Dr Sarah Barnes - Public Health: ScHARR, University of Sheffield
Dr Katherine Berry - School of Psychological Sciences, University of Manchester
Dr Girish Dwivedi - Department of Cardiovascular Medicine, University of Birmingham
Miss Lanxing Fu - School of Medicine, University of Manchester
Dr Gunn Grande - School of Nursing, Midwifery & Social Work, University of Manchester
Mrs Jean Hennings - Health Research, University of Lancaster
Mr David Humes - Department of Surgery, University of Nottingham
Dr Louise Michaelis - DOHaD, University of Southampton
Dr Shilpa Patel - Warwick Medical School Clinical Trials Unit
Dr Rami Salib - Division of Infection, Inflammation & Immunity, University of Southampton
Fiona Smith - Older Adults Community Mental Health Team, NHS Highland
Grant £19,924
Pre-protocol to develop a Randomised Controlled Trial to enhance patient-professional communication about end of life issues in life limiting conditions other than cancer
Aim
It's understood that patients with advanced coronary obstructive pulmonary disease (COPD), or heart failure (HF), often have a poor understanding of their diagnosis and prognosis and as a result are unable to participate in Advanced Care Planning. The aim of this proposal is to enable a multi-disciplinary research team to develop an intervention to improve patient-professional communication about end of life issues for people with such conditions.
Findings
The research team will first undertake a critical review of relevant research that has already been published in this area. They will then consult service users and health professionals to provide additional expertise to assist in the development of an intervention which will improve both communication and patient education for people with COPD and HF. This will then inform the construction of a clinical trial to assess and evaluate the intervention in terms of its effectiveness in practice.
Patient benefit
It is anticipated that the intervention developed by Dr Barnes' team will improve patients' understanding about their life-limiting condition (whether it is COPD of HF) and this will enable them to make plans for the end of their life.
Grant £19,463
Feasibility of a nurse-led psychosocial group intervention for older people with schizophrenia
Aim
This study aims to develop and pilot a nurse-led group psychosocial intervention to improve social and daily living skills in older people with schizophrenia. The findings from this research will be used to inform the construction and implementation of a future, larger, randomised trial.
Findings
In total, 12 older adults over the age of 65 with schizophrenia will be assessed before and after the psychosocial intervention. The groups, led by mental health nurses (who will be trained and supervised by psychologists), will run for two hours weekly for a period of six months. Data related to social functioning, daily living skills, self-esteem, coping, quality of life and psychiatric symptoms will be collected from the individuals taking part in the research. Also, the nurses carrying out the intervention will be monitored and assessed through patient feedback interviews. This will help the researchers to design a more powerful and extensive study of the intervention.
Patient benefit
This preparatory research will provide useful insights into a psychosocial intervention for older people with schizophrenia who have unmet needs in terms of social and daily living skills.
Grant £20,000
Myocardial Perfusion Using Myocardial Contrast Echocardiography: Relationship to Retinal and Systemic Macro/Micro- vascular dysfunction in Hypertension
Aim
Previous research has shown that people with high blood pressure (hypertension) have damaged and abnormal functioning cells in the lining of blood vessel walls (endothelium) both in the heart and elsewhere. This is a key factor for the development of serious complications such as heart attacks and stroke. This research aims to investigate abnormalities of microcirculation in the eyes of people with hypertension using a retinal imaging technique.
Finding
Dr Dwivedi's team will assess endothelial cell function in the eyes (specifically the retina, which is the light-sensitive tissue lining the inner surface of the eye) of high-risk hypertensive patients using a currently underutilised imaging technique. The 45 people in the study group will be matched and compared against people both with and without hypertension. Data combined from clinical, echocardiographic and retinal studies in this project will further current knowledge of the pathophysiology of hypertension.
Patient benefit
Early detection of abnormally functioning endothelial cells in people with hypertension may help clinicians treat those affected more effectively and prevent complications.
Grant £3,200
Psychological Distress in People with Disfigurement from Facial Palsy
Aim
Facial palsy causes the muscles of the face to become weak, resulting in sagging and difficulties with eye closure. Even after corrective surgery, people affected can experience significant levels of distress. This study aims to ascertain the nature of and how widespread psychological issues are in a sample of people with facial palsy.
Findings
The study group will include adults from the North West of England who have received a diagnosis of facial palsy, but who aren't mentally ill or aren't having treatment for a psychological problem. An established tool - The Self-Regulatory Model - will be used as the theoretical framework to assess the affected individuals. It will help the researchers to establish some of the factors that influence patients' emotional adjustment to their condition, which is a key indicator of overall recovery. The results of this study will be used to help develop an appropriate intervention for people distressed by their facial palsy.
Patient benefit
This research will help clinicians better understand the important issues causing distress in people with facial palsy. This will help to inform treatment options.
Grant £19,946
Piloting a carer support needs assessment tool to facilitate communication in palliative home care practice
Aim
Family carers play a crucial role in allowing patients to be cared for at home towards the end of their life. This can often be mentally and physically challenging and it's therefore important to make sure that carers have proper support. Dr Grande's team have previously developed an evidence-based Carer Support Needs Assessment Tool (CSNAT) to identify carer needs that require further assessment and help. The CSNAT will be piloted within one hospice at home to optimise its intervention before being used in a larger scale trial.
Findings
A total of 20 carers in a hospice at home will be recruited to the study. Under the guidance of health professionals, the carers will explore the usefulness of the tool and identify challenges in its implementation and use. In addition to making video diaries and conducting telephone interviews with carers and staff, the research team will also explore the CSNAT through other stakeholder interviews and focus groups both before and after they have tested the intervention. This will ensure that the researchers can make CSNAT and its procedure for use as effective as possible.
