A5029896235- Hip and Femur Fractures
- Health Systems, Economic Evaluations, Quality of Life
- Spine and Intervertebral Disc Pathology
- Musculoskeletal pain and rehabilitation
- Physical Activity and Health
- Chronic Disease Management Strategies
- Cardiac, Anesthesia and Surgical Outcomes
- Colorectal Cancer Screening and Detection
- Emergency and Acute Care Studies
- Global Cancer Incidence and Screening
- Healthcare Policy and Management
- Clinical practice guidelines implementation
- Lung Cancer Treatments and Mutations
- Economic and Financial Impacts of Cancer
- Complementary and Alternative Medicine Studies
- Primary Care and Health Outcomes
- Bone health and osteoporosis research
- Health disparities and outcomes
- Cardiac Health and Mental Health
- Lung Cancer Diagnosis and Treatment
- Occupational Therapy Practice and Research
- Frailty in Older Adults
- Bayesian Methods and Mixture Models
- Family Support in Illness
- Income, Poverty, and Inequality
Bangor University
2013-2021
COMSATS University Islamabad
2014
Primary Health Care
2012
Cardiff University
2010
The primary aim was to use routine data compare cancer diagnostic intervals before and after implementation of the 2005 NICE Referral Guidelines for Suspected Cancer. secondary change in across different categories presenting symptoms. Using from General Practice Research Database, we analysed patients with one 15 cancers diagnosed either 2001–2002 or 2007–2008. Putative symptom lists each were classified into whether not they qualified urgent referral under guidelines. Diagnostic interval...
Background The Wales National Exercise Referral Scheme (NERS) is a 16-week programme including motivational interviewing, goal setting and relapse prevention. Method A pragmatic randomised controlled trial with nested economic evaluation of 2160 inactive participants coronary heart disease risk (CHD, 1559, 72%), mild to moderate depression, anxiety or stress (79, 4%) both (522, 24%) receive (1) NERS (2) normal care brief written information. Outcome measures at 12 months included the 7-day...
Background Time from symptomatic presentation to cancer diagnosis (diagnostic interval) is an important, and modifiable, part of the patient’s pathway, can be affected by various factors such as age, gender type presenting symptoms. The aim this study was quantify relationships diagnostic interval with these variables in 15 cancers diagnosed between 2007 2010 using routinely collected data Clinical Practice Research Datalink (CPRD) UK. Methods Symptom lists for each were prepared literature...
Background and objectives: Referring clinicians’ experiences of exercise referral schemes (ERS) can provide valuable insights into their uptake. However, most qualitative studies focus on patient views only. This paper explores health professionals’ perceptions role in promoting physical activity a National Exercise Referral Scheme (NERS) Wales. Design: Qualitative semi-structured group interviews. Setting: General practice premises. Methods: Nine interviews involving 46 professionals were...
Abstract Purpose Primary-care referral to community-based exercise specialists (exercise referral) is common in the UK despite limited evidence of effectiveness. A recent pragmatic randomised trial Welsh National Exercise Referral Scheme (NERS), demonstrated promising impacts upon physical activity and mental health. This paper presents a mixed-method process evaluation exploring how outcomes were achieved. Design/methodology/approach Structured observation, implementer interviews routine...
Objective To conduct a rigorous feasibility study for future definitive parallel-group randomised controlled trial (RCT) and economic evaluation of an enhanced rehabilitation package hip fracture. Setting Recruitment from 3 acute hospitals in North Wales. Intervention delivery the community. Participants Older adults (aged ≥65) who received surgical treatment fracture, lived independently prior to had mental capacity (assessed by clinical team) Wales area. Remote randomisation usual care...
The benefits to health of a physically active lifestyle are well established and there is evidence that sedentary plays significant role in the onset progression chronic disease. Despite recognised need for effective public interventions encouraging people with medical condition become more active, few rigorous evaluations their effectiveness. Following NICE guidance, Welsh national exercise referral scheme was implemented within context pragmatic randomised controlled trial. trial, nested...
Objectives To develop an evidence and theory-based complex intervention for improving outcomes in elderly patients following hip fracture. Design Complex-intervention development (Medical Research Council (MRC) framework phase I) using realist literature review, surveys focus groups of rehabilitation teams. Setting North Wales. Participants Surveys therapy managers (n=13), community hospital-based physiotherapists (n=129) occupational therapists (n=68) throughout the UK. Focus with their...
Proximal femoral fracture is a major health problem in old age, with annual UK and social care costs of £2.3B. Rehabilitation has the potential to maximise functional recovery maintain independent living, but evidence clinical effectiveness cost-effectiveness lacking. To develop an enhanced community-based rehabilitation package following surgical treatment for proximal assess acceptability feasibility future definitive randomised controlled trial (RCT) economic evaluation. Phase I - realist...
Proximal femoral fracture is a common, major health problem in old age resulting loss of functional independence and high-cost burden on society, with estimated social care costs £2.3 billion per year the UK. Rehabilitation has potential to maximise recovery maintain independent living, but evidence effectiveness lacking. Usual rehabilitation delivered by multi-disciplinary team hospital community. An 'enhanced rehabilitation' intervention been developed consisting workbook, goal-setting...
Objectives To describe the implementation of an enhanced rehabilitation programme for elderly hip fracture patients with mental capacity, in a randomised feasibility study compared usual rehabilitation. compare processes between two and to collect views patients, carers therapy staff about trial participation. Design Mixed methods process evaluation study. Setting Patient participants were recruited on orthopaedic wards; intervention was delivered community following hospital discharge....
In this study, older patients who recently experienced hip fracture were asked to state their preferences about services.A method used specifically for eliciting preferences, the discrete choice experiment, was used.Using a questionnaire, hypothetical services presented 3 months after fracture, asking them which service they preferred.Older stated fully-qualified physiotherapist or occupational therapist deliver rehabilitation sessions, and session last less than 90 min.By structure (for...
Health economic evaluations rely on the accurate measurement of health service resource use in order to calculate costs. These are usually measured with patient completed questionnaires using instruments such as Client Service Receipt Inventory (CSRI). participants' recall and can be burdensome complete. activity data routinely captured by electronic databases. The aim was test methods for obtaining these compare those collected CSRI, within a feasibility study an enhanced rehabilitation...