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3. Abstracts from the NIHR INVOLVE Conference 2017: London, UK. 28 November 2017

Author

Muir, Delia, Vat, Lidewij Eva, Keller, Malori, Bell, Tim, Jørgensen, Clara R., Eskildsen, Nanna B., Johnsen, Anna T., Pandya-Wood, Raksha, Blackburn, Steven, Day, Ruth, Ingram, Carol, Hapeshi, Julie, Khan, Samaira, Muir, Delia, Baird, Wendy, Pavitt, Sue H., Boards, Richard, Briggs, Janet, Loughhead, Ellen, Patel, Mariya, Khalil, Rameesa, Cooper, David, Day, Peter, Boards, Jenny, Wu, Jianhua, Zoltie, Timothy, Barber, Sophy, Thompson, Wendy, Kenny, Kate, Owen, Jenny, Ramsdale, Martin, Grey-Borrows, Kara, Townsend, Nigel, Johnston, Judith, Maddison, Katie, Duff-Walker, Harry, Mahon, Katie, Craig, Lily, Collins, Rebecca, O’Grady, Alice, Wadd, Sarah, Kelly, Adrian, Dutton, Maureen, McCann, Michelle, Jones, Rebecca, Mathie, Elspeth, Wythe, Helena, Munday, Diane, Millac, Paul, Rhodes, Graham, Roberts, Nick, Simpson, Jean, Barden, Nat, Vicary, Penny, Wellings, Amander, Poland, Fiona, Jones, Julia, Miah, Jahanara, Bamforth, Howard, Charalambous, Anna, Dawes, Piers, Edwards, Steven, Leroi, Iracema, Manera, Valeria, Parsons, Suzanne, Sayers, Ruth, Pinfold, Vanessa, Dawson, Paul, Gibbons, Bliss, Gibson, John, Hobson-Merrett, Charley, McCabe, Catherine, Rawcliffe, Tim, Frith, Lucy, Gudgin, Bernard, Wellings, Amander, Horobin, Adele, Ewart, Colleen, Higton, Fred, Vanhegan, Stevie, Pandya-Wood, Raksha, Stewart, Jane, Wragg, Andy, Wray, Paula, Widdowson, Kirsty, Brighton, Lisa Jane, Pask, Sophie, Benalia, Hamid, Bailey, Sylvia, Sumerfield, Marion, Etkind, Simon, Murtagh, Fliss E. M., Koffman, Jonathan, Evans, Catherine J., Hrisos, Susan, Marshall, Julie, Yarde, Lyndsay, Riley, Bren, Whitlock, Paul, Jobson, Jacqui, Ahmed, Safia, Rankin, Judith, Michie, Lydia, Scott, Jason, Barker, Caroline R., Barlow-Pay, Megan, Kekere-Ekun, Aisha, Mazumder, Aniqa, Nishat, Aniqa, Petley, Rebecca, Brady, Louca-Mai, Templeton, Lorna, Walker, Erin, Moore, Darren, Shaw, Liz, Nunns, Michael, Thompson Coon, Jo, Blomquist, Paula, Cochrane, Sarah, Edelman, Natalie, Calliste, Josina, Cassell, Jackie, Mader, Laura B., Kläger, Sabine, Wilkinson, Ian B., Hiemstra, Thomas F., Hughes, Mel, Warren, Angela, Atkins, Peter, Eaton, Hazel, Keenan, Julia, Poland, Fiona, Wythe, Helena, Wellings, Amander, Vicary, Penny, Rhodes, Carol, Skrybrant, Magdalena, Blackburn, Steven, Chatwin, Lucy, Darby, Mary-Anne, Entwistle, Andrew, Hull, Diana, Quann, Naimh, Hickey, Gary, Dziedzic, Krysia, Eltringham, Sabrina A., Gordon, Jim, Franklin, Sue, Jackson, Joni, Leggett, Nick, Davies, Philippa, Nugawela, Manjula, Scott, Lauren, Leach, Verity, Richards, Alison, Blacker, Anthony, Abrams, Paul, Sharma, Jitin, Donovan, Jenny, Whiting, Penny, Stones, Simon R., Wright, Catherine, Boddy, Kate, Irvine, Jenny, Harris, Jim, Joseph, Neil, Kok, Michele, Gibson, Andy, Evans, David, Grier, Sally, MacGowan, Alasdair, Matthews, Rachel, Papoulias, Constantina, Augustine, Cherelle, Hoffman, Maurice, Doughty, Mark, Surridge, Heidi, Tembo, Doreen, Roberts, Amanda, Chambers, Eleni, Beever, Daniel, Wildman, Martin, Davies, Rosemary L., Staniszewska, Sophie, Stephens, Richard, Schroter, Sara, Price, Amy, Richards, Tessa, Demaine, Andrew, Harmston, Rebecca, Elliot, Jim, Flemyng, Ella, Sproson, Lise, Pryde, Liz, Reed, Heath, Squire, Gill, Stanton, Andy, Langley, Joe, Briggs, Moya, Brindle, Philip, Sanders, Rod, McDermott, Christopher, David, Coyle, Nicola, Heron, Simon, Davies, Martin, Wilkie, Coldham, Tina, Ballinger, Claire, Kerridge, Lynn, Mullee, Mark, Eyles, Caroline, Barlow-Pay, Megan, Hickey, Gary, Johns, Tracey, Paylor, Jon, Turner, Katie, Whiting, Lisa, Roberts, Sheila, Petty, Julia, Meager, Gary, Grinbergs-Saull, Anna, Morgan, Natasha, Turner, Kati, Collins, Flavia, Gibson, Sarah, Passmore, Siobhan, Evans, Liz, Green, Stuart A., Trite, Jenny, Matthews, Rachel, Hrisos, Susan, Thomson, Richard, Green, Dave, Atkinson, Helen, Mitchell, Alex, Corner, Lynne, AM, Anne Mc Kenzie, Nguyen, Rebecca, Frank, Belinda, McNeil, Ngaire, and Harrison, Hayley

