A5049137001- Geriatric Care and Nursing Homes
- Frailty in Older Adults
- Health Systems, Economic Evaluations, Quality of Life
- Dementia and Cognitive Impairment Research
- Nutrition and Health in Aging
- Intensive Care Unit Cognitive Disorders
- Health disparities and outcomes
- Hip and Femur Fractures
- Aging and Gerontology Research
- Intergenerational Family Dynamics and Caregiving
- Chronic Disease Management Strategies
- Palliative Care and End-of-Life Issues
- Interprofessional Education and Collaboration
- Balance, Gait, and Falls Prevention
- Delphi Technique in Research
- Cerebral Palsy and Movement Disorders
- Long-Term Effects of COVID-19
- Cardiac, Anesthesia and Surgical Outcomes
- COVID-19 and healthcare impacts
- Stroke Rehabilitation and Recovery
- Healthcare innovation and challenges
- Health Policy Implementation Science
- Innovations in Medical Education
- Retirement, Disability, and Employment
- Migration, Aging, and Tourism Studies
University of Nottingham
2016-2025
Queen Mary University of London
2024-2025
Barts Health NHS Trust
2024-2025
Royal Marsden NHS Foundation Trust
2020-2025
Institute of Mental Health
2025
Maimonides Medical Center
2025
University of California, Irvine
2025
University Hospitals of Derby and Burton NHS Foundation Trust
2019-2024
Royal Derby Hospital
2016-2024
Nottingham Biomedical Research Centre
2018-2024
Background: UK care home residents are often poorly served by existing healthcare arrangements. Published descriptions of residents’ health status have been limited lack detail and use data derived from surveys drawn social, rather than health, records. Aim: to describe in the resource Design setting: a 180-day longitudinal cohort study 227 across 11 homes, 5 nursing 6 residential, selected be representative for nursing/residential dementia registration. Method: Barthel index (BI),...
Fluorescence in situ hybridization (FISH) is the most widely used method for detecting unbalanced chromosome rearrangements preimplantation embryos but it known to have several technical limitations. We describe clinical application of a molecular-based assay, array comparative genomic (array-CGH), simultaneously screen translocation derivatives and aneuploidy all 24 chromosomes. Cell biopsy was carried out on cleavage-stage (Day 3). Single cells were first lysed DNA amplified by...
Comprehensive geriatric assessment (CGA) is the most comprehensively researched model for healthcare delivery to frail older patients. It has been shown, through a series of high-quality research studies and subsequent meta-analyses, deliver measurable health improvements people. Although it well understood by specialists in care people, remains unrecognised many non-specialists. Because multifaceted complex intervention, whose title acronym do not convey its full meaning, may be...
Abstract The COVID-19 pandemic has disproportionately affected care home residents internationally, with 19–72% of deaths occurring in homes. presents atypically and up to 56% may test positive whilst pre-symptomatic. In this article, we provide a commentary on challenges dilemmas identified the response for homes their residents. We highlight low sensitivity polymerase chain reaction testing difficulties poses blanket screening isolation discuss quarantine potential harms associated this....
Abstract Introduction Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty unclear. Methods This multi-centre cohort study involved patients aged 18 years and hospitalised COVID-19, using routinely collected data. We used Cox regression analysis to assess impact age, delirium on risk inpatient mortality, adjusting for sex, illness severity, inflammation co-morbidities. ordinal logistic Clinical Frailty Scale (CFS)...
Abstract Background We developed a prototype minimum data set (MDS) for English care homes, assessing feasibility of extracting directly from digital records (DCRs) with linkage to health and social data. Methods Through stakeholder development workshops, literature reviews, surveys public consultation, we an aspirational MDS. identified ways extract this existing sources, including DCRs routine datasets. To address gaps, added validated measures delirium, cognitive impairment, functional...
Abstract Purpose In response to the growing recognition of geriatric rehabilitation and support healthcare providers which need strategies older people with frailty who have experienced functional decline, we developed a consensus statement about core principles future priorities for rehabilitation. Methods We used three-stage approach establish consensus—preparation, review. Results The is grouped under 11 headings from (1) “Definition GR” (11) “Effective develop GR in Europe”, define way...
