Publications by authors named "NOBLE H"

Introduction Due to the chronic nature of kidney disease and the challenges of symptom burden, reduced mortality and co-morbidity, individuals living with the condition experience substantial anxiety and depression. Incorporating the arts into clinical practice is encouraged to promote and support mental health and wellbeing. The aim of the PAINT project was to undertake an international mapping exercise to identify the current provision of arts programmes in kidney centres for people living with kidney disease.

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Introduction: There is inequity in the provision of physical rehabilitation services for people living with chronic kidney disease (CKD). The Kidney BEAM trial evaluated the clinical value and cost effectiveness of a physical activity digital health intervention (DHI) in CKD.

Methods: In a single-blind, 11 center, randomized controlled trial, 340 adult participants with CKD were randomly assigned to either the Kidney BEAM physical activity DHI or a waitlist control.

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Article Synopsis
  • After kidney transplant failure, patients can choose between peritoneal dialysis (PD), haemodialysis (HD), or re-transplantation, with each option potentially affecting their clinical outcomes differently.
  • A systematic review identified eight relevant studies, revealing that chronic damage is the primary reason for transplant failure, and showed that re-transplantation (TX-TX group) had a lower mortality rate compared to HD (TX-HD group).
  • The TX-PD group not only had lower mortality rates compared to the TX-HD group but also a higher rate of re-transplantation; however, factors like age and comorbidities may influence these outcomes.
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Background: People living with advanced, non-malignant chronic conditions often have extensive and complex care needs. Informal or family caregivers often provide the care and support needed by those with advanced chronic conditions at home. These informal caregivers experience many challenges associated with their caring role, which can impact their own wellbeing.

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  • - Chronic kidney disease affects around 13% of the global population and is expected to be a major cause of life years lost by 2040, with end-stage kidney disease leading to complications like renal cachexia, which is not well understood and has limited treatment options.
  • - The study aims to understand the experiences of individuals with renal cachexia and their carers through in-depth interviews, adhering to ethical research practices in a UK healthcare setting.
  • - Seven participants (four patients and three carers) were recruited, with the data analyzed to identify six key themes related to their lived experiences, including issues like appetite loss, weight decline, social withdrawal, and emotional struggles.
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Heart failure (HF) is one of the most common diagnoses on admission to hospital in Germany, and one which incurs high costs. Integrated care in case management programs (CMPs) aims to improve treatment quality in the sense of guideline-driven treatment, while reducing hospital admissions, hospital costs, and mortality. A total of 1,844 patient data records from 11 German statutory health insurance companies enrolled in the CMP (intervention group [IG]) were compared with 1,844 standard-care patients (control group) using propensity score matching.

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Background: Fatigue among patients with end-stage kidney disease (ESKD) receiving haemodialysis imposes a substantial burden on patients' quality of life and expected treatment outcomes. This study explores the perspective on ESKD-related fatigue and contributing factors among Omani patients receiving haemodialysis.

Methods: An exploratory qualitative design was used.

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Tubulin plays a fundamental role in cellular function and as the subject for microtubule-active agents in the treatment of ovarian cancer. Microtubule-binding proteins (e.g.

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Microtubules are dynamic polymers composed of α- and β-tubulin heterodimers. Microtubules are universally conserved among eukaryotes and participate in nearly every cellular process, including intracellular trafficking, replication, polarity, cytoskeletal shape, and motility. Due to their fundamental role in mitosis, they represent a classic target of anti-cancer therapy.

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  • Functional motor disorder, a type of neurological issue, can lead to significant health problems and new treatment methods like specialized physiotherapy have been developed, though large scale studies are limited.
  • A phase 3 randomized controlled trial was conducted across 11 hospitals in England and Scotland, where participants were assigned to either specialized physiotherapy or standard care to assess the effectiveness of the intervention on physical functioning after 12 months.
  • The trial included 355 participants, with recruitment affected by the COVID-19 pandemic, and aimed to provide evidence on whether specialized physiotherapy leads to better outcomes compared to conventional treatment.
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Background: Patients with end stage kidney disease (ESKD) receiving haemodialysis experience multiple symptoms, which can present physical and emotional challenges for both patients and their informal caregivers. Caregivers can experience anxiety, depression, and social isolation negatively impacting their overall wellbeing and resulting in caregiver burden. The needs of this group of caregivers have been largely neglected, with little emphasis placed on supportive interventions that might assist and support them in their caring role.

