CaHRU newsletter (Winter 2017/18)

CaHRU_logotypeThe latest edition of the CaHRU Newsletter (Winter 2017/18) was published in March 2018. The newsletter presents the work of the research centre over the previous three months and includes articles from the CaHRU blog covering publications, conferences and funding. The newsletter is written by members of the CaHRU team and produced by Sue Bowler, CaHRU administrator.

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/03/CaHRU-Newsletter-Winter-2017-18.pdf” width=”640″ responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

‘Tribulations and trials in primary care insomnia’ at BSS 2017

brighton_metropole This year’s British Sleep Society (BSS) conference, held in Brighton at the Hilton Metropole, featured an invited presentation from Prof Niro Siriwardena, director of CaHRU, entitled ‘Tribulations and trials in primary care insomnia’.

After a welcome to the conference by Professor Mary Morell, President of the BSS, the opening keynote was given by Professor Franco Cappuccio, from the University of Warwick on the topic of ‘Healthy sleep’. This was followed by the opening session of the conference on ‘Sleep and health’ chaired by Professor Graham Law, secretary of the BSS and a member of CaHRU. This session included three presentations. The first was on ‘Sleep and chronic pain: moving from association to causation?’ give by Dr John brighton_peopleMcBeth, Reader at the University of Manchester. He described the bidirectional relationship between chronic pain and sleep, with pain giving rise to insomnia and sleep disturbance exacerbating or even causing pain. Studies had shown that treating insomnia in people with chronic pain, for example due to fibromyalgia led to improvements in wellbeing and quality of life but no improvement in pain.

Prof Siriwardena next talked about how he had initially developed an interest in the problem of insomnia through initial research into use of sleeping tablets by general practitioners. ‘Tribulations and trials in primary care insomnia’ went on to describe the studies that showed that hypnotic drugs like benzodiazepines and z-drugs though often prescribed for insomnia did more harm than good, and that primary care trials of cognitive behavioural therapy for insomnia (CBT-I) showed positive effects. He went on to describe the work on the Resources for Effective Sleep Treatment (REST) project, a quality improvement project which successfully implemented CBT-I in general practice which led to reduced hypnotic prescribing in those practices. Because of the low uptake of CBT-I in primary care, there was increasing evidence that online or self-help CBT-I was effective with similar effect sizes to face-to-face individual or group therapy. Finally he presented the evidence on short behavioural therapies such as sleep restriction therapy including a forthcoming HTA funded trial led by Oxford University’s Simon Kyle and involving the Universities of Manchester (Peter Bower) and Lincoln (Niro Siriwardena).

brighton_sea

The final talk in the session was Dr Eleanor Scott, Senior Lecturer at Leeds University and Consultant Diabetologist at Leeds Teaching Hospitals, who spoke on Sleep and metabolic health, describing the relationship between insomnia and diabetes, obesity and cardiovascular disease. This was followed by Dr Jason Rihel,of University College London discussing his work on sleep in zebrafish and Dr Claire Sexton of Oxford University on her work on sleep related to dementia. Brighton was an excellent setting for a well-attended BSS conference.

By Niro Siriwardena

CaHRU Newsletter (Winter 2016-17)

CaHRU_logotypeThe latest edition of the CaHRU Newsletter (Winter 2016-17) was published in March 2017. The newsletter presents the work of the research centre over the previous three months and includes articles from the CaHRU blog covering publications, conferences and funding. The newsletter is written by members of the CaHRU team and produced by Sue Bowler, CaHRU administrator.

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2017/04/CaHRU-Newsletter-Winter-2016-17.pdf” responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

Improving healthcare commissioning for probation: mapping the landscape

Healthcare services available to probationers and how they access them will be examined as part of a new research project.

The project, funded by the National Institute of Health Research (NIHR) Research for Patient Benefit Programme aims to produce a toolkit which will help commissioners and staff delivering health services to effectively measure and improve the quality of probationers’ healthcare.

Researchers say better healthcare could help increase the number of people successfully completing community sentences and could potentially reduce the rate of recidivism, while also saving the NHS substantial sums of money by reducing the unnecessary use of urgent and emergency services.

The research, led by the University of Lincoln (Dr Coral Sirdifield, Professor Niro Siriwardena) with colleagues from Royal Holloway, University of London (Professor David Denney, Professor Charlie Brooker), will address three key areas: the best way of providing healthcare to achieve good health outcomes for probationers; how healthcare is currently delivered to probationers, for example by probation services, through local partnerships, or through clinical commissioning groups; and what data are already available that could be used to measure and improve probationers’ health and the quality of their healthcare.

The team of researchers will carry out a literature review of the existing studies, conduct national surveys, examine written policy and procedure documents, and conduct telephone interviews with senior members of probation and health services.

Lead investigator, Dr Coral Sirdifield from the University of Lincoln’s School of Health and Social Care, said: “There are more than 200,000 offenders on probation in the UK, and they are often deprived, vulnerable and have complex health needs such as mental health, drug and alcohol problems compared with the general population.

probation wordcloud“Many probationers are not registered with a GP, or only access healthcare during crises. To reduce health inequalities, we first need to understand how healthcare is provided to probationers, and how its quality can be measured and improved.

“This is important because providing better, evidence-based healthcare will improve probationers’ health, increase their chances of completing probation, and could potentially reduce their risk of reoffending. There are potential cost savings to the NHS by reducing the unnecessary use of urgent and emergency services.”

The grant bid was put together following consultation with probation workers and service users to ensure the research would tackle relevant issues. Those probation workers and the service users will be on the project steering group and will help develop information resources, carry out interviews, and share the findings of the study. The funding is just under £150,000.

The findings will be shared with all participants, relevant organisations and policy makers as a toolkit, and submitted to relevant journals for publication.

Details on the research as it progresses will be uploaded to the Community and Health Research Unit at the University of Lincoln. Visit http://cahru.org.uk/ for more.

The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).

Experts convene for Wellcome funded Network Exploring Ethics in Ambulance Trials (NEAT) project meeting

NOn 4th November 2016, CaHRU played host to an eminent group of researchers, ethicists and patient representatives in a meeting to discuss ethics in ambulance based trials. The group was formed as part of the Network Exploring Ethics in Ambulance Trials (NEAT) project, funded by the Wellcome Trust, which is seeking to understand the issues related to ethics in ambulance trials. The meeting had two main objectives, firstly to update the network on the findings of the NEAT project to date and secondly to discuss potential recommendations and future funding opportunities.

neat_ws1In the morning presentations by Dr Adele Langlois and Dr Stephanie Armstrong, outlined the findings of the project to date. These included a systematic review of published randomised controlled trials, a review of global and national regulations and the preliminary results of interview studies with expert informants, paramedics and patients who have been involved in ambulance trials. The morning sessions generated a lot of lively debate centring on both consent models and regulations, and in fact where there was agreement and conflict between these areas.

NAfter a pleasant lunch the discussion continued with possible recommendations of the project being that more work need to be done to clarify the guidance and regulations ultimately leading to a code of practice for ambulance trials and accompanying common ethics framework. Funding opportunities were discussed and the day ended with an agreement that there should be a commitment to continue the work of the network through collaborative research opportunities.

By Dr Stephanie Armstrong