Tag Archives: general practice

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CaHRU sleep research cited in UK parliamentary briefings on Sleep and Health

Sleep and healthResearch from CaHRU was cited in the recently published parliamentary briefing on Sleep and Health and Sleep and Long-term Health. The briefing was issued as a POSTnote from the Parliamentary Office of Science and Technology and cited CAHRU’s work on primary care for insomnia including the Resources for Effective Sleep Treatment (REST) website. Professor Graham Law and Niro Siriwardena met with one of the co-authors Lev Tankelevitch earlier this year to discuss their work.

Sleep and longterm healthThe briefing on Sleep and Health also cites two systematic reviews led by CaHRU’s Dr Coral Sirdifield on patient and general practitioner (GP) perceptions of the problems of benzodiazepine sleeping pills, an article by Prof Siriwardena providing guidance for GPs, and the OASIS trial (led by Prof Dan Freeman of Oxford University) showing the effects of treatment using digital Cognitive Behavioural Therapy for Insomnia (dCBTi) on psychiatric symptoms. The briefing on Sleep and Long-term Health  research papers on sleep assessment and the DIALS trial showing the effect of dCBTI on quality of life which is due for publication this autumn.

rest-logoThe REST project is also explicitly mentioned: ‘One strategy to improve training for healthcare professionals is through online training developed by the Resources for Effective Sleep Treatment project’ and the REST e-learning programme for GPs and healthcare staff has been accessed over 16,000 times by users in over 160 countries.

POSTnotes are distributed in paper copies to Parliamentarians, placed in the reference libraries of both Houses of Parliament and also promoted via social media using Twitter @POST_UK. CaHRU are currently collaborating in a major trial of sleep restriction therapy in primary care, the HABIT trial. You can find out more about our work on sleep from our infographic on ‘Sleep and Insomnia‘.

By Prof Niro Siriwardena

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Joseph Akanuwe receives PhD for work on communicating cancer risk

Joseph Akanuwe, doctoral student at CaHRU was recently confirmed by the College of Social Science Research Degrees Board that he be awarded his PhD for his thesis ‘Exploring service user and practitioner perspectives of using cancer risk assessment tools in primary care consultations. Cancer risk prediction tools are novel tools that combine risk factors and symptoms to predict an individual’s risk of developing cancer.

WP_20160208_16_16_01_RichThe work included a systematic scoping review followed by interviews of 19 service users and 17 primary care practitioners, the latter before and after they had used the tools in patient consultations. Participants suggested ways to best communicate cancer risk to patients in primary care consultations, emphasising the importance of: tailoring visual representation of risk; being open and honest; informing and involving patients in use of cancer risk prediction tools and providing time for listening, explaining and reassuring in the context of a professional approach.

He also found barriers to the uptake of cancer risk prediction tools including: the additional time required; worry and anxiety generated by referral for investigations; potential for over-referral; practitioner scepticism about using the new tool; and the need for evidence of effectiveness before introducing cancer risk prediction tools in general practice consultations. These barriers were perceived before the use of the tools. The findings add to the knowledge and understanding of how best to communicate cancer risk information to patients when using cancer risk prediction tools. Joseph was supervised by Profs Niro Siriwardena and Sara Owen, together with Dr Sharon Black.

By Prof Niro Siriwardena

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CaHRU study presented at Abu Dhabi medical education conference

ottawa3_750 Dr Julie Pattinson presented at the Ottawa-International Conference on Medical Education (ICME), Abu Dhabi, United Arab Emirates; March 10th – 14th 2018. The conference is held biennially and provides a forum for medical and other health care profession educationalists to network and share ideas on all aspects of the assessment of competence in both clinical and non-clinical domains, throughout the continuum of education. There were near 1500 attendees, and hosted plenary sessions, symposia, oral presentations, workshops and poster sessions. Overall it was an educative programme covering all aspects of Health Professions with special emphasis on assessment.

ottawa2_750Julie Pattinson of CaHRU gave a presentation in parallel session 13, titled Postgraduate Assessment on Understanding Reasons for Variations by Ethnicity in Attainment in the Performance of General Practitioners in Speciality Training completing the Membership of the Royal College of General Practitioners (MRCGP) Applied Knowledge Test; cognitive interview study. The study was conducted in collaboration with Professor Niro Siriwardena, University of Lincoln, Dr Bijoy Sinha, GP Speciality Training Director, Lincolnshire, and Dr Carol Blow, MRCGP clinical lead. Dr Pattinson talked about the differences that exists in ottawa4_750candidate performance in high stakes medical licensing examinations, specifically the MRCGP AKT, between black and minority ethnic doctors (BME) compared to white British doctors. Grounded theory analysis generated discussions into why differences exist in candidates of different ethnicity highlighted that overseas trained doctors do face additional difficulties answering AKT questions.

