Dr Stephanie Armstrong joined CaHRU this month to work on the Wellcome Trust funded ‘Network exploring Ethics in Ambulance Trials (NEAT)’ project. She says, “I come to Community and Health Research Unit from a rather diverse background having begun my academic life in the field of Zoology. I completed a PhD in Zoology from Trinity College, Dublin in 2006, where my work focussed on the nutrition and behaviour of large captive herbivores and in particular zebra.
In 2004 I joined Sparsholt College, Hampshire as a lecturer in the Equine Studies section and worked my way up to Head of Department for Animal Management Higher Education. This career path however, took me away from hands on research and, after working for Sparsholt College for 7 years, I realised that I needed a change of direction. With that in mind I undertook an MSc in Forensic Anthropology at the University of Lincoln, reigniting my passion for research. I also hold degrees in Equine Studies and Herbal Medicine.
As a result I have extensive experience in a wide range of research both quantitative and qualitative ranging from novel animal behaviour studies to in-depth systematic reviews. My research interests lie within the areas of ethics and human rights.” The NEAT project is CaHRU’s first Wellcome Trust grant, led by Prof Siriwardena in collaboration with Dr Adele Langlois from the School of Social and Political Sciences.
An international team of researchers led by Prof Niro Siriwardena with statistician Dr Zahid Asghar from CaHRU has been awarded funding from the Falck Foundation to study prehospital pain management. The study involves collaboration between CaHRU at the University of Lincoln, with East Midlands, East of England and South Central Ambulance Service NHS Trusts, together with the Universities of Swansea, Hertfordshire and the Sunshine Coast (Australia).
The study, ‘Exploring factors increasing Paramedics’ likelihood of administering Analgesia in pre-hospital pain: cross sectional study (ExPLAIN)’ aims to identify how patient factors such as age, gender, ethnicity and the cause of pain together with clinician factors such as sex or role seniority affect pain assessment and use of analgesic drugs by ambulance staff. The study builds on previous research conducted by members of the team in the area of prehospital pain management and the findings will be used to inform recommendations to improve the rate and quality of acute pain relief provided by ambulance staff and to reduce unintended variations in care.
The study is part of CaHRU’s ongoing research as part of its Prehospital and Emergency Quality and Outcomes (PEQO) workstream which involves collaboration with other ambulance services in England and which has already led to new measures and improvements in the quality of ambulance service care provision.
Professor Niro Siriwardena from CaHRU and Dr Adele Langlois from the School of Social and Political Sciences at the University of Lincoln have been awarded a seed award in humanities and social science from the Wellcome Trust to develop a Network exploring the Ethics of Ambulance Trials (NEAT). Dr Langlois is a social scientist who is an expert in biomedical ethics and governance. The network also includes leading prehospital researchers: Profs Philip Bath (Nottingham University), Jonathan Benger (University of West of England), Gavin Perkins (Warwick), Tom Quinn (University of Surrey), Helen Snooks (Swansea University) and Drs Chris Price (Newcastle University) and Sarah Voss (University of West of England).
Randomised controlled trials in ambulance settings are a relatively recent but growing area of research which poses particular challenges, including urgency of conditions and treatment, and difficulties with recruitment, randomisation and informed consent where time may be limited or patient capacity impaired. NEAT will involve interviews with researchers, health professionals and patients involved in ambulance trials together with the legal and systematic reviews and networking activities bringing together national experts in the ethical issues and design of prehospital clinical trials.
The team seek to raise awareness among researchers, practitioners, ethics committees and the public of developments in the ethics and conduct of ambulance trials and provide the basis for much needed research to inform recommendations for best ethical practice in future trials. Prof Siriwardena and Dr Langlois are currently recruiting a research assistant to join them to work on the study in 2016.
A new study has been published by led by Prof Sarah Redsell of Anglia Ruskin University and a team of researchers at the Universities of Cambridge, Nottingham and Lincoln, including Prof Niro Siriwardena of CaHRU. The study, published in Maternal and Child Nutrition, was entitled ‘Systematic review of randomised controlled trials of interventions that aim to reduce the risk, either directly or indirectly, of overweight and obesity in infancy and early childhood’.
This new review sought to identify randomised controlled trials of interventions delivered antenatally or during the first 2 years of life and designed to reduce the risk of overweight/obesity from birth to seven years of age. The authors identified 35 eligible studies published from January 1990 to September 2013 in six electronic databases. This included 27 unique trials of interventions including nutritional and/or responsive feeding, breastfeeding promotion and lactation support for mothers, parenting and family lifestyle, maternal health changing formula milk composition or diet, and modifying parental responsiveness to infant cues. The interventions had variable effects on feeding practices, behaviour and weight in infancy or childhood.
There were few intervention studies for pregnant women that continued during infancy. The authors are developing and testing the feasibility of a complex intervention comprising an interactive, educational programme (ProAsk) for health practitioners to guide and enhance communication with parents of infants about obesity risk identification and prevention strategies, funded by the Medical Research Council.
The Healthier Aging Patient and Public Involvement (HAPPI) group, established in July 2014, was recently successful in gaining funding from the East Midlands Academic Health Science Network. The group has expanded and is working with researchers from the Community and Health Research Unit on several research projects.
The group has informed bids for funding, given a patient and public perspective on current research projects, reviewed documents to help make them more accessible to the general public and have been actively involved in recruitment of participants for studies. The award from the Academic health Science Network will help to further expand the team and enable the HAPPI group to collaborate with other PPI groups in the East Midlands.
Some of the members are pictured here with members of CaHRU taking part in a National Institute for Health Research (NIHR) Research Design Service East Midlands PPI training course run by Raksha Pandya Wood who is the regional lead for PPI. The course looked at what PPI is, and why the public are involved in our research. We looked at how to incorporate meaningful public involvement in research and what some of the challenges are. The training has motivated the group to continue to develop involvement in research and to work together to improve health research, delivery and outcomes patients in Lincolnshire and the East Midlands.