28 results on '"Feltham, Max G."'
Search Results
2. Mirror Visual Feedback Induces Lower Neuromuscular Activity in Children with Spastic Hemiparetic Cerebral Palsy
- Author
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Feltham, Max G., Ledebt, Annick, and Deconinck, Frederik J. A.
- Abstract
The study examined the effects of mirror feedback information on neuromuscular activation during bimanual coordination in eight children with spastic hemiparetic cerebral palsy (SHCP) and a matched control group. The "mirror box" creates a visual illusion, which gives rise to a visual perception of a zero lag, symmetric movement between the two arms. The study incorporated two additional visual feedback conditions by placing a glass or opaque screen between the arms. During bilateral symmetric circular arm movements mirror visual feedback induced lower neuromuscular intensities in the shoulder muscles of the less impaired arm of children with SHCP compared to the other visual conditions. In addition, the mirror lead to shorter relative durations of eccentric and concentric activity in the elbow muscles of the more impaired arm, whereas no effects of visual feedback were found in a matched control group. These results suggest that replacing veridical visual information of the more impaired arm with a mirror reflection of the less impaired arm improves the motor control of children with SHCP during interlimb coupling. The effects of the availability of visual feedback in individuals with hemiparesis are discussed with reference to: (1) increase ipsilateral motor cortex excitability and (2) congruence between afferent (visual) feedback and the internal copy of the motor commands. (Contains 3 tables and 3 figures.)
- Published
- 2010
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- View/download PDF
3. Mirror visual feedback induces lower neuromuscular activity in children with spastic hemiparetic cerebral palsy
- Author
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Feltham, Max G., Ledebt, Annick, Deconinck, Frederik J.A., and Savelsbergh, Geert J.P.
- Published
- 2010
- Full Text
- View/download PDF
4. The positive effect of mirror visual feedback on arm control in children with Spastic Hemiparetic Cerebral Palsy is dependent on which arm is viewed
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Smorenburg, Ana R. P., Ledebt, Annick, Feltham, Max G., Deconinck, Frederik J. A., and Savelsbergh, Geert J. P.
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- 2011
- Full Text
- View/download PDF
5. Assets-based infant feeding help Before and After birth:a randomised controlled feasibility trial for improving breastfeeding initiation and continuation
- Author
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Clarke, Joanne, Ingram, Jenny, Johnson, Debbie, Thomson, Gill, Trickey, Heather, Dombrowski, Stephan U., Stitch, Alice, Dykes, Fiona, Feltham, Max G., MacArthur, Christine, Roberts, Tracy, Hoddinott, Pat, and Jolly, Kate
- Subjects
Bristol Population Health Science Institute - Abstract
Background The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on positive capabilities of individuals and communities, rather than their deficits and problems. The Assets-based feeding help Before and After birth (ABA) intervention offers an assets-based approach based on behaviour change theory. Objective To investigate the feasibility of delivering the ABA infant feeding intervention within a randomised controlled trial. Design Individually randomised controlled feasibility trial; women randomised on a 1:1 ratio to either the intervention or the comparator (usual care). Setting Two separate English sites, selected for having an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage, and low rates of breastfeeding. Participants Women aged 16 years or older, pregnant with their first child, irrespective of feeding intention (n=103), recruited by researchers in antenatal clinics. Intervention Proactive, woman-centred support, using an assets-based approach and including Behaviour Change Techniques, provided by an Infant Feeding Helper (a breastfeeding peer supporter trained in ABA intervention), delivered through face-to-face contact, telephone conversations and text messages. The intervention commenced at around 30 weeks gestation and could continue until 5 months postnatally. Main outcome measures Feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, Infant Feeding Helpers and maternity services; feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow up rates at 3 days, 8 weeks and 6 months postnatal, with collection of outcomes for a future full trial via participant questionnaires. A mixed methods process evaluation included qualitative interviews with women, Infant Feeding Helpers and maternity services; Infant Feeding Helper logs; and audio recordings of antenatal contacts to check intervention fidelity. Results Of 135 eligible women approached, 103 (76.3%) agreed to participate. The study was successful in recruiting teenagers (8.7%) and women living in areas of socioeconomic disadvantage (37.3% resided in the most deprived 40% of small areas in England). Postnatal follow up rates were 68.0%, 85.4% and 80.6% at 3 days, 8 weeks and 6 months respectively. Feeding status at 8-weeks was obtained for 95.1% of participants. Recruitment took place February-August 2017. It was possible to recruit and train existing peer supporters to the Infant Feeding Helper role. The intervention was delivered with relatively high fidelity to most women. Of 50 women, 39 received antenatal visits and 40 received postnatal support. Qualitative data showed the intervention to be acceptable. There was no evidence of intervention-related harms. Limitations Birth notification delays resulted in delays in collection of postnatal feeding status data, and the offer of postnatal support. In addition, the intervention needs to better consider all infant feeding types and did not adequately accommodate women who delivered prematurely. Conclusions It is feasible to deliver the intervention and trial. The intervention should be tested in a fully powered randomized controlled trial.
