A5083254109- Geriatric Care and Nursing Homes
- Palliative Care and End-of-Life Issues
- Dementia and Cognitive Impairment Research
- Health Systems, Economic Evaluations, Quality of Life
- Mental Health and Patient Involvement
- Nutrition and Health in Aging
- Interprofessional Education and Collaboration
- Parkinson's Disease Mechanisms and Treatments
- Cerebral Palsy and Movement Disorders
- Patient-Provider Communication in Healthcare
- Balance, Gait, and Falls Prevention
- Grief, Bereavement, and Mental Health
- Stroke Rehabilitation and Recovery
- Chronic Disease Management Strategies
- Primary Care and Health Outcomes
- Clinical practice guidelines implementation
- Intergenerational Family Dynamics and Caregiving
- Health Policy Implementation Science
- Mental Health and Psychiatry
- Patient Dignity and Privacy
- Behavioral Health and Interventions
- Patient Satisfaction in Healthcare
- Ginkgo biloba and Cashew Applications
- Delphi Technique in Research
- Psychiatric care and mental health services
Newcastle University
2014-2023
Newcastle Hospitals - Campus for Ageing and Vitality
2014-2019
Wishaw General Hospital
2019
Manchester Academic Health Science Centre
2017
University of Manchester
2017
University of Newcastle Australia
1998-2014
University of York
1999-2000
Medical Research Council
1999
University of Aberdeen
1992
University of Surrey
1988
Background People with dementia and their families need support in different forms, but currently services are often fragmented variable quality of care. Case management offers a way co-ordinating along the care pathway therefore could provide individualised support; however, evidence effectiveness case for is inconclusive. Objective To adapt intervention used promising project USA test its feasibility acceptability English general practice. Design In work package 1, design group varied...
Background: Advance care planning comprises discussions about an individual’s wishes for future while they have capacity. Aim: To explore professionals’ experiences on the implementation of advance in two areas clinical care, dementia and palliative care. Design: Qualitative study, focus groups individual interviews. Setting: North East England. Sample: Ninety-five participants from one Primary Care Trust, acute National Health Service Hospital Trusts, Ambulance Local Authority voluntary...
Brain imaging with glucose (<sup>18</sup>F-FDG) PET or blood flow (hexamethylpropyleneamine oxime) SPECT is widely used for the differential diagnosis of dementia, though direct comparisons to clearly establish superiority one method have not been undertaken. <b>Methods:</b> Subjects Alzheimer disease (AD; <i>n</i> = 38) and dementia Lewy bodies (DLB; 30) controls (<i>n</i> underwent <sup>18</sup>F-FDG in balanced order. The main outcome measure was area under curve (AUC)...
Background Falls cause fear, anxiety and loss of confidence, resulting in activity avoidance, social isolation increasing frailty. The umbrella term for these problems is ‘fear falling’, seen up to 85% older adults who fall. Evidence effectiveness physical psychological interventions limited, with no previous studies examining the role an individually delivered cognitive–behavioural therapy (CBT) approach. Objectives Primary objective To develop then determine a new CBT intervention (CBTi)...
ABSTRACT Background: Advance care planning (ACP) is increasingly prominent in many countries; however, the evidence base for its acceptability and effectiveness limited especially conditions where cognition impaired, as dementia. Method: This qualitative study used semi-structured interviews with people mild to moderate dementia ( n = 17) family carers 29) investigate their views about future generally ACP specifically. Results: People families make a number of plans future. Most undertook...
There is growing recognition of the need for outcome measures which reflect aims services people with dementia. The development and application existing has often marginalised ‘Experts’ carers have been viewed as primary sources when identifying relevant outcomes or domains quality life, proxy respondents responsible rating on resulting measures. This paper reports a small consultation dementia their to identify desired community care. While there was considerable overlap in identified by...
Ensuring the development and delivery of person-centred care in services providing respite short breaks for people with dementia their carers has a number challenges health social service providers. This article explores role organisational culture barriers facilitators to care. As part mixed-methods study carers, 49 telephone semi-structured interviews, two focus groups (N = 16) five face-to-face in-depth interviews involving front-line staff operational strategic managers were completed...
Background: In recent years, UK policy has increasingly recognised the importance of end-of-life care in dementia. While professional consensus on optimal palliative dementia been reported, little is known about perspectives people with and family carers. Aim: To compare views carers (current recently bereaved) care. Design: Qualitative interviews (32) a focus group were conducted. Data thematically analysed. Setting/participants: Participants comprised early stage dementia, living at home...
