Population Health projects

Projects:

A systematic review and meta-analysis of drug resistance in relapse vs new tuberculosis patients.

Main Supervisor

Professor Pete Dodd (p.j.dodd@sheffield.ac.uk)

Second Supervisor

Dr Lesley Uttley (l.uttley@sheffield.ac.uk)

Aim and Objectives

1. Systematically review published literature to identify cohorts with levels of resistance to anti-TB drugs (including isoniazid and rifampicin), reported stratified by anti-TB treatment history.
2. Meta-analyse these data to understand epidemiological patterns across countries and regions, and to generate summary measures of the relative levels of resistance in patient groups.

Research Methodology

Two students will be working together, with regular supervisory meetings.
The core methodologies will be in systematic reviewing, study appraisal, data management, statistical analysis (if desired), and academic writing.

Expected Outcome

An article submitted for peer review. This quantity has been used in the WHO global TB burden estimation process & estimates of rifampicin-resistant tuberculosis incidence are used by the Global Fund in its funding allocation model. Refining our understanding of this quantity therefore has the potential to be quite consequential.

Type of Project

Qualitative Project/non-lab based - primarily using qualitative methods

Additional Training

As above, systematic reviewing, study appraisal, data management, and academic writing with learning by doing and supervision from experienced researchers. If students are keen to learn R for statistical analysis and visualization, this will also be possible (otherwise the primary supervisor will lead the statistical analysis).

Developing and refining a new intervention seeking to improve cultural competence and improve quality of life in dementia care - the Caribbean Dementia Toolbox

Main Supervisor

Dr Josephine Reynolds (josephine.reynolds@sheffield.ac.uk)

Second Supervisor

Dr Caroline Mitchell (c.mitchell@sheffield.ac.uk)

Aim and Objectives

Aim:
- To develop and refine the Caribbean Dementia Toolkit intervention which seeks to improve cultural competence in dementia care, improve quality of life for people with dementia and enhance the caring dyad.

Objectives:
- To qualitatively evaluate people with dementia, informal/family carers, professional carers and health professionals' useability and experience of the Caribbean Dementia Toolkit, considering the acceptability of the content, format, style and delivery of the intervention.

- To feedback the findings of this research to the intervention development team and collaboratively develop an improved intervention prototype for further refinement.

Research Methodology

The role will include recruitment of participants from each category of interest, communication with participants throughout the research process, gaining informed consent from participants, organisation and facilitation of the qualitative 'think aloud' interviews, rapid analysis and synthesis of the findings, presentation of findings to the intervention development team, organisation and faciliation of check back qualitative interviews with participants once a refined intervention prototype has been developed.

Expected Outcome

It is expected that the participants will suggest minor changes towards the content, format, style and delivery of the intervention but that overall the intervention will be acceptable to all groups. We anticipate the professional carers and health professionals from cultural backgrounds other than African Caribbean may have the greatest learning curve in terms of cultural skills and knowledge and therefore may struggle more with the delivery of the intervention. This may lead to the intervention being refined into seperate versions targeted at different audiences.

Type of Project

Qualitative Project/non-lab based - primarily using qualitative methods

Additional Training

Introduction to qualitative research methods
Training on intervention development methodology and evaluation studies

"Best Interests" in Medicine - a Historical and Ethical Investigation

Main Supervisor

Dr Chris Millard (c.millard@sheffield.ac.uk)

Second Supervisor

Professor Ian Sabroe (i.sabroe@sheffield.ac.uk)

Aim and Objectives

Tie uncover the roots of the concept of "best interests" in medicine, and how it has been used as a foundation-stone of ethical problem-solving and practice in medicine.

To understand such a concept as rooted in a particular time, place and context, that can be understood historically.

To write an extended historical account of the ideas that fed into "best interests" across a number of areas in medicine, including psychiatry, care for individuals with limited capacity, palliative care, intensive care, geriatric medicine, care for people with disabilities, bioethics, medical ethics, and medical research.

Research Methodology

The student will undertake literature searches to find instances of this term and related concepts. The student will contextualise these instances of the concept being used, and also note the particular areas in which it becomes most prominent. The student will be supervised by Dr Millard and Prof Sabroe, who will set essay questions, provide readings, and comment on draft work, as well as discussing the ideas.

The student will read widely in the history of medicine, the history of various medical specialisms, the history of bioethics and medical ethics, and also curate a robust primary source base (potentially of medical journal articles, government reports, Royal (and other) Commissions set up to deal with patient's rights and patient activism.

Expected Outcome

A historical account of the emergence and use of the term "best interests" in medicine that helps to understand where the concept came from, how it functions in the context of nineteenth- and twentieth-century medicine, and how it functions today. A key outcome will be to understand where concepts come from, and why they emerge at a particular time and place, in response to specific problems. This will help to see how - as times change - concepts might become bent out of shape, or change their meanings.

Type of Project

Medical Humanities

Additional Training

Introduction to, and practical supervision concerning, doing humanities research, and managing an independent research project.

Effectiveness of ketogenic (low carbohydrate) diets in the treatment of people with serious mental illness

Main Supervisor

Professor Scott Weich (s.weich@sheffield.ac.uk)

Second Supervisor

Dr Viren Ranawana (viren.ranawana@sheffield.ac.uk)

Other Supervisors

Dr Reem Abed

Aim and Objectives

To establish the acceptability, feasibility and potential effectiveness of ketogenic (low carbohydrate) diets for people with serious mental illness.

Research Methodology

The research will comprise two elements: (i) evidence synthesis (in the form of a systematic review) of published and grey literature, including both research using animal models as well as studies in humans; and (ii) establishing the acceptability and feasibility of undertaking a trail of ketogenic diets in people with SMI through consultation with lived experience experts, and through interviews and focus groups with people with SMI and professionals responsible for their care.