The study has provided a basis for developing interventions to reduce differential attainment in UK speciality training for general practice. Overall the conference was interactive and five minute questions were addressed after each presentation.

By Julie Pattinson

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Hannah Henderson receives PhD for studies on exercise referral schemes

Dr Hannah Henderson, lecturer in the School of Sport and Exercise Science was awarded her PhD at this week’s graduation ceremony at Lincoln Cathedral attended by students, parents and friends, staff, and senior staff from the University of Lincoln. Hannah’s doctoral thesis entitled, “Intended actions, unintended outcomes: towards a processual graduationunderstanding of exercise referral schemes” investigated referrals for supervised physical activity by GPs and other primary care professionals. The these was supervised by Professor Siriwardena of CaHRU, Professor Jaqui Allen-Collinson (Sport and Exercise Science) and Dr Adam Evans (University of Copenhagen).

Exercise referral schemes (ERSs) have developed since the 1990s. Although the evidence for their effectiveness is still equivocal, the complexity of how schemes operate and individuals working with them interact, has been largely overlooked. Hannah was interested in how individual interpretations of ERSs might be co-produced by interactions between those central to the service, and how this might influence both service delivery and impact. The study therefore aimed to address this by exploring participants’ understanding of ERSs, and how these perceptions affected ERS service provision.

The research focused on one case-study ERS in the East of England, using semi-structured group and one-to-one interviews. A process sociological lens was adopted to provide novel insights into participants’ perceptions of ERSs, their role and their ability to influence ERS service provision. Data were also supported by self-elicited reflections from the researcher’s ‘insider’ position to the county’s ERS. The analysis revealed conflicting interpretations of ERS service provision, and perceptions of the scheme’s receipt and impact. The networks of relationships affected participants’ experiences and shaped the delivery of exercise referral. The findings suggested how the actions and interpretations of those central to a service fundamentally altered delivery which influenced the very existence of the scheme.

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CaHRU receives university team award for achievement in research

CaHRU2017webThis year members of the Community and Health Research Unit received the University of Lincoln team award for Achievement in Research at the Individual Merit and Team Achievement Awards 2017. This was the team’s fifth team award over the past 6 years and the fourth time the team have received the team award for achievement in research. Members of the team include Prof Niro Siriwardena (director), Prof Graham Law, Dr Murray Smith, Dr Zahid Asghar, Dr Coral Sirdifield, Dr Stephanie Armstrong, Dr Julie Pattinson, Dr Rebecca Marples, Viet-Hai Phung, Despina Laparidou, Michael Toze, Laura Simmons, Joseph Akanuwe, Dr Nadeeka Chandraratne, Dr Ravindra Pathirathna and Sue Bowler (administrator).

ResearchTeamAward2017CertificateThe CaHRU team are striving to conduct research which will make a difference to patients and healthcare delivery. The group conducts basic and translational interdisciplinary research in collaboration with health service and academic partners.  It currently has over 30 active projects in progress across a range of research methods from systematic reviews (e.g. role of community first responders, ethics of ambulance trials), major clinical trials (investigating conditions such as hyper-acute care of stroke, prehospital pain management, ambulance hypoglycaemia pathways and primary care for insomnia), observational studies (investigating prehospital pain and seizure management), qualitative designs (community first responders, dementia carers, ethics of ambulance trials, fairness of medical licensing exams), consensus methods (ambulance indicators), and surveys (healthcare for offenders on community sentences) to quality improvement programmes (prescribing safety) and international research networks (ethics of ambulance trials). Details of current studies are available on the CaHRU website (http://cahru.org.uk/research/).

CaHRU_logotypeThis has led to over 20 publications in the past year covering research on development of new pathways and indicators for ambulance services, assessment and treatment for insomnia and use of health technology innovations, in major journals such as Resuscitation, Annals of Emergency medicine, Health Technology Assessment, Health Expectations and Lancet Psychiatry. The team have  received several major grants over the past year, particularly from the National Institute for Health Research, as well as continuing to work on studies funded by the Wellcome Trust, Health Foundation and Falck Foundation. This year we have also welcomed international fellows from the University of Colombo to the team for the first time.