Patient benefit
The outcomes of this research will go some way to help develop an assessment tool to help address the needs of family carers looking after people who wish to remain at home towards the end of their life.
Grant £19,982
Improving end of life care for those with dementia in care homes: A pilot study
Aim
Caring for a person with dementia can have a major impact on mental health, particularly during the placement of the affected individual into a care home. Currently, there is limited information available about how this kind of situation affects the carer. This study will pilot test research methods with spouse carers of people with dementia in care homes (who are approaching end of life) in order to optimise recruitment rate, and assess acceptability of the data collection techniques, for use in a future, more extensive study.
Findings
Over a period of six months, spouse carers recruited to the study will be interviewed face to face on three occasions about their current situation and experiences. They will also be asked to keep a diary to record key events, moments or conversations and to reflect upon them. Collectively, the findings from this study will be used to inform the design of a larger study.
Patient benefit
The preliminary evidence gathered in this study will lead to a better understanding of the feelings, changing roles, and redefinition of relationships of carers who look after spouses with dementia.
Grant £20,000
An investigation of the epidemiology of complicated diverticular disease using linked primary and secondary data
Aim
There is currently a limited understanding of the occurrence, cause and mortality associated with diverticular disease (outpouchings from the large bowel, which is a common surgical emergency). This research aims to utilise a large set of patient data to investigate the occurrence and current treatments of, and complications that stem from, diverticular disease.
Findings
Mr Humes' team will collect and review patient data from the General Practice Research Database that has recently been linked to the Hospital Episodes Statistics Database, which contains information regarding all hospital admissions in England. This will allow the researchers to not only investigate how many people are affected by diverticular disease (and mortality associated with it), but also the treatment options provided by clinicians. The outcomes of this research will help to more accurately quantify the burden of diverticular disease and better understand possible opportunities for prevention.
Patient benefit
This research will provide greater insight into diverticular disease and ultimately will help to inform clinicians' knowledge of modifiable risk factors for patients.
Grant £20,000
Does antenatal vitamin D supplementation deviate the neonatal immune response away from the allergic phenotype?
Aim
Previous studies have suggested that insufficient vitamin D levels may play a part in the development of allergies, such as asthma, in infants. This research aims to find out if supplementing the diet of pregnant women with vitamin D can effectively prevent children getting such conditions.
Findings
Dr Michaelis' team of specialists will examine umbilical cord blood from 40 infants in a randomised controlled trial. They will compare the immune responses of infants whose mothers have been assigned to either a placebo group or a vitamin D group. If the immune responses of the infants are significantly different between the two groups, this may indicate that supplementation with vitamin D can help prevent allergy. Further work would then be undertaken to assess these babies later in childhood.
Patient benefit
If the outcomes of this research show that vitamin D can effectively reduce allergy in this study group of infants, many other mothers and their babies could potentially benefit from taking a supplement.
Grant £19,866
Group exercise for community dwelling older adults with osteoarthritis
Aim
Osteoarthritis (OA) is the most common form of arthritis. It causes joints to become stiff and painful and mostly affects the hands, knees, hips, feet and spine. Older people with OA can often become physically restricted, which then has an impact on their quality of life and mental health. Dr Patel's team will develop and test a group-based interventional programme, which will include exercise and behavioural components, to help manage the physical and mental health issues that affect older people in the community with OA.
Findings
An intervention protocol will be developed with a review of evidence and the help of an expert advisory panel. A group programme will be designed for between six and eight people and will last up to eight weeks. It will be delivered by trained health professionals including physiotherapists, psychologists and nurses. This developmental work will allow the team to provide an intervention protocol to be used in a pilot study in the future.
Patient benefit
Dr Patel's team hope to provide a group based exercise programme for older adults in the community with OA to prevent them becoming isolated and developing related health problems.
Grant £20,000
Characterisation of Bacterial and Fungal Community Diversity in Chronic Rhinosinusitis Using a Novel Culture-independent Technique
Aim
Dr Salib's team aim to use a novel, experimental technique to detect and evaluate bacteria and fungi in sinus tissue samples. This will help to better understand the development of chronic rhinosinusitis (CRS) - a common upper respiratory tract infection in which the membranous linings in one or more the sinuses become inflamed.
Findings
Terminal-restriction fragment length polymorphism (T-RFLP) is a culture-independent technique that can be used to detect the presence of microbes in clinical samples. It is anticipated that this new technique will be able to detect which bacteria (and potentially fungi) are involved in the CRS disease process much more accurately than standard culture techniques. This will mean that better diagnostic and interventional approaches can be utilised for people affected by CRS.
Patient benefit
Using T-RFLP to gain a better understanding of the role of bacterial and fungal infections in CRS will help to improve the management and treatment of patients with this condition.
Grant £19,952
Improving mental wellbeing of well older people through provision of Integrated Memory Stimulation
Aim
This study aims to show that older people who participate in an 'Integrated Memory Stimulation' (IMS) programme can improve their mental health and well-being more than just doing physical activity. The IMS programme includes a range of cognitive, perceptual and educational exercises.
Findings
This pilot study will take place in the Highlands of Scotland. It will include only elderly people who are living alone. One group will participate in physical activities only, a second will have a 12 week course of IMS and a third will have the same as the second, but with one booster session after a further 8 weeks. Results from this trial are hoped to indicate that IMS will have improved people's mental health and wellbeing more than physical activity alone.
Patient benefit
The outcomes of this study may go some way to inform a new and innovative intervention approach for older people who become socially isolated and who are at risk of developing mental health problems.
