CaHRU at Society for Academic Primary Care annual conference in Oxford 2015

Keble_OxfordMembers of the CaHRU team and School of Health & Social Care had a strong presence at the conference the 44th Annual Conference of the Society for Academic Primary Care (SAPC) from 8th to 10th July at the University of Oxford. After an entertaining train journey to the historical Oxford, we had our first glimpses of the beautiful surroundings we were to spend the following three days.

Coral_OxfordDespina_OxfordOn the first day there was great interest in Coral Sirdifield’s poster “Comparing what patients value and what they experience in English general practice: a cross sectional survey“. Ana Godoy Caballero and Despina Laparidou also had lively conversations while presenting their posters on “Patient values and patient experiences in English general practice: a comparison by patient characteristics” and “Psycho-educational interventions for informal caregivers of people with dementia: a systematic review“.


Cahru_OxfordIn the evening we were treated to “Drinks with the Dinosaurs” at the museum of Natural History which was a fantastically unique setting to mingle with fellow SAPC attendees.

Zahid_OxfordThe second day was full of thought-provoking talks, especially the “Dangerous Ideas” session which was extremely popular and lead to some heated discussions. Dr Zahid Asghar gave a brilliant elevator pitch on “Bisphosphonates and risk of stroke: self-controlled case series study“, followed by Ana Godoy Caballero Ana_Oxford_EPwho gave an equally brilliant elevator pitch on “Bisphosphonates and risk of stroke: matched case-control study“. After a busy second day, we got dressed up and attended a wonderful formal dinner at Keble College where many gasped at how “Harry Potter” the setting was.

Jolien_Oxford_OralThe final day was as equally jam-packed as previous days with posters and oral presentations. Posters were presented by Jolien Vos on “Applicability of the Health Information Technology Acceptance Model in assessing readiness of older patients with multiple chronic diseases to adopt telecare – qualitative study” and Professor Niro Siriwardena presented Fiona Togher’s poster on “The development of a Patient Reported Experience Measure (PREM) for use in UK ambulance services“. Jolien Vos also gave a superb oral presentation on “Cast adrift in the care system? A systematic Rebecca_Oxford2scoping review of care navigation for older people with multimorbidity“, which provided a popular talking point during the elderly care and dementia session. Finally, Rebecca Porter’s poster presentation of “Mr Grumpy becomes Mr Happy: Effective sleep treatment using community pharmacists” was voted best poster by delegates! Mr Grumpy becomes Mr Happy was also one of 11 projects to be presented on the SAPC blog, an amazing achievement for Mr Grumpy!

The SAPC conference was full of great accomplishments for the University of Lincoln and we are all looking forward to next year’s conference in Dublin.

Rebecca Porter

CaHRU Spring 2015 Newsletter

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The latest edition of the CaHRU Newsletter (Spring 2015) was published this week. 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 produced by Sue Bowler, CaHRU administrator.

Improvement science and research methods seminar on discourse analysis given by Michael Toze

CaHRU Website

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mtozeThe latest ‘Improvement science and research methods seminar’ on ‘Discourse analysis’ was delivered by Michael Toze, doctoral student at CaHRU. Discourse analysis aims to study the use of oral and textual communication in relation to meaning beyond the words, social context and thought and focuses on analysing how speech and text are organised to achieve an end. The speaker went on to explain related methods such as conversation analysis, content analysis, critical discourse analysis and ethnomethodology an their applications. Finally, Michael described how he was using discourse analysis in his doctoral research exploring competing discourses about sexuality, gender identity and health in LGBT people interacting with general practice staff. The seminar was well attended by colleagues from CaHRU, the School of Health and Social Care, and researchers from Lincolnshire Community Health Services NHS Trust and East Midlands Ambulance Service NHS Trust.

New systematic review published on interventions to reduce risk of overweight and obesity in infancy and childhood

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.

Comparison of coronary heart disease genetic assessment with conventional cardiovascular risk assessment

jo1A new study, published in April 2015 in the journal Primary Health Care Research and Development, entitled ‘Comparison of coronary heart disease genetic assessment with conventional cardiovascular risk assessment in primary care: reflections on a feasibility study‘ was led by Prof Nadeem Qureshi of the University of Nottingham and included CaHRU researcher Dr Jo Middlemass as a co-author. The study assessed the feasibility of collecting genetic samples and the changes in self-reported outcomes after cardiovascular risk assessment (conventional and genetic), particularly lifestyle changes or anxiety.

B0007708 Molecular model: DNAAs part of Government Guidelines, general practitioners (GPs) routinely offer their patients an assessment to assess their risk of getting heart disease over the next ten years. These conventional cardiovascular risk assessments capture environmental risk factors and gene-environment including family history of premature heart disease. However, there are also genetic tests assessing genetic predisposition. Commercial direct-to-consumer CHD genetic tests are being actively marketed, and patients, particularly those with a perceived strong family history, may opt to access these services without prior consultation with their health providers. What is not known is the level of discrepancy between the results of conventional and genetic tests and also what, if any, lifestyle changes patients will make as a consequence of having the genetic test.

B0005637 Enhanced image of a human heartIn an observational feasibility study in ten British general practices in Central England, 320 individuals, who had completed conventional cardiovascular risk assessment, were offered CHD genetic test, with follow-up outcome questionnaire at 8 months for lifestyle changes and anxiety. Over a third of individuals offered genetic testing in primary care, as part of an enhanced CVD risk assessment, took up the offer and returned genetic test specimens, with over a third reporting family history of CHD in a specified relative. This study found that most participants (82%) classified at above-average risk on conventional CVD risk assessment in primary care were classified at only average risk using genetic-based assessment. In contrast, fewer participants (39%) at above-average risk on genetic assessment were classified as average risk on conventional CVD risk assessment.

Study participation was not associated with increased anxiety between baseline and follow-up or between participants at average and above-average risk based on genetic assessment. Considering lifestyle change from baseline to eight month follow-up among participants reporting at both time points, the proportion in the action/maintenance phase of change increased by 13% (from 54 to 61) for diet, 2% (from 51 to 52) for exercise, and decreased by 3% (from 35 to 34) for smokers.

B0008609 Blood clotThis feasibility study had limited ability to demonstrate the relationship between change in anxiety and lifestyle risk-reducing behaviour with genetic risk identification. This may be explained by the CHD genetic test following the conventional assessment because there may have already been some lifestyle change due to the previous cardiovascular risk assessment undertaken prior to the genetic test. The current research suggests GPs will face the challenge of patients presenting with direct-to-consumer genetic results that are inconsistent with conventional cardiovascular risk assessment, suggesting that GPs and practice nurses should explore patients’ rationale for undertaking genetic test-based risk assessment and their perceptions of family history and conventional risk assessment.

Dr Jo Middlemass