- Published
- 2020
6. An assets-based intervention before and after birth to improve breastfeeding initiation and continuation: the ABA feasibility RCT
- Author
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Clarke, Joanne L, Ingram, Jenny, Johnson, Debbie, Thomson, Gillian, Trickey, Heather, Dombrowski, Stephan U, Sitch, Alice, Dykes, Fiona Clare, Feltham, Max G, MacArthur, Christine, Roberts, Tracy, Hoddinott, Pat, Jolly, Kate, Clarke, Joanne L, Ingram, Jenny, Johnson, Debbie, Thomson, Gillian, Trickey, Heather, Dombrowski, Stephan U, Sitch, Alice, Dykes, Fiona Clare, Feltham, Max G, MacArthur, Christine, Roberts, Tracy, Hoddinott, Pat, and Jolly, Kate
- Abstract
The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer-support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on the positive capabilities of individuals and communities, rather than their deficits and problems. The Assets-based feeding help Before and After birth (ABA) intervention offers an assets-based approach based on behaviour change theory. Objective To investigate the feasibility of delivering the ABA infant feeding intervention in a randomised controlled trial. Design This was an individually randomised controlled feasibility trial; women were randomised in a 1 : 1 ratio to either the intervention group or the comparator (usual care) group. Setting Two separate English sites were selected because they had an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage and low rates of breastfeeding. Participants Women aged ≥ 16 years who were pregnant with their first child, irrespective of feeding intention (n = 103), were recruited by researchers in antenatal clinics. Interventions Proactive, woman-centred support, using an assets-based approach and including behaviour change techniques, was provided by an infant-feeding helper (a breastfeeding peer supporter trained in the ABA intervention) and delivered through face-to-face contact, telephone conversations and text messages. The intervention commenced at around 30 weeks’ gestation and could continue until 5 months postnatally. Main outcome measures The main outcome measures were feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, infant-feeding helpers and maternity services; and feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow-up rates at 3 days, 8 weeks and 6 months postnatally, and outcomes for a future full trial wer
- Published
- 2020
7. Under-prescribing of Prevention Drugs and Primary Prevention of Stroke and Transient Ischaemic Attack in UK General Practice: A Retrospective Analysis
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Turner, Grace M., Calvert, Melanie, Feltham, Max G., Ryan, Ronan, Fitzmaurice, David, Cheng, K. K., and Marshall, Tom
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Antihypertensive agents -- Dosage and administration ,Anticoagulants -- Dosage and administration ,Stroke -- Care and treatment -- Prevention ,Transient ischemic attack -- Risk factors ,Biological sciences - Abstract
Background Stroke is a leading cause of death and disability; worldwide it is estimated that 16.9 million people have a first stroke each year. Lipid-lowering, anticoagulant, and antihypertensive drugs can prevent strokes, but may be underused. Methods and Findings We analysed anonymised electronic primary care records from a United Kingdom (UK) primary care database that covers approximately 6% of the UK population. Patients with first-ever stroke/transient ischaemic attack (TIA), [greater than or equal to]18 y, with diagnosis between 1 January 2009 and 31 December 2013, were included. Drugs were considered under-prescribed when lipid-lowering, anticoagulant, or antihypertensive drugs were clinically indicated but were not prescribed prior to the time of stroke or TIA. The proportions of strokes or TIAs with prevention drugs under-prescribed, when clinically indicated, were calculated. In all, 29,043 stroke/TIA patients met the inclusion criteria; 17,680 had [greater than or equal to]1 prevention drug clinically indicated: 16,028 had lipid-lowering drugs indicated, 3,194 anticoagulant drugs, and 7,008 antihypertensive drugs. At least one prevention drug was not prescribed when clinically indicated in 54% (9,579/17,680) of stroke/TIA patients: 49% (7,836/16,028) were not prescribed lipid-lowering drugs, 52% (1,647/3,194) were not prescribed anticoagulant drugs, and 25% (1,740/7,008) were not prescribed antihypertensive drugs. The limitations of our study are that our definition of under-prescribing of drugs for stroke/TIA prevention did not address patients' adherence to medication or medication targets, such as blood pressure levels. Conclusions In our study, over half of people eligible for lipid-lowering, anticoagulant, or antihypertensive drugs were not prescribed them prior to first stroke/TIA. We estimate that approximately 12,000 first strokes could potentially be prevented annually in the UK through optimal prescribing of these drugs. Improving prescription of lipid-lowering, anticoagulant, and antihypertensive drugs is important to reduce the incidence and burden of stroke and TIA., Author(s): Grace M. Turner *, Melanie Calvert, Max G. Feltham, Ronan Ryan, David Fitzmaurice, K. K. Cheng, Tom Marshall Introduction Stroke is a leading cause of death and disability worldwide, [...]
