRP) is acute-phase biomarker that can rapidly measured at the point predict benefit from antibiotic treatment AECOPD. It clear whether addition a CRP point-of-care test (POCT) to clinical assessment leads reduction consumption without having negative impact on COPD health...
Tuberous sclerosis complex (TSC) is a genetic disorder affecting about 1 in 6000 people and characterised by the development of tumours many organs, including skin kidneys, range neurological neuropsychiatric manifestations. TSC-associated disorders (TAND) occur majority those with TSC, they have significant impact on patients their families, given everyday TAND education, employment, family social life. The potential benefits better treatment for therefore include reduction health care...
Urine culture at the point of care minimises delay between obtaining sample and agar inoculation in a microbiology laboratory, quantification sensitivity results can be available more rapidly primary care. To identify degree to which clinicians' interpretations point-of-care-test (POCT) urine (Flexicult™ SSI-Urinary Kit) agrees with laboratory women presenting symptoms uncomplicated urinary tract infections (UTI). Primary clinicians used Flexicult™-POCT, recorded their findings took...
Little is known about clinicians' experiences of using a point-of-care test (POCT) to inform management urinary tract infection (UTI) in general practice.To explore the Flexicult UTI and views on requirements for an optimal POCT successful implementation.Telephone interviews with 35 primary care clinicians healthcare professionals Wales, England, Spain, Netherlands, who had participated trial based urine culture.Thematic analysis semi-structured interviews.Most interviewed agreed need...
Background C-reactive protein (CRP) point-of-care testing can reduce antibiotic use in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) primary care, without compromising patient care. Further safe reductions may be possible. Aim To investigate the associations between presenting features and prescribing AECOPD Design setting Secondary analysis a randomised controlled trial participants care (the PACE trial). Method Clinicians collected participants’...
The Active Connected Engaged [ACE] study is a multi-centre, pragmatic, two-arm, parallel-group randomised controlled trial [RCT] with an internal pilot phase. ACE incorporates multi-level mixed methods process evaluation including systems mapping approach and economic evaluation. aims to test the effectiveness cost-effectiveness of peer-volunteer led active ageing intervention designed support older adults at risk mobility disability become more physically socially within their communities...
Background: It has been demonstrated that antibiotic prescribing for Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) can be safely reduced in primary care when general practitioners have access to C-reactive protein (CRP) rapid testing. Aim: To investigate the factors associated with post-consultation COPD health status patients presenting AECOPD this setting. Design and Setting: A cohort study enrolled a randomised controlled trial. Patients aged 40+ years clinical...
Patients presenting with UTI symptoms are among the most frequent clinical presentations in primary care accounting for 15% of all community antibiotic prescriptions. The diagnostic accuracy assessment and appropriate management uncomplicated remain unclear. Primary clinicians more likely to treat empirically without additional testing. Some advances being made development novel Point Care Tests (POCTs ) diagnosis infection resistance care. incorporation a test, which enumerates identifies...