People with advanced dementia often experience suboptimal end of life care (EoLC) inadequate pain control, increased hospitalisation, and fewer palliative interventions compared to those cancer. Existing policy, guidance recommendations are based largely on expert opinion because a shortage high quality, empirical research. Previous studies have tended consider the views particular groups. Whilst providing important evidence, they do not take into account diversity perspectives different...
Background There has been a shift in focus of international dementia policies from improving diagnostic rates to enhancing the post-diagnostic support provided people with and their carers. is, however, little agreement over what constitutes good support. This study aimed identify components Methods We adopted qualitative design using interviews, groups observation explore perspectives key stakeholders on content Purposive sampling was used sites England Wales recognised as delivering...
To estimate the effects of medical audit, particularly setting clinical standards, on general practitioners' behaviour.Before and after study strengthened by a replicated Latin square.62 training practices in north England.92 practitioner trainers, 84 (91%) whom completed study; random sample 3500 children consulting one these trainers for any five conditions--acute cough, acute vomiting, bedwetting, itchy rash, recurrent wheezy chest--stratified doctor consulted, condition, age.Clinical...
Despite growing evidence that many people with dementia want to know their diagnosis, there is wide variation in attitudes of professionals towards disclosure. The disclosure the diagnosis increasingly recognised as being a process rather than one-off behaviour. However, different behaviours contribute this have not been comprehensively defined. No intervention studies improve diagnostic reported date. As part larger study develop an promote appropriate disclosure, we sought identify...
Optimizing the dietary intake of older people can prevent nutritional deficiencies and diet-related diseases, thereby improving quality life. However, there is evidence that living in care homes suboptimal, with high levels saturated fat, salt, added sugars. The UK Food Standards Agency therefore developed nutrient- food-based guidance for residential homes. acceptability these guidelines their feasibility practice unknown. This study used Normalization Process Theory (NPT) to understand...
Case management has been suggested as a way of improving the quality and cost-effectiveness support for people with dementia. In this study we adapted implemented successful United States' model case in primary care England. The results are reported elsewhere, but key finding was that little took place. This paper reports findings process evaluation which used Normalization Process Theory to understand barriers implementation.Ethnographic methods were explore views experiences management....
Objective The Lewy body dementias (LBD, dementia with bodies and Parkinson's disease dementia) are the second most common cause of neurodegenerative but remain under‐recognised, long delays from initial assessment to diagnosis. Whilst validated instruments have been developed for key symptoms, there is no brief instrument overall diagnostic suitable routine practice. We here report development such toolkits. Methods LBD toolkits in three stages. First, we conducted a systematic search...
There is concern over delayed diagnosis of dementia in primary care.To determine whether care record review can facilitate earlier dementia.Retrospective notes-based case-control study. Older people with (cases) were identified through older age psychiatrists the north-east England. Age- and sex-matched controls care. Frequency place consultations, symptoms, presentation, tests investigations, management, referrals selected prescription data during 5 years prior to recorded.Relevant...
Background Cognitive deficits in schizophrenia have major functional impacts. Modafinil is a cognitive enhancer whose effect healthy volunteers well-described, but effects on the of appear to be inconsistent. Two possible reasons for this are that test batteries vary their sensitivity, or phase illness may important, with patients early responding better. Methods A double-blind, randomised, placebo-controlled single-dose crossover study modafinil 200 mg examined two [MATRICS Consensus...
Background Evidence consistently shows that people with advanced dementia experience suboptimal end of life care compared to those cancer; increased hospitalisation, inadequate pain control and fewer palliative interventions. Understanding the views service managers frontline staff who organise provide is crucial in order develop better for dementia. Methods findings Qualitative interviews focus groups were conducted from 2013 2015 33 54 involved care, including doctors, nurses, nursing home...
Positron emission tomography (PET) and single photon computed (SPECT) brain imaging are widely used as diagnostic tools for suspected dementia but no studies have directly compared participant views of the two procedures. We a range methods to explore preferences PET SPECT.Patients controls (and accompanying carers) completed questionnaires immediately after undergoing SPECT scans. Pulse rate data were collected during each scan. Scan attributes prioritized using card sorting exercise;...
The development and description of interventions to change professional practice are often limited by the lack an explicit theoretical empirical basis. We set out develop intervention promote appropriate disclosure a diagnosis dementia based on work.We identified three key behaviours: finding what patient already knows or suspects about their diagnosis; using actual words 'dementia' 'Alzheimer's disease' when talking patient; exploring means patient. conducted questionnaire survey older...