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- 2016
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8. Gabapentin for chronic pelvic pain in women (GaPP2): a multicentre, randomised, double-blind, placebo-controlled trial
- Author
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Horne, Andrew W, primary, Vincent, Katy, additional, Hewitt, Catherine A, additional, Middleton, Lee J, additional, Koscielniak, Magda, additional, Szubert, Wojciech, additional, Doust, Ann M, additional, Daniels, Jane P, additional, Abdi, Suraiya, additional, Acharya, Santanu, additional, Al-Inizi, Shamma, additional, Ball, Elizabeth, additional, Baranowski, Andrew, additional, Bhal, Nadia, additional, Bhatia, Kalsang, additional, Bhattacharya, Siladitya, additional, Birch, Judy V., additional, Carpenter, Tyrone, additional, Chalhoub, Tony, additional, Cheong, Ying C., additional, Clark, T. Justin, additional, Cregg, Roman, additional, Dada, Tunde D., additional, Datta, Dib, additional, Faraj, Radwan, additional, Feltham, Max G., additional, Gupta, Pratima, additional, Hapangama, Dharani, additional, Hardwick, Chris, additional, Hughes, Jon, additional, Khatri, Pinky, additional, Kumar, Geeta, additional, Leighton, Lisa J., additional, Majumder, Kingshuk, additional, MacFarlane, Gary J., additional, Mortimer, Alex, additional, Odedra, Smita, additional, Ramsay, Bruce, additional, Raza, Amer, additional, Rea, William, additional, Roy, Somendra, additional, Sajid, Afia, additional, Saraswat, Lucky, additional, Shah, Ahmar, additional, Sivasamy, Jambulingam, additional, Srivastava, Rashmi, additional, Stubbs, Clive, additional, Swaminathan, Ajay, additional, Thampi, Premila, additional, Thanoon, Omar, additional, Thomas, Tony, additional, Tracey, Irene, additional, Underwood, Martyn, additional, Willocks, Clare, additional, Williams, Amanda C de C., additional, Wood, Simon, additional, and Zondervan, Krina, additional
- Published
- 2020
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9. An assets-based intervention before and after birth to improve breastfeeding initiation and continuation: the ABA feasibility RCT
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Clarke, Joanne L, primary, Ingram, Jenny, additional, Johnson, Debbie, additional, Thomson, Gill, additional, Trickey, Heather, additional, Dombrowski, Stephan U, additional, Sitch, Alice, additional, Dykes, Fiona, additional, Feltham, Max G, additional, MacArthur, Christine, additional, Roberts, Tracy, additional, Hoddinott, Pat, additional, and Jolly, Kate, additional
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- 2020
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10. A cluster randomised controlled trial of an occupational therapy intervention for residents with stroke living in UK care homes (OTCH): study protocol
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Sackley Cath M, Burton Chris R, Herron-Marx Sandy, Lett Karen, Mant Jonathan, Roalfe Andrea K, Sharp Leslie J, Sheehan Bart, Stant Katie E, Walker Marion F, Watkins Caroline L, Wheatley Keith, Williams Jane, Yao Guiqing L, and Feltham Max G
- Subjects
Stroke ,Occupational therapy ,Care homes ,Cluster randomised controlled trial ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Background The occupational therapy (OT) in care homes study (OTCH) aims to investigate the effect of a targeted course of individual OT (with task training, provision of adaptive equipment, minor environmental adaptations and staff education) for stroke survivors living in care homes, compared to usual care. Methods/Design A cluster randomised controlled trial of United Kingdom (UK) care homes (n = 90) with residents (n = 900) who have suffered a stroke or transient ischaemic attack (TIA), and who are not receiving end-of-life care. Homes will be stratified by centre and by type of care provided and randomised (50:50) using computer generated blocked randomisation within strata to receive either the OT intervention (3 months intervention from an occupational therapist) or control (usual care). Staff training on facilitating independence and mobility and the use of adaptive equipment, will be delivered to every home, with control homes receiving this after the 12 month follow-up. Allocation will be concealed from the independent assessors, but the treating therapists, and residents will not be masked to the intervention. Measurements are taken at baseline prior to randomisation and at 3, 6 and 12 months post randomisation. The primary outcome measure is independence in self-care activities of daily living (Barthel Activities of Daily Living Index). Secondary outcome measures are mobility (Rivermead Mobility Index), mood (Geriatric Depression Scale), preference based quality of life measured from EQ-5D and costs associated with each intervention group. Quality adjusted life years (QALYs) will be derived based on the EQ-5D scores. Cost effectiveness analysis will be estimated and measured by incremental cost effectiveness ratio. Adverse events will be recorded. Discussion This study will be the largest cluster randomised controlled trial of OT in care homes to date and will clarify the currently inconclusive literature on the efficacy of OT for stroke and TIA survivors residing in care homes. Trial registration ISRCTN00757750
