Transcript Health Services Research Group

Research Groups/Research areas within CPH
• Health Services Research/Methodological Research Group
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Eye Health/Eye Disease
Oral Health
Cancer
Mental Health
• Public Health Research Group
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Physical Activity Research
Public Health Interventions
Renal Disease
Ageing research
Social epidemiology
Data linkage
• Cancer Epidemiology
• Nutrition and Metabolism (with Institute of Global Food
Security)
Cancer Epidemiology Group
• Studies focussed on premalignant to malignant transition
• The Northern Ireland Barrett’s Oesophagus Register
• Colorectal polyp register
• Cancer progression studies
• Pharmaco-epidemiological studies in relation to cancer
• Population-based Molecular Oncology
• Aetiological studies
• The Finbar study
• Early life influences on cancer risk
• Case control study of myeloproliferative neoplasms
Cancer Epidemiology Group
• Cancer awareness and early detection
• International Cancer Benchmarking Partnership
• Population awareness and beliefs about cancer
• Delay in the pathway to treatment etc.
• NAEDI research
• Comparison of patient, clinical, disease and service related factors in
cancer patients with long and short term cancer survival
• Cancer services/survivorship
• Late effects of cancer treatment
• Patient reported outcomes in prostate cancer patients
Global Eye Health Research (Nathan)
• Research areas:
• Novel methods to prevent myopia and improve the delivery
of high-quality, low cost refractive services to children in rural
China
• New approaches to assessing cataract surgical outcomes in
areas of limited resources
• Novel treatments for glaucoma and diabetic eye disease in
rural China
• Funding:
• Government: US NIH, UK MRC, Chinese and HK governments
• Private: Standard Chartered Bank, Fred Hollows Foundation
• International : World Bank, WHO
Global Eye Health Research
• Collaborators:
• Rural Education Action Project, Stanford University
• Zhongshan Ophthalmic Center, Guangzhou China
• Various NGOs: Fred Hollows Foundation, Orbis
International, SightLife
• Johns Hopkins University School of Medicine
• Wenzhou Medical College, Wenzhou China
• HCM City Eye Hospital, HCM City Vietnam
• Tongren Hospital, Beijing China
Health Services Research Group
1. Methodological research (Prof Mike Clarke)
2. Eye Health/Eye Disease (Professor Azuro-Blanco)
3. Oral Health Care (Dr Gerry McKenna)
4. Cancer Care (Michael D)
5. Mental Health Care (Michael D)
Some examples of HSR studies…
Health Services Research Group
Example of cancer care research in the CPH
• Population needs assessment eg Cancer survivors with selfreported late effects: health status, care needs and service
utilisation
• Cochrane Reviews eg Non-pharmacological interventions for
cognitive impairment due to cancer treatment
• Outcome measurement eg A methodological review of the SF36 among breast cancer patients.
• Intervention studies eg Intervening to reduce cognitive
impairment and maintain cognitive functioning due to cancer
treatment.
Health Services Research Group
Example of mental health services research in CPH
• Population needs assessment eg The mental health needs of
people detained in custody
• Systematic Reviews eg How effective are CJ Liaison and
Diversion Services for people with mental disorder?
• Outcome measurement eg. Factor structure of the Alcohol Use
Disorders Identification Test (AUDIT)
• Intervention studies eg A non-randomised controlled
evaluation of a police station-based mental health service.
UKCRC
Translation and Impact highlights
• ESRC Knowledge Exchange grant
(KESUE – Knowledge Exchange Spatial Analysis and Healthy Urban Environments)
• Physical Activity Loyalty Card
Potential for scalability and Social Enterprise
• CVD IMPACT and trend modelling;
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NISRA secondee, Dr John Hughes
• Pedometer Self Monitoring for people with
diabetes (KE grant from HSCRDO)
(with South Eastern HSC Trust)
EuroHeart II
• Team Med Trial; Food in Schools Trial
• Capacity development:
eg Dr Mark O’Doherty, Ruth Hunter, Dr Lynsey Patterson
• Community wide initiative to improve CVD
health with the West Belfast Partnership
• Roots of Empathy Trial
Renal Research - Background
• Chronic kidney disease (CKD) is a non-communicable disease
affecting 5-10 % of adult population
• Associated with ill health, reduced quality of life and
premature death
• CKD is a major public health problem contributing to health
care costs in both developed and developing countries
• Diabetes is the major cause of CKD
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~40% people with diabetes develop diabetic kidney disease
Current clinical screening methods identify the unlucky
Treatment for kidney disease is only partially successful
W3; GENIE; diabetic nephropathy collaborative research initiative (DNCRI)
Renal Research – Typical experiments
• Clinical phenotyping; long-term international collaborations
• Patient cohorts (UK; ROI; Europe; Worldwide); multiple registries
• Environmental risks: smoking, diet, blood sugar control etc.
• Inherited genomic factors: candidate gene studies, genome-wide
association studies, common and rare variants, copy number variation, whole
genome ‘next generation’ sequencing, and transcriptome analyses
• Epigenetics: interaction between genes and environment; early life exposure
• DNA methylation; histone modifications; microRNAs
Renal Research – retinal vascular calibre as a potential
biomarker for early renal and retinal diseases
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Microcirculation pathology underpins renal and retinal diabetic complications
Use of routine NHS diabetic retinal screening images and clinical chemistry
Case-control study (progressive CKD vs. stable GFR)
Does change in retinal vessel calibre predict CKD?
Nutrition and Metabolism
Biomarker
identification and
assessment:
Dietary intervention
studies:
1) Whole foods/diets
1) Disease risk
2) Nutritional status
2) Supplementation
studies
Achieving behaviour
change
Peer support to encourage adoption of the
Mediterranean diet
• Explore feasibility of peer
support as a strategy to
encourage adoption of
the MD in those at high
risk of CVD
• Peer support
intervention, specific for
the target group,
developed through direct
interaction with the
intended target group
McKinley, Kee, Young, Woodside
National Prevention Research Initiative
MRC guidelines: Developing and evaluating complex interventions
Centre for Public Health
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What are effective and
appropriate interventions for
weight loss after pregnancy?
Group-based – limited success
Challenges - engagement, reach,
sustainability
Exploit SMS technology?
e.g. txt 2 stop – smoking cessation