Introduction: the rise in number of older, frail adults necessitates that future doctors are adequately trained skills geriatric medicine. Few countries have dedicated curricula medicine at undergraduate level. The aim this project was to develop a consensus among geriatricians on curriculum with minimal requirements medical student should achieve by end school. Methods: modified Delphi process used. First, educational experts and proposed set learning objectives based literature review....
the European Union of Medical Specialists (UEMS-GMS) recommendations for training in Geriatric Medicine were published 1993. The practice has developed considerably since then and it therefore become necessary to update these recommendations. under auspices UEMS-GMS, Society (EuGMS) Academy Ageing (EAMA), a group experts, representing all member states respective bodies new framework education specialists using modified Delphi technique. Thirty-two expert panel members from 30 different...
The COVID-19 pandemic serves as a potent reminder that older people are at very high risk of adverse outcomes from infectious disease because comorbidities associated with ageing and decreased immunological competence (immunosenescence). Care home residents particularly physiological vulnerability is compounded by cohabitation other frail adults, increasing exposure infection. Immunosenescence not only increases susceptibility to but also blunts the effectiveness vaccines1Lord JM effect...
From late February 2020, English care homes rapidly adapted their practices in response to the COVID-19 pandemic. In addition accommodating new guidelines and policies, staff had adjust rapid reconfiguration of services external home that they would normally depend upon for support. This study examined complex interdependencies support as responded COVID-19. The aim was inform more effective responses ongoing pandemic, improve understanding how work with organisations after pandemic has passed.
Abstract Purpose We compared the prevalence of COVID-19 and related mortality in nursing homes (NHs) 14 countries until October 2021. explored relationship between NHs with average size deaths at a population level. Methods The total number cases COVID-19-related all as well NH beds were provided by representatives countries. level respective figures each country up to Results There was wide variation observed significant correlation that mean deaths. Conclusion Side-by-side comparisons...
Abstract Purpose Rasch analysis and exploratory factor (EFA) were used to evaluate the structural validity of ASCOT-Proxy measures completed by staff on behalf older adults resident in care homes, comparison ASCOT-SCT4, measure social care-related quality life (SCRQoL) from which was developed. Methods EFA conducted ASCOT-SCT4 two (Proxy-Proxy, Proxy-Resident), determine if they retained single original found samples community-dwelling adults. also applied with a structure EFA. Results...
To assess the feasibility of capturing older care home residents' quality life (QoL) in digital social records and construct validity (hypothesis testing) internal consistency (Cronbach's alpha) four QoL measures. Cross-sectional data collected wave 1 DACHA (Developing resources And minimum dataset for Care Homes' Adoption) study, a mixed-methods pilot prototype (MDS). homes (with or without nursing) registered to provide adults (>65 years) and/or those living with dementia. All used record...
Perioperative risk assessment helps inform clinical practice for older people with hip fractures. This is a cohort study, where perioperative screening, including NHFS, was performed at admission, followed by an evaluation of 30-day outcomes. 503 patients were included, 73% female, 79.4 ± 9.3 years old; 58% presented extracapsular and 42% intracapsular fractures, mortality 9%. The NHFS higher in the who died 5.6 1.1 compared to survivals 4.3 1.5 (p-value < 0.001). > 4 associated observed Cox...
This commentary discusses the perception of frailty by different key stakeholders—most notably older people. It considers need to integrate predominantly medically driven understandings within a wider conceptual framework. is imperative if potential as construct, around which optimisation health and well-being people can take place, be realised.
Background Care homes are the institutional providers of long-term care for older people. The OPTIMAL study argued that it is probable there key activities within different models health-care provision important residents’ health care. Objectives To understand ‘what works, whom, why and in what circumstances?’. Study questions focused on how mechanisms various service delivery act as ‘active ingredients’ associated with positive health-related outcomes home residents. Methods Using realist...