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  • The study looked at how women in the UK with HIV managed their pregnancies, especially those who can keep their virus levels very low without treatment.
  • It compared pregnancies before and after 2012 when new guidelines changed how HIV was treated during pregnancy.
  • Even with the changes in treatment, there were no new cases of HIV passed to babies, and the way babies were delivered varied quite a bit in recent years.
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Purpose: The aim of our work was to demonstrate the importance of artificial intelligence-based analysis of fractional flow reserves of computed tomographically detected coronary artery stenosis with regard to their hemodynamic relevance in patients with unclear chest pain and suspected stable coronary heart disease with a low to medium pre-test probability.

Material And Methods: The collective of our retrospective analysis includes 63 patients in whom coronary artery stenosis was detected by volume computed tomographic examination in "one beat, whole heart" mode in the period from March to October 2022. In these patients, the fractional flow reserve was also determined by computed tomography, which was modulated by the use of artificial intelligence.

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  • This systematic review and meta-analysis examined the rates and reasons for patients switching from hemodialysis (HD) to peritoneal dialysis (PD) and subsequently dropping out of PD.
  • It found no significant difference in PD dropout rates between those who started with PD versus those who switched from HD, although the latter group showed a notable reduction in mortality.
  • Key reasons for switching included vascular access failure and patient preference, while inadequate dialysis and peritonitis were common dropout reasons, indicating the need for more research on psychosocial factors and a unified definition of PD dropout.
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Background: Palliative care (PC) focuses on relieving pain and difficult symptoms rather than treating disease or delaying its progress. Palliative care views death as a natural process and allows patients to live the last phase of their existence in the best possible way, encouraging them to express their opinions and wishes for a good death. Interventions are advocated to control symptoms and distress and promote wellbeing and social functioning.

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Background: Individuals with chronic kidney disease experience difficult physical and psychological symptoms, that impact quality of life, and are at increased risk of anxiety and depression. Access to specialist psychological support is limited. This study aimed to support a new service development project, in collaboration with Kidney Care UK, to implement the Compassionate Mindful Resilience (CMR) programme, developed by MindfulnessUK, which provides accessible mindfulness techniques and practices to enhance compassion and resilience, and explore its feasibility for people living with stage 4 or 5 kidney disease and transplant.

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This trial assessed the feasibility and acceptability of Kidney BEAM, a physical activity and emotional well-being self-management digital health intervention (DHI) for people with chronic kidney disease (CKD), which offers live and on-demand physical activity sessions, educational blogs and videos, and peer support. In this mixed-methods, multicentre randomised waitlist-controlled internal pilot, adults with established CKD were recruited from five NHS hospitals and randomised 1:1 to Kidney BEAM or waitlist control. Feasibility outcomes were based upon a priori progression criteria.

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Background: The oral glucose tolerance test (OGTT) is the gold standard for detecting gestational diabetes mellitus (GDM). However, during the COVID-19 pandemic, screening practices were reevaluated due to the risk of infection associated with the prolonged hospital visit required for the OGTT. Some countries have published novel screening protocols for GDM, suggesting the utilization of hemoglobin A1c (HbA1c), random plasma glucose (RPG), or fasting plasma glucose (FPG) in favor of OGTTs during the pandemic.

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Background: Kidney disease is a progressive, debilitating condition. Patients experience challenging physical and psychological symptoms and are at increased risk of anxiety, depression, and poor mental wellbeing. Access to specialist psychological or social support is limited, with inadequate provision of psychosocial support available across UK renal units.

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Background: Remote digital health interventions to enhance physical activity provide a potential solution to improve the sedentary behaviour, physical inactivity, and poor health-related quality of life that are typical of chronic conditions, particularly for people with chronic kidney disease. However, there is a need for high-quality evidence to support implementation in clinical practice. The Kidney BEAM trial evaluated the clinical effect of a 12-week physical activity digital health intervention on health-related quality of life.

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Background: Virtual reality (VR) based meditation has been shown to help increase relaxation and decrease anxiety and depression in younger adults. However, this has not been studied in Randomized Controlled Trials (RCT) in the older adult population. The aim of this RCT is to assess the feasibility and acceptability of a VR-guided meditation intervention for community-dwelling older adults and its effect on stress and mental health.

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Background: Adolescence and young adulthood are high risk periods for kidney transplant recipients. The reasons for this are complex; but are predominantly thought to be due to poor adherence to immunosuppressive medications. Patient education can help support young recipients to reduce their risk of behaviour-related transplant loss.

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Background: Diabetes Mellitus is a public health problem becoming more prevalent. Diabetic foot is a debilitating condition caused by diabetes mellitus. Diabetic foot, which includes foot ulceration, infection, and destruction of tissues may necessitate amputation.

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