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- 2012
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11. Supplementary material
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Christmas, Pauline M, Sackley, Catherine, Feltham, Max G, and Cummins, Carole
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FOS: Clinical medicine ,110604 Sports Medicine ,FOS: Health sciences ,110314 Orthopaedics ,110904 Neurology and Neuromuscular Diseases - Abstract
Appendix
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- 2018
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12. Protocol for a feasibility trial for improving breastfeeding initiation and continuation: Assets-based infant feeding help Before and After birth (ABA)
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Jolly, Kate, Ingram, Jenny, Clarke, Joanne, Johnson, Debbie, Heather, Trickey, Thomson, Gillian, Dombrowski, Stephan U., Sitch, Alice, Dykes, Fiona Clare, Feltham, Max G., Darwent, Kirsty, MacArthur, Christine, Roberts, Tracy, Hoddinott, Pat, Jolly, Kate, Ingram, Jenny, Clarke, Joanne, Johnson, Debbie, Heather, Trickey, Thomson, Gillian, Dombrowski, Stephan U., Sitch, Alice, Dykes, Fiona Clare, Feltham, Max G., Darwent, Kirsty, MacArthur, Christine, Roberts, Tracy, and Hoddinott, Pat
- Abstract
Introduction: Breastfeeding improves the health of mothers and infants; the UK has low rates, with marked socio-economic inequalities. Whilst trials of peer support services have been effective in some settings, UK trials have not improved breastfeeding rates. Qualitative research suggests many women are alienated by the focus on breastfeeding. We propose a change from breastfeeding focussed interactions to respecting a woman’s feeding choices, inclusion of behaviour change theory and an increased intensity of contacts in the two weeks after birth when many women cease to breastfeed. This will take place alongside an assets-based approach which focuses on the positive capability of individuals, their social networks and communities. We propose a feasibility study for a multicentre randomised controlled trial of the ABA infant feeding service versus usual care. Methods and analysis: A two-arm, non-blinded randomised feasibility study will be conducted in two UK localities. Women expecting their first baby will be eligible, regardless of feeding intention. The ABA infant feeding intervention will apply a proactive, assets-based, woman-centred, non-judgemental approach, delivered antenatally and postnatally tailored through face-to face contacts, telephone and SMS texts. Outcomes will test the feasibility of delivering the intervention with recommended intensity and duration to disadvantaged women; acceptability to women, feeding helpers and professionals; and feasibility of a future randomised controlled trial, detailing recruitment rates, willingness to be randomised, follow-up rates at 3 days, 8 weeks and 6 months and level of outcome completion. Outcomes of the proposed full trial will also be collected. Mixed methods will include qualitative interviews with women/partners, feeding helpers and health service staff; feeding helper logs and review of audio-recorded helper-women interactions to assess intervention fidelity. Ethics and dissemination: Study results will
- Published
- 2018
13. A randomized controlled trial to compare two methods of constraint-induced movement therapy to improve functional ability in the affected upper limb in pre-school children with hemiplegic cerebral palsy: CATCH TRIAL
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Christmas, Pauline M, primary, Sackley, Catherine, additional, Feltham, Max G, additional, and Cummins, Carole, additional
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- 2018
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14. Protocol for a feasibility trial for improving breast feeding initiation and continuation: assets-based infant feeding help before and after birth (ABA)
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Jolly, Kate, primary, Ingram, Jenny, additional, Clarke, Joanne, additional, Johnson, Debbie, additional, Trickey, Heather, additional, Thomson, Gill, additional, Dombrowski, Stephan U, additional, Sitch, Alice, additional, Dykes, Fiona, additional, Feltham, Max G, additional, Darwent, Kirsty, additional, MacArthur, Christine, additional, Roberts, Tracy, additional, and Hoddinott, Pat, additional
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- 2018
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15. The "Mirror Box" Illusion: Effect of Visual Information on Bimanual Coordination in Children with Spastic Hemiparetic Cerebral Palsy.