Expected Outcome

There will be two outcomes: (i) a systematic review suitable for publication in a peer-reviewed journal; and (ii) a qualitative paper reporting the findings of the acceptablity and feasibility study. This report will also be used to inform the desgn of a grant application for a randomised clinical trial, which the student will be invited to contribute to (and be credited for) beyond their BMedSci year.

Type of Project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional Training

The student will be provided with training in evidence synthesis and qualitative research methodds. They will also have the opportunityof placements with the R&D team at Sheffield Health and Social Care NHS Foundation Trust, to learn about clinical trials (including training in Good Clinical Practice in Research).

Evaluation of NEWS2 as an Emergency Department Triage Tool

Main Supervisor

Professor Steve Goodacre (s.goodacre@sheffield.ac.uk)

Second Supervisor

Dr Gordon Fuller (g.fuller@sheffield.ac.uk)

Aim and Objectives

The National Early Warning Score version 2 (NEWS2) is a simple clinical score based on routinely recorded clinical measurements that is used across the NHS as a standardised way of assessing acute illness severity. NEWS2 is recorded on all patients arriving at the Emergency Department (ED) with acute illness. It can be used to assist ED triage decisions, involving prioritising patients for urgent treatment, but it is not known how well NEWS2 predicts the need for urgent treatment. This project aims to determine the accuracy of NEWS2 in predicting the need for urgent treatment among patients attending the ED.

Research Methodology

Quantitative retrospective observational cohort study. The student will use the ED IT system to select a cohort of patients who attended the ED with acute illness, and extract data recording their characteristics, NEWS2 scores, treatments, and outcome. They will then review ED records of cases with selected treatments or outcomes to determine whether they needed urgent treatment. Statistical analysis will involve estimating the accuracy of NEWS2 in predicting the need for urgent treatment, and decriptive analysis of false negatives (patients requiring urgent treatment not prioritised by NEWS2) and false positives (patients prioritised by NEWS2 but not requiring urgent treatment).

Expected Outcome

The study will determine the potential role of NEWS2 in ED triage. It will inform ED care and the development of future research in this area. Previous emergency medicine BSc projects have resulted in presentation at a national conference and publication in a peer-reviewed journal. If successfully completed, this project would be expected to achieve the same.

Type of Project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional Training

The project will involve additional training in information governance, data management, and statistical analysis using software, such as SPSS.

Optimising New Roles in NHS Mental Health Services

Main Supervisor

Professor Scott Weich (s.weich@sheffield.ac.uk)

Second Supervisor

Professor Damian Hodgson (d.hodgson@sheffield.ac.uk)

Aim and Objectives

The principal aim of this funded research is to better understand what happens when new roles are introduced into mental health services on a large scale. We are interested in how new roles are integrated into mental health services and how professional boundaries and relationships are managed and optimised.

We would also like to know how the introduction of new roles (many of which have unfamiliar job titles) this affects patient experience and outcomes, and the latter will be the focus for the student's research.

Research Methodology

The study involves both evidence synthesis (in the form of a realist review, to which the student will contribute) and primary research, including interviews and focus groups with staff and patients. This primary research will be qualitative in nature. We expect that the student will play a leading role in the patient interviews, and in analysing and reporting the data that arises from these.

Expected Outcome

The student will produce a thesis and at least one first author peer-reviewed publication. They will also be included as a co-author on the main study report and at least 2 other peer-reviewed papers. The student will also have the opportunity to contribute to policy-relevant documents and briefing papers.

Type of Project

Qualitative Project/non-lab based - primarily using qualitative methods

Additional Training

The student will have the opportunity to attend a range of short courses at ScHARR, including methods in evidence synthesis and qualitative research (including qualitative interviewing and data analysis.

Health and well-being among older people in England during the Covid-19 pandemic: a longitudinal analysis using the English Longistudinal Study of Ageing

Main Supervisor

Professor Peter Bath (p.a.bath@sheffield.ac.uk)

Second Supervisor

Dr Madina Hasan (m.hasan@sheffield.ac.uk)

Aim and Objectives

The overall aim of the project is to develop a better understanding of the risk factors for changes in health and well-being and/or multimorbidity in older people during the Covid-19 pandemic. More specifically, the objectives are to:


i) undertake an extensive review of the research literature to identify studies of health and well-being in older people and identify potential arreas of interest for further exploration;
ii) develop skills in data analytics (e.g., statistical methods) and apply these to a systematic series of analyses to develop a better understanding of risk factors for changes in health and well-being and multimorbidity in older people;
iii) prepare reports on the analyses and draft papers for submission to a conference and for peer-reviewed journals.

Research Methodology

Initially you will undertake a literature review to identify previous research in this field, identify gaps in knowledge and refine your research questions.

The project itself involves a secondary analysis of an existing data-set, the English Longitudinal Study of Ageing (ELSA), which contains a large nationally-representative sample. The methods of analysis will include bivariate and multivariable statistical methods, e.g., Chi-squared tests, logistic regression, cluster analysis. You could also use AI methods, such as machine learning, to develop predictive models, if that interests you and aligns with the research questions.

Expected Outcome

The project will identify risk factors for health outcomes (e.g., health service utilisation, multimorbidity) and changes in health and well-being in older people.
In collaboration with your supervisor, you will be able to write this up for presentation at an appropriate conference and/or for publication in a peer-reviewed journal(s).

Type of Project

Medical Humanities

Additional Training

You will have the opportunity to have training in statistical methods and the principles of applying them, and this will include practical sessions. Further training in using AI and data mining methods can be arranged if you are wishing to use these methods.