Published
2017
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4. Undiagnosed dementia in primary care: a record linkage study

Author

Aldus, Clare F, primary, Arthur, Antony, additional, Dennington-Price, Abi, additional, Millac, Paul, additional, Richmond, Peter, additional, Dening, Tom, additional, Fox, Chris, additional, Matthews, Fiona E, additional, Robinson, Louise, additional, Stephan, Blossom CM, additional, Brayne, Carol, additional, and Savva, George M, additional

Published
2020
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8. Supporting shared decision-making for older people with multiple heath and social care needs: a protocol for a realist synthesis to inform integrated care models

Author

Bunn, Frances, Goodman, Claire M., Manthorpe, Jill, Durand, Marie-Anne, Hodkinson, Isabel, Rait, Greta, Millac, Paul, Davies, Sue L., Russell, Bridget, Wilson, Patricia M., Bunn, Frances, Goodman, Claire M., Manthorpe, Jill, Durand, Marie-Anne, Hodkinson, Isabel, Rait, Greta, Millac, Paul, Davies, Sue L., Russell, Bridget, and Wilson, Patricia M.

Abstract

Introduction: Including the patient or user perspective is a central organising principle of integrated care. Moreover, there is increasing recognition of the importance of strengthening relationships among patients, carers and practitioners, particularly for individuals receiving substantial health and care support, such as those with long-term or multiple conditions. The overall aims of this synthesis are to provide a context-relevant understanding of how models to facilitate shared decision-making (SDM) might work for older people with multiple health and care needs, and how they might be applied to integrated care models. Methods: and analysis The synthesis draws on the principles of realist inquiry, to explain how, in what contexts and for whom, interventions that aim to strengthen SDM among older patients, carers and practitioners are effective. We will use an iterative, stakeholder-driven, three-phase approach. Phase 1: development of programme theory/theories that will be tested through a first scoping of the literature and consultation with key stakeholder groups; phase 2: systematic searches of the evidence to test and develop the theories identified in phase 1; phase 3: validation of programme theory/theories with a purposive sample of participants from phase 1. The synthesis will draw on prevailing theories such as candidacy, self-efficacy, personalisation and coproduction. Ethics and dissemination: Ethics approval for the stakeholder interviews was obtained from the University of Hertfordshire ECDA (Ethics Committee with Delegated Authority), reference number HSK/SF/UH/02387. The propositions arising from this review will be used to develop recommendations about how to tailor SDM interventions to older people with complex health and social care needs in an integrated care setting.

Published
2017

10. Supporting shared decision-making for older people with multiple health and social care needs: a protocol for a realist synthesis to inform integrated care models

Author

Bunn, Frances, primary, Goodman, Claire, additional, Manthorpe, Jill, additional, Durand, Marie-Anne, additional, Hodkinson, Isabel, additional, Rait, Greta, additional, Millac, Paul, additional, Davies, Sue L, additional, Russell, Bridget, additional, and Wilson, Patricia, additional

Published
2017
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15. CORRESPONDENCE.

Author

Fothergill, Roger, Heaney, G.A., Spence, J.C., Gate, J.M., Wyatt, T.D., Ferguson, W.P., Wilson, T.S., Espir, Michael, Millac, Paul, Hansman, David, Garrod, L.P., Paton, A., Jones, Ian G., Barclay, R., Langton, Margaret S.B., Shepherd, W.C., Vetter, Norman, and Gissane, William

Subjects
MEDICINE, DEXTRAN, PENICILLIN, THERAPEUTICS
Abstract

Presents a letter related to medicine to the editors of the 'British Medical Journal'. Side effects of dextran; Occurrence of paroxysmal brain stem dysfunctions in multiple sclerosis; Use of penicillin for the prevention of pneumonia in New Guinea.