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Feltham, Max G., Ledebt, Annick, Bennett, Simon J., Deconinck, Frederik J. A., Verheul, Martine H. G., and Savelsbergh, Geert J. P.
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CHILDREN with cerebral palsy ,HEMIPLEGIA ,VISUAL perception ,MOVEMENT disorders in children ,KINEMATICS ,MOTOR ability in children ,KINESIOLOGY - Abstract
The study examined symmetrical bimanual coordination of children with spastic hemiparetic cerebral palsy (SHCP) and a typically developing (TD) control group under conditions of visual feedback created by placing a glass screen, opaque screen or a mirror ("mirror box") between the arms. The "mirror box" creates a visual illusion, which gives rise to a visual perception of a zero lag, symmetric movement between the two arms. Children with SHCP exhibited a similar mean coordination pattern as the TD control group, but had greater movement variability between the arms. Furthermore, movement variability in children with SHCP was significantly greater in the screen condition compared with the glass and mirror condition, which were similar to each other. The effects of the availability of visual feedback in individuals with hemiparesis are discussed with reference to central and peripheral mechanisms. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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16. Retrospective case review of missed opportunities for primary prevention of stroke and TIA in primary care: protocol paper
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Moran, Grace M, Calvert, Melanie, Feltham, Max G, and Marshall, Tom
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Adult ,Male ,Primary Health Care ,Cardiovascular Medicine ,Middle Aged ,Primary Prevention ,Stroke ,PREVENTIVE MEDICINE ,PRIMARY CARE ,Ischemic Attack, Transient ,Protocol ,Humans ,Female ,cardiovascular diseases ,Aged ,Retrospective Studies - Abstract
Introduction Stroke is a major health problem and transient ischaemic attack (TIA) is an important risk factor for stroke. Primary prevention of stroke and TIA will have the greatest impact on reducing the burden of these conditions. Evidence-based guidelines for stroke/TIA prevention identify individuals eligible for preventative interventions in primary care. This study will investigate: (1) the proportion of strokes/TIAs with prior missed opportunities for prevention in primary care; (2) the influence of patient characteristics on missed prevention opportunities and (3) how the proportion of missed prevention opportunities has changed over time. Methods and analysis A retrospective case review will identify first-ever stroke and patients with TIA between 2000 and 2013 using anonymised electronic medical records extracted from the health improvement network (THIN) database. Four categories of missed opportunities for stroke/TIA prevention will be sought: untreated high blood pressure in patients eligible for treatment (either blood pressure ≥160/100 or ≥140/90 mm Hg in patients at high cardiovascular disease (CVD) risk); patients with atrial fibrillation with high stroke risk and no anticoagulant therapy; no lipid modifying drug therapy prescribed in patients at high CVD risk or with familial hypercholesterolaemia. The proportion of patients with each missed opportunity and multiple missed opportunities will be calculated. Mixed effect logistic regression will model the relationship between demographic and patient characteristics and missed opportunities for care; practice will be included as a random effect. Ethics and dissemination THIN data collection was approved by the NHS South East Multi-centre Research Ethics Committee (MREC) in 2003. This study was approved by the independent scientific review committee in May 2013. Dissemination of findings has the potential to change practice, improve the quality of care provided to patients and ultimately reduce the incidence of strokes and TIAs. Findings will be published in a peer-reviewed journal and disseminated at national and international conferences.
- Published
- 2014
17. Assessment of spatio-temporal gait parameters using inertial measurement units in neurological populations
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Esser, Patrick, Dawes, Helen, Collett, Johnny, Feltham, Max G., and Howells, Ken
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- 2011
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18. Reflections on Mirror Therapy
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Deconinck, Frederik J. A., primary, Smorenburg, Ana R. P., additional, Benham, Alex, additional, Ledebt, Annick, additional, Feltham, Max G., additional, and Savelsbergh, Geert J. P., additional
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- 2014
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19. A cluster randomised controlled trial of an occupational therapy intervention for residents with stroke living in UK care homes (OTCH): study protocol
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Sackley, Cath M, Burton, Chris R, Herron-Marx, Sandy, Lett, Karen, Mant, Jonathan, Roalfe, Andrea K, Sharp, Leslie J, Sheehan, Bart, Stant, Katie E, Walker, Marion F, Watkins, Caroline L, Wheatley, Kevin, Williams, Jane, Yao, Guiqing L, Feltham, Max G, Sackley, Cath M, Burton, Chris R, Herron-Marx, Sandy, Lett, Karen, Mant, Jonathan, Roalfe, Andrea K, Sharp, Leslie J, Sheehan, Bart, Stant, Katie E, Walker, Marion F, Watkins, Caroline L, Wheatley, Kevin, Williams, Jane, Yao, Guiqing L, and Feltham, Max G
- Abstract
Background The occupational therapy (OT) in care homes study (OTCH) aims to investigate the effect of a targeted course of individual OT (with task training, provision of adaptive equipment, minor environmental adaptations and staff education) for stroke survivors living in care homes, compared to usual care. Methods A cluster randomised controlled trial of United Kingdom (UK) care homes (n = 90) with residents (n = 900) who have suffered a stroke or transient ischaemic attack (TIA), and who are not receiving end-of-life care. Care homes are randomised to either the intervention group (3 months of OT) or the control group (standard care). The primary outcome measure is independence in self-care activities of daily living (Barthel Activities of Daily Living Index). Secondary outcome measures are mobility (Rivermead Mobility Index), mood (Geriatric Depression Scale), preference based quality of life measured from EQ-5D and costs associated with each intervention groups. Quality adjusted life years (QALYs) will be derived based on the EQ-5D scores. Cost effectiveness analysis will be estimated and measured by incremental cost effectiveness ratio. Measurements are taken at baseline prior to randomisation and at 3, 6 and 12 months post randomisation. Staff training on facilitating independence and mobility and the use of adaptive equipment, will be delivered to every home, with control homes receiving this after the 12 month follow-up. Homes will be stratified by centre and by type of care provided and randomised (50:50) using blocked randomisation within strata to receive either the OT intervention or control (usual care). Allocation will be concealed from the independent assessors, but the treating therapists and residents will be unblinded from the intervention. Discussion This study will be the largest cluster randomised control trial of OT in care homes to date and will clarify the currently inconclusive literature on the efficacy of OT for stroke and TIA survivors
- Published
- 2012
20. A systematic review investigating fatigue, psychological and cognitive impairment following TIA and minor stroke: protocol paper
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Moran, Grace M, primary, Fletcher, Benjamin, additional, Calvert, Melanie, additional, Feltham, Max G, additional, Sackley, Catherine, additional, and Marshall, Tom, additional
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- 2013
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21. Occupational therapy for care home residents with stroke
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Fletcher-Smith, Joanna C, primary, Walker, Marion F, additional, Feltham, Max G, additional, Steultjens, Esther EMJ, additional, and Sackley, Catherine M, additional
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- 2012
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22. Validity and inter-rater reliability of inertial gait measurements in Parkinson's disease: A pilot study
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Esser, Patrick, primary, Dawes, Helen, additional, Collett, Johnny, additional, Feltham, Max G., additional, and Howells, Ken, additional
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- 2012
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23. Assessment of neuromuscular activation of the upper limbs in children with spastic hemiparetic cerebral palsy during a dynamical task
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Feltham, Max G., primary, Ledebt, Annick, additional, Deconinck, Frederik J.A., additional, and Savelsbergh, Geert J.P., additional
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- 2010
- Full Text
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24. Reflections on Mirror Therapy: A Systematic Review of the Effect of Mirror Visual Feedback on the Brain.
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Deconinck, Frederik J. A., Smorenburg, Ana R. P., Benham, Alex, Ledebt, Annick, Feltham, Max G., and Savelsbergh, Geert J. P.
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- 2015
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25. A retrospective cohort study to investigate fatigue, psychological or cognitive impairment after TIA: protocol paper.
