Sheffield Children's Hospital projects

Projects:

Complications and outcomes of Periacetabular Ostetomy (PAO)

Main Supervisor:

Mr Sanjeev Madan

sanjeev.madan2@nhs.net

Second Supervisor:

Professor Reza Saatchi

r.saatchi@shu.ac.uk

Type of Project:

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

Aims and Objectives:

Determine complications rates and predictors for outcome for PAO

Research Methodology:

Literature review of PAO (limited evidence available) to determine key outcomes and complications to measure. Review of PAO database at SCH and DRI and retrospective/prospective addition of patient data (indications, operative details, radiograph interpretation, complications and patient reported outcomes). Determine key outcomes in large patient cohort. Determine independent risk factors for significant complications/failure and good/bad patient reported outcomes. This will largely be undertaken in clinic environment at two hospitals but the student will also be part of the surgical team carrying out these operations.

Expected Outcome:       

Add to the evidence for this relatively new technique in orthopaedics. Expected outcome is presentation of work at national/international meetings and ideally publication in peer reviewed journal.

Additional Training:

Assistance in literature review. Teaching on basic and complex orthopaedic deformity correction. Teaching on X-ray interpretation and measuring. Guidance on statistical analysis.

Ethical Approval:

Service Evaluation - NHS Service Evaluation number required - UoS Ethics will additionally be required.

Evaluation of complications of Peri-Acetabular Osteotomy

Main Supervisor:

Mr Sanjeev Madan

Sanjeev.madan2@nhs.net

Second Supervisor:

Mr Nicholas Green

Nick.green6@nhs.net

Type of Project:

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

Aims and Objectives:

To understand and minimise complications in a major surgery: Peri-Acetabular Osteotomy

Research Methodology:

To review notes and xrays. Collect data, measure angles on images. and take part if necessary in few operations to understand steps of operation.

Expected Outcome:       

To measure radiological and clinical outcomes using validated scores such as iHOT, Modified Harris Hip Score, UCLA etc. After this study, recommend certain preventative steps to minimise complications and also recommend steps to manage and treat complications.

Additional Training:

In house training on clinical practice, examine patients and training on image interpretation and measurements

Ethical Approval:

Study in Trust involving NHS staff working methods only – no NHS ethics approval required (although this should still be agreed by the relevant Trust R&D department). However as a medical student is completing the study, please contact Fran Oldale about putting the study through UREC. 

Assessment of Respiratory Function in Early Onset Scoliosis

Main Supervisor:

Mr Lee Breakwell

l.breakwell@shef.ac.uk

Second Supervisor:

Mr Bayley Edward

edward.bayley4@nhs.net

Type of Project:

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

Aims and Objectives:

To assess the baseline respiratory status of young children with scoliosis. Progressive curves harm the lungs and ribcage of children, and monitoring such changes are difficult in clinical practice. Assessing the baseline and monitoring changes using novel techniques will allow our collaborative team to intervene in the child's spinal management in the optimum manner

Research Methodology:

Our student colleague will work alongside us in the scoliosis clinic, recruit the patients, and undertake several of the respiratory tests themselves. The study is a collaboration between the spinal and respiratory teams at SCH. Use of the new EOS Xray software to assess chest wall shape on one of only two systems available in the UK. Support in grant application will be given to ensure the longitudinal follow up of patients is possible.

Expected Outcome:       

As ethics is already in place, recruitment of 20 patients is expected, with serial measurements of function over the 10 months period. Novel measurement of chest geometry will lead to peer review publication in this new field. This study is the first step to identifying the best manner of monitoring changing respiratory function in this potentially fatal condition. Podium presentation at national spinal meeting is expected.

Additional Training:

Training in respiratory test deployment, EOS software measurements, xray assessment. Regular opportunities to attend outpatient and theatre sessions as desirable for the successful candidate

Ethical Approval:

Original research involving human tissues/human participants and/or patient details and information - UREC or NHS REC ethics approval obtained already.

High bone mass Osteogenesis Imperfecta

Main Supervisor:

Dr Meena Balasubramanian

meena.balasubramanian@sch.nhs.uk

Second Supervisor:

Dr Enrico Da'llara

enrico.dallara@sheffield.ac.uk

Type of Project:

Lab/Bench Project - primarily working in a lab environment, Clinical project - based in the clinical environment with patients/including service evaluation

Aims and Objectives:

In order to develop new treatments for OI, we need to clearly understand how the mutation affects the properties of the bone tissue at different dimensional levels and the cell behaviour. Therefore, the primary objectives of this study are to:

characterise the bone phenotype associated with mutations in BMP1, C-propeptide cleavage sites. In particular, in patients with high bone mass OI phenotypes, it is paramount to measure the bone density and morphology as well as its local mechanical properties in order to understand the effect of the mutation on the organic component of the extracellular matrix (ECM); to undertake phenotype-based assays in fibroblasts and osteoblasts to study pathways in patients with high bone mass phenotype OI.

Research Methodology:

The plan of this study is to undertake phenotype based assays on osteoblasts and cultured fibroblasts and study bone material and morphological properties in patients with high bone mass phenotypes in OI patients, who have C-propeptide cleavage and BMP1 mutations. We have a cohort of 10 patients thus identified that we plan to recruit to this study. We will be using stored bone and skin tissue samples that will be collected from patients with this specific gene fault as part of another ethically approved research study, where this research project falls within the terms of the donors consent.

Expected Outcome:       

The plan of this study was to undertake in-depth clinical and tissue phenotyping in patients with rare, phenotypic presentations of osteogenesis imperfecta. Hence, we already have prior experience with doing similar work. By undertaking this study in high bone mass phenotypes in OI, we aim to make a real and tangible difference for patients with brittle bones.

Additional Training:

Bone tissue analysis; research consenting

Ethical Approval:

Secondary data or tissue samples - