ORCID Profile
0000-0002-3889-7357
Current Organisations
University of Surrey
,
University of Leicester
,
Northumbria University
,
Newcastle University
,
University of Warwick
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Publisher: BMJ
Date: 29-11-2009
Abstract: Tonsillectomies are frequently performed, yet variations exist in tonsillectomy rates. Clinicians use guidelines, but complex psychosocial influences on childhood tonsillectomy include anecdotal evidence of parental enthusiasm. Studies indicate that undergoing preferred treatment improves outcome. Despite the enthusiasm with which tonsillectomy is offered and sought, there is little evidence of efficacy. This resulted in a randomised controlled trial to evaluate the cost-effectiveness of (adeno)tonsillectomy in children with recurrent sore throats. To compare characteristics of children entering the randomised trial with those recruited to a parallel, non-randomised study, to establish trends in referral and patient preferences for treatment. Baseline data from a randomised controlled trial with parallel non-randomised preference study, comparing surgical intervention with medical treatment in children aged 4-15 years with recurrent sore throat referred to five secondary care otolaryngology departments located in the north of England or west central Scotland. Centres assessed 1546 children 21% were not eligible for tonsillectomy. Among older children (8-15 years), girls were significantly more likely to be referred to secondary care. Of 1015 eligible children, 268 (28.2%) agreed to be randomised, while 461 (45.4%) agreed to the parallel, non-randomised preference study, with a strong preference for tonsillectomy. Participants reporting that progress at school had been impeded or with more experience of persistent sore throat were more likely to seek tonsillectomy. Referred boys were more likely than girls to opt for medical treatment. Socio-economic data showed no effect. Preference for tonsillectomy reflects educational impact and recent experience, rather than age or socio-economic status.
Publisher: Oxford University Press (OUP)
Date: 09-2000
Abstract: The aim of the study was to establish the prevalence of urinary symptoms and felt need in adults. This paper discusses problems with setting thresholds to distinguish cases from non-cases in this field of research. Few studies have provided detailed age- and sex-specific prevalence estimates for felt need in relation to urinary symptoms. A cross-sectional postal survey was carried out of 15,904 community-dwelling adults aged 40 years or more registered with general practitioners in Leicestershire. Subjects were selected randomly by household from the Leicestershire Health Authority Register. The postal questionnaire consisted of questions on general health, urinary and bowel symptoms, quality of life, service use and demographic characteristics. Thirty-four per cent of the s le reported clinically significant symptoms. The prevalence and severity of symptoms increased with age. However, only 2 per cent of the s le reported symptoms that were clinically significant, bothersome and socially disabling. Urinary symptoms are very common in adults over 40 years of age living in the community. However, symptom-based estimates probably overestimate the level of need for health care in the community. It may be more effective and efficient to target services, in the first instance, on those people who report clinically significant symptoms that are bothersome or socially disabling. A consensus on thresholds and definitions of urinary symptoms is required to standardize clinical and research work and to target services more appropriately.
Publisher: Cambridge University Press (CUP)
Date: 05-02-2009
Publisher: ACM
Date: 05-05-2012
Publisher: Informa UK Limited
Date: 2007
Publisher: Oxford University Press (OUP)
Date: 22-07-2017
Abstract: The oldest-old (aged ≥85 years) are the fastest growing age group, with the highest risk of cognitive impairment and dementia. This study investigated whether cognitive reserve applies to the oldest-old. This has implications for cognitive interventions in this age group. Baseline and 5-year follow-up data from the Newcastle 85+ Study were used (N = 845, mean age = 85.5, 38% male). A Cognitive Reserve Index (CRI) was created, including: education, social class, marital status, engagement in mental activities, social participation, and physical activity. Global (Mini-Mental State Examination) and domain specific (Cognitive Drug Research Battery subtests assessing memory, attention, and speed) cognitive functions were assessed. Dementia diagnosis was determined by health records. Logistic regression analysis examined the association between CRI scores and incident dementia. Mixed effects models investigated baseline and longitudinal associations between the CRI scores and cognitive function. Analyses controlled for sex, age, depression, and cardiovascular disease history. Higher reserve associated with better cognitive performance on all baseline measures, but not 5-year rate of change. The CRI associated with prevalent, but not incident dementia. In the oldest-old, higher reserve associated with better baseline global and domain-specific cognitive function and reduced risk of prevalent dementia but not cognitive decline or incident dementia. Increasing reserve could promote cognitive function in the oldest-old. The results suggest there would be little impact on trajectories, but replication is needed. Development of preventative strategies would benefit from identifying the role of each factor in building reserve and why rate of change is not affected.