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Moran, Grace M., Calvert, Melanie, Feltham, Max G., Ryan, Ronan, and Marshall, Tom
- Abstract
Introduction: Transient ischaemic attack (TIA) is defined by short-lasting, stroke-like symptoms, and is recognised as a medical emergency. Symptoms are assumed to completely resolve, and treatment is focused on secondary stroke/TIA prevention. However, evidence suggests that patients with TIA may experience ongoing residual impairments, which they do not receive therapy for as standard practice. TIA-induced sequelae could impact on patients' quality of life and ability to return to work or social activities. We aim to investigate whether TIA is associated with t subsequent consultation for fatigue, psychological or cognitive impairment in primary care. Methods and analysis: A retrospective open cohort study of patients with first-ever TIA and matched controls. Relevant data will be extracted from The Health Improvement Network (THIN) database, an anonymised primary care database which includes data for over 12 million patients and covers approximately 6% of the UK population. Outcomes will be the first consultation for fatigue, anxiety, depression, post-traumatic stress disorder or cognitive impairment. Principal analysis will use Kaplan-Meier survivor functions to estimate time to first consultation, with log-rank tests to compare TIA and control patients. Cox proportional hazard models will predict the effect of demographic and patient characteristics on time to first consultation. Ethics and dissemination: Approval was granted by a THIN Scientific Review Committee (ref: 14-008). The study's findings will be published in a peer-reviewed journal and disseminated at national and international conferences and through social media. [ABSTRACT FROM AUTHOR]
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- 2015
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26. A cluster randomised controlled trial of an occupational therapy intervention for residents with stroke living in UK care homes (OTCH): study protocol
- Author
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Sackley, Cath M., Burton, Chris R., Herron-Marx, Sandy, Lett, Karen, Mant, Jonathan, Roalfe, Andrea K., Sharp, Leslie J., Sheehan, Bart, Stant, Katie E., Walker, Marion F., Watkins, Caroline L., Wheatley, Keith, Williams, Jane, Yao, Guiqing L., Feltham, Max G., Sackley, Cath M., Burton, Chris R., Herron-Marx, Sandy, Lett, Karen, Mant, Jonathan, Roalfe, Andrea K., Sharp, Leslie J., Sheehan, Bart, Stant, Katie E., Walker, Marion F., Watkins, Caroline L., Wheatley, Keith, Williams, Jane, Yao, Guiqing L., and Feltham, Max G.
- Abstract
Background: The occupational therapy (OT) in care homes study (OTCH) aims to investigate the effect of a targeted course of individual OT (with task training, provision of adaptive equipment, minor environmental adaptations and staff education) for stroke survivors living in care homes, compared to usual care. Methods/Design: A cluster randomised controlled trial of United Kingdom (UK) care homes (n = 90) with residents (n = 900) who have suffered a stroke or transient ischaemic attack (TIA), and who are not receiving end-of-life care. Homes will be stratified by centre and by type of care provided and randomised (50:50) using computer generated blocked randomisation within strata to receive either the OT intervention (3 months intervention from an occupational therapist) or control (usual care). Staff training on facilitating independence and mobility and the use of adaptive equipment, will be delivered to every home, with control homes receiving this after the 12 month follow-up. Allocation will be concealed from the independent assessors, but the treating therapists, and residents will not be masked to the intervention. Measurements are taken at baseline prior to randomisation and at 3, 6 and 12 months post randomisation. The primary outcome measure is independence in self-care activities of daily living (Barthel Activities of Daily Living Index). Secondary outcome measures are mobility (Rivermead Mobility Index), mood (Geriatric Depression Scale), preference based quality of life measured from EQ-5D and costs associated with each intervention group. Quality adjusted life years (QALYs) will be derived based on the EQ-5D scores. Cost effectiveness analysis will be estimated and measured by incremental cost effectiveness ratio. Adverse events will be recorded. Discussion: This study will be the largest cluster randomised controlled
27. A cluster randomised controlled trial of an occupational therapy intervention for residents with stroke living in UK care homes (OTCH): study protocol
- Author
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Sackley, Cath M., Burton, Chris R., Herron-Marx, Sandy, Lett, Karen, Mant, Jonathan, Roalfe, Andrea K., Sharp, Leslie J., Sheehan, Bart, Stant, Katie E., Walker, Marion F., Watkins, Caroline L., Wheatley, Keith, Williams, Jane, Yao, Guiqing L., Feltham, Max G., Sackley, Cath M., Burton, Chris R., Herron-Marx, Sandy, Lett, Karen, Mant, Jonathan, Roalfe, Andrea K., Sharp, Leslie J., Sheehan, Bart, Stant, Katie E., Walker, Marion F., Watkins, Caroline L., Wheatley, Keith, Williams, Jane, Yao, Guiqing L., and Feltham, Max G.
