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.

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.

‘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).

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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

Despina Laparidou presents Scaling up PINCER at ISQua 2017

IMG_0923Despina Laparidou, Research Assistant at CaHRU, together with Antony Chuter, a patient representative for Scaling Up PINCER (pharmacist-led information technology intervention for reducing clinically important errors) recently attended the International Society for Quality in Health Care (ISQua) Conference at the Queen Elizabeth II Conference Centre in London (1st – 4th October 2017) and presented the preliminary findings of the Scaling Up PINCER project, funded by the Health Foundation.

IMG_1639The Main Conference offered a combination of exciting plenaries, short oral presentations and longer themed sessions, while poster and e-poster presentations were also presented throughout the duration of the conference. One of the most interesting sessions was the “A Mile in My Shoes”. A Mile in My Shoes is an interactive shoe shop that invited delegates to “(literally) step into someone else’s shoes and embark on a mile-long physical, emotional and imaginative journey to see the world through their eyes”. The session involved listening to, while wearing their shoes at the same time, unique audio stories from people working within health and social care, sharing their experiences and showing the remarkable contribution and challenges faced by those working in, and using, our health and social care system.

IMG_1634Despina and Antony gave their presentation on the morning of Tuesday 3rd October during a session on “Health Foundation Improving Quality in Community Health Services” and was very well received by the audience. PINCER is a pharmacist-led information technology intervention for reducing clinically important errors in medication management in general practices and the study’s preliminary results show early indications of improvement in most of the study’s safety indicators for gastrointestinal bleed, stroke, heart failure and acute kidney injury, but not for the two asthma indicators. The session, chaired by Will Warburton from The Health Foundation, also showcased studies, such as the “Ophelia Project” on improving health literacy for vulnerable people in the community, and “Making Waves” on Promoting a positive experience for people with COPD.

The Conference came to an end with Wednesday’s plenary and the promise to meet again in 2018 for an even more exciting ISQua Conference in Malaysia!

By Despina Laparidou

CaHRU Newsletter (Spring 2017)

CaHRU_logotypeThe latest edition of the CaHRU Newsletter (Spring 2017) was published in June 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.

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