Publisher: National Institute for Health and Care Research
Date: 03-2010
DOI: 10.3310/HTA14130
Abstract: To examine the clinical effectiveness and cost-effectiveness of tonsillectomy/adeno-tonsillectomy in children aged 4-15 years with recurrent sore throats in comparison with standard non-surgical management. A pragmatic randomised controlled trial with economic analysis comparing surgical intervention with conventional medical treatment in children with recurrent sore throats (trial) and a parallel non-randomised cohort study (cohort study). Five secondary care otolaryngology departments located in the north of England or west of Scotland. 268 (trial: 131 allocated to surgical management 137 allocated to medical management) and 461 (cohort study: 387 elected to have surgical management 74 elected to have medical management) children aged between 4 and 15 years on their last birthday with recurrent sore throats. Participants were stratified by age (4-7 years, 8-11 years, 12-15 years). Treatment was tonsillectomy and adeno-tonsillectomy with adenoid curettage and tonsillectomy by dissection or bipolar diathermy according to surgical preference within 12 weeks of randomisation. The control was non-surgical conventional medical treatment only. The primary clinical outcome was the reported number of episodes of sore throat in the 2 years after entry into the study. Secondary clinical outcomes included: the reported number of episodes of sore throat number of sore throat-related GP consultations reported number of symptom-free days reported severity of sore throats and surgical and anaesthetic morbidity. In addition to the measurement of these clinical outcomes, the impact of the treatment on costs and quality of life was assessed. Of the 1546 children assessed for eligibility, 817 were excluded (531 not meeting inclusion criteria, 286 refused) and 729 enrolled to the trial (268) or cohort study (461). The mean (standard deviation) episode of sore throats per month was in year 1 - cohort medical 0.59 (0.44), cohort surgical 0.71 (0.50), trial medical 0.64 (0.49), trial surgical 0.50 (0.43) and in year 2 - cohort medical 0.38 (0.34), cohort surgical 0.19 (0.36), trial medical 0.33 (0.43), trial surgical 0.13 (0.21). During both years of follow-up, children randomised to surgical management were less likely to record episodes of sore throat than those randomised to medical management the incidence rate ratios in years 1 and 2 were 0.70 [95% confidence interval (CI) 0.61 to 0.80] and 0.54 (95% CI 0.42 to 0.70) respectively. The incremental cost-effectiveness ratio was estimated as 261 pounds per sore throat avoided (95% confidence interval 161 pounds to 586 pounds). Parents were willing to pay for the successful treatment of their child's recurrent sore throat (mean 8059 pounds). The estimated incremental cost per quality-adjusted life-year (QALY) ranged from 3129 pounds to 6904 pounds per QALY gained. Children and parents exhibited strong preferences for the surgical management of recurrent sore throats. The health of all children with recurrent sore throat improves over time, but trial participants randomised to surgical management tended to experience better outcomes than those randomised to medical management. The limitations of the study due to poor response at follow-up support the continuing careful use of 'watchful waiting' and medical management in both primary and secondary care in line with current clinical guidelines until clear-cut evidence of clinical effectiveness and cost-effectiveness is available. Current Controlled Trials ISRCTN47891548.
Publisher: Informa UK Limited
Date: 16-10-2007
Publisher: BMJ
Date: 04-2002
DOI: 10.1136/GUT.50.4.480
Abstract: Prevalence studies of faecal incontinence in the general population are rare and the impact of faecal incontinence on quality of life has not been previously addressed. To establish the prevalence of faecal incontinence in adults in terms of frequency of leakage, degree of soiling, and level of impact on quality of life. In a cross sectional postal survey, 15 904 adults aged 40 years or more (excluding residents of nursing and residential homes) were selected randomly by household from the Leicestershire Health Authority patient register. Participants were asked to complete a confidential health questionnaire. Major faecal incontinence was defined as soiling of underwear or worse with a frequency of several times a month or more. Respondents were also asked if bowel symptoms had an impact on their quality of life. From a total s le of 10 116 respondents, 1.4% reported major faecal incontinence and 0.7% major faecal incontinence with bowel symptoms that had an impact on quality of life. Major faecal incontinence was significantly associated with a lot of impact on quality of life (odds ratio 12.4, 95% confidence interval 7.5-20.6). Incontinence was more prevalent and more severe in older people but there was no significant difference between men and women. This study has confirmed that faecal incontinence is a fairly common symptom, particularly in older people. Faecal incontinence in men has received little attention in the past and the results from this study indicate that it is as much of a problem in men as it is in women while the level of unmet need in this group is high. Estimates of need for health care for this symptom should be multidimensional and assess both the severity of symptoms and the impact it has on quality of life.
Publisher: Association for Computing Machinery (ACM)
Date: 17-02-2015
DOI: 10.1145/2696867
Abstract: Ageing has become a significant area of interest in Human-Computer Interaction (HCI) in recent years. In this article we provide a critical analysis of 30 years of ageing research published across the ACM Special Interest Group on Computer-Human Interaction (SIGCHI) community. Discourse analysis of the content of 644 archival papers highlights how ageing is typically framed as a “problem” that can be managed by technology. We highlight how ageing is typically defined through an emphasis on the economic and societal impact of health and care needs of older people, concerns around socialisation as people age, and declines in abilities and associated reductions in performance when using technology. We draw from research within the fields of social and critical gerontology to highlight how these discourses in SIGCHI literature represent common stereotypes around old age that have also prevailed in the wider literature in gerontology. We conclude by proposing strategies for future research at the intersection of ageing and HCI.
Publisher: Future Medicine Ltd
Date: 08-2013
DOI: 10.2217/AHE.13.35
Abstract: Our aging populations have led to concern as to whether existing care provision will cope with the predicted future demand. The oldest old (those over 85 years) are a particular challenge they are the fastest growing sector of our population and have high rates of comorbidity and cognitive impairment. Assistive technologies provide one possible solution to promote independence for older in iduals, but are often underutilized in routine care. In this perspective, we consider how assistive technology can support the future care of the oldest old. First, we summarize the evidence on the health of the oldest old and their current use of assistive technology with a review on the evidence to date on the effectiveness, and potential benefits, of assistive technology. We then discuss the ethical issues associated with the use of assistive technology in this population and, finally, identify key directions for future research and service development in this field.
Publisher: SAGE Publications
Date: 05-05-2014
Abstract: In this review we explore the provision of assistive technology products and services currently available for people with dementia within the United Kingdom. A scoping review of assistive technology products and services currently available highlighted 171 products or product types and 331 services. In addition, we assimilated data on the amount and quality of information provided by assistive technology services alongside assistive technology costs. We identify a range of products available across three areas: assistive technology used ‘by’, ‘with’ and ‘on’ people with dementia. Assistive technology provision is dominated by ‘telecare’ provided by local authorities, with services being subject to major variations in pricing and information provision few currently used available resources for assistive technology in dementia. We argue that greater attention should be paid to information provision about assistive technology services across an increasingly mixed economy of dementia care providers, including primary care, local authorities, private companies and local/national assistive technology resources.
Publisher: MDPI AG
Date: 03-11-2019
DOI: 10.3390/HEALTHCARE7040130
Abstract: Taking an international perspective of healthy ageing, people are living longer and are generally in better health than previous generations [...]
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Katie Brittain.