- Abstract
Background: The occupational therapy (OT) in care homes study (OTCH) aims to investigate the effect of a targeted course of individual OT (with task training, provision of adaptive equipment, minor environmental adaptations and staff education) for stroke survivors living in care homes, compared to usual care. Methods/Design: A cluster randomised controlled trial of United Kingdom (UK) care homes (n = 90) with residents (n = 900) who have suffered a stroke or transient ischaemic attack (TIA), and who are not receiving end-of-life care. Homes will be stratified by centre and by type of care provided and randomised (50:50) using computer generated blocked randomisation within strata to receive either the OT intervention (3 months intervention from an occupational therapist) or control (usual care). Staff training on facilitating independence and mobility and the use of adaptive equipment, will be delivered to every home, with control homes receiving this after the 12 month follow-up. Allocation will be concealed from the independent assessors, but the treating therapists, and residents will not be masked to the intervention. Measurements are taken at baseline prior to randomisation and at 3, 6 and 12 months post randomisation. The primary outcome measure is independence in self-care activities of daily living (Barthel Activities of Daily Living Index). Secondary outcome measures are mobility (Rivermead Mobility Index), mood (Geriatric Depression Scale), preference based quality of life measured from EQ-5D and costs associated with each intervention group. Quality adjusted life years (QALYs) will be derived based on the EQ-5D scores. Cost effectiveness analysis will be estimated and measured by incremental cost effectiveness ratio. Adverse events will be recorded. Discussion: This study will be the largest cluster randomised controlled
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28. An assets-based intervention before and after birth to improve breastfeeding initiation and continuation: the ABA feasibility RCT
- Author
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Clarke JL, Ingram J, Johnson D, Thomson G, Trickey H, Dombrowski SU, Sitch A, Dykes F, Feltham MG, MacArthur C, Roberts T, Hoddinott P, and Jolly K
- Abstract
Background: The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer-support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on the positive capabilities of individuals and communities, rather than their deficits and problems. The Assets-based feeding help Before and After birth (ABA) intervention offers an assets-based approach based on behaviour change theory., Objective: To investigate the feasibility of delivering the ABA infant feeding intervention in a randomised controlled trial., Design: This was an individually randomised controlled feasibility trial; women were randomised in a 1 : 1 ratio to either the intervention group or the comparator (usual care) group., Setting: Two separate English sites were selected because they had an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage and low rates of breastfeeding., Participants: Women aged ≥ 16 years who were pregnant with their first child, irrespective of feeding intention ( n = 103), were recruited by researchers in antenatal clinics., Interventions: Proactive, woman-centred support, using an assets-based approach and including behaviour change techniques, was provided by an infant-feeding helper (a breastfeeding peer supporter trained in the ABA intervention) and delivered through face-to-face contact, telephone conversations and text messages. The intervention commenced at around 30 weeks’ gestation and could continue until 5 months postnatally., Main Outcome Measures: The main outcome measures were feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, infant-feeding helpers and maternity services; and feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow-up rates at 3 days, 8 weeks and 6 months postnatally, and outcomes for a future full trial were collected via participant questionnaires. A mixed-methods process evaluation included qualitative interviews with women, infant-feeding helpers and maternity services; infant-feeding helper logs; and audio-recordings of antenatal contacts to check intervention fidelity., Results: Of the 135 eligible women approached, 103 (76.3%) agreed to participate. The study was successful in recruiting teenagers (8.7%) and women living in areas of socioeconomic disadvantage (37.3% resided in the most deprived 40% of small areas in England). Postnatal follow-up rates were 68.0%, 85.4% and 80.6% at 3 days, 8 weeks and 6 months, respectively. Feeding status at 8 weeks was obtained for 95.1% of participants. Recruitment took place from February 2017 until August 2017. It was possible to recruit and train existing peer supporters to the infant-feeding helper role. The intervention was delivered to most women with relatively high fidelity. Among the 50 women in the intervention group, 39 received antenatal visits and 40 received postnatal support. Qualitative data showed that the intervention was acceptable. There was no evidence of intervention-related harms., Limitations: Birth notification delays resulted in delays in the collection of postnatal feeding status data and in the offer of postnatal support. In addition, the intervention needs to better consider all infant-feeding types and did not adequately accommodate women who delivered prematurely., Conclusion: It is feasible to deliver the intervention and trial., Future Work: The intervention should be tested in a fully powered randomised controlled trial., Trial Registration: Current Controlled Trials ISRCTN14760978., Funding: This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research ; Vol. 8, No. 7. See the NIHR Journals Library website for further project information., (Copyright © Queen’s Printer and Controller of HMSO 2020. This work was produced by Clarke et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.)
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- 2020
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