Published
1976

16. Neurosurgery in the older patient.

Author

Stewart, Ian, Millac, Paul, Shephard, R. H., Stewart, I, Millac, P, and Sheppard, R H

Abstract

The outcome of brain and spinal surgery has been assessed in 141 patients who were over the age of 65 at the time of operation. Patients tolerated investigation and surgery remarkably well and good results were obtained for benign lesions. Survival times and the contribution of surgery to reducing disability in malignant disease were disappointing. [ABSTRACT FROM PUBLISHER]

Published
1975

17. Diencephalic epilepsy in a patient with agenesis of the corpus callosum confirmed by computerised axial tomography.

Author

Carr-Locke, David, Millac, Paul, Carr-Locke, D, and Millac, P

Abstract

A case of diencephalic epilepsy is described in whom stereotyped attacks of spontaneous hypothermia and diaphoresis occurred over a 20 year period. No abnormality of the hypothalamo-pituitary-adrenal axis was found, and there was no evidence of an intracranial mass lesion. Pneumoencephalography and computerised axial tomography (EMI scan) demonstrated agenesis of the corpus callosum. [ABSTRACT FROM AUTHOR]

Published
1977

18. Treatment of paroxysmal disorders in multiple sclerosis with carbamazepine (Tegretol).

Author

Espir, Michael L. E., Millac, Paul, Espir, M L, and Millac, P

Abstract

During an eight year period, 32 patients with definite or suspected multiple sclerosis (MS) were seen with paroxysmal neurological disturbances, which included tonic seizures, paroxysmal dysarthria, paraesthesiae and pain in the limbs, as well as trigeminal neuralgia. In 21 of these patients the paroxysmal disorders were treated with carbamazepine, and in six the effect was compared with placebo. In the majority carbamazepine was effective in controlling the paroxysmal symptoms. Side-effects were troublesome in a few patients, but they could usually tolerate small doses, which still gave relief. Although the patho-physiological basis for these paroxysmal disorders remains unexplained, their response to carbamazepine suggests a common mechanism. [ABSTRACT FROM AUTHOR]

Published
1970

20. Lines of communication.

Author

Khendek, Uta and Millac, Paul

Subjects
*HOSPITAL communication systems
Abstract

Reports on a study of communication networks at Leicester Royal Infirmary which highlights the effective planning of medical office space. Study of siting of hospital office accommodations; Optimization of communication and information flow in medical directorate wards.

Published
1995

23. Undiagnosed dementia in primary care: a record linkage study

Author

Aldus CF, Arthur A, Dennington-Price A, Millac P, Richmond P, Dening T, Fox C, Matthews FE, Robinson L, Stephan BCM, Brayne C, and Savva GM

Abstract

Background: The number of people living with dementia is greater than the number with a diagnosis of dementia recorded in primary care. This suggests that a significant number are living with dementia that is undiagnosed. Little is known about this group and there is little quantitative evidence regarding the consequences of diagnosis for people with dementia., Objectives: The aims of this study were to (1) describe the population meeting the criteria for dementia but without diagnosis, (2) identify predictors of being diagnosed and (3) estimate the effect of diagnosis on mortality, move to residential care, social participation and well-being., Design: A record linkage study of a subsample of participants ( n  = 598) from the Cognitive Function and Ageing Study II (CFAS II) ( n  = 7796), an existing cohort study of the population of England aged ≥ 65 years, with standardised validated assessment of dementia and consent to access medical records., Data Sources: Data on dementia diagnoses from each participant’s primary care record and covariate and outcome data from CFAS II., Setting: A population-representative cohort of people aged ≥ 65 years from three regions of England between 2008 and 2011., Participants: A total of 598 CFAS II participants, which included all those with dementia who consented to medical record linkage ( n  = 449) and a stratified sample without dementia ( n  = 149)., Main Outcome Measures: The main outcome was presence of a diagnosis of dementia in each participant’s primary care record at the time of their CFAS II assessment(s). Other outcomes were date of death, cognitive performance scores, move to residential care, hospital stays and social participation., Results: Among people with dementia, the proportion with a diagnosis in primary care was 34% in 2008–11 and 44% in 2011–13. In both periods, a further 21% had a record of a concern or a referral but no diagnosis. The likelihood of having a recorded diagnosis increased with severity of impairment in memory and orientation, but not with other cognitive impairment. In multivariable analysis, those aged ≥ 90 years and those aged < 70 years were less likely to be diagnosed than other age groups; those living with a spouse (odds ratio 2.38, 95% confidence interval 1.04 to 5.41) were more likely to be diagnosed than people living alone. The median time to diagnosis from first meeting the criteria for dementia was 3 years. Diagnosis did not affect survival or the probability of a move to residential care., Limitations: People with moderate to severe dementia at baseline could not consent to record linkage. The small numbers in some groups limited power to detect effects., Conclusions: The lack of relationship between severity of non-memory impairment and diagnosis may reflect low awareness of other symptoms of dementia. There remains little objective evidence for benefits of diagnosis for people with dementia., Future Work: Potential benefits of diagnosis can be realised only if effective interventions are accessible to patients and carers. Future work should focus on improving support for people living with cognitive impairment., Study Registration: National Institute for Health Research Clinical Research Network Central Portfolio Management System (CPMS 30655)., Funding: This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research ; Vol. 8, No. 20. See the NIHR Journals Library website for further project information., (Copyright © Queen’s Printer and Controller of HMSO 2020. This work was produced by Aldus 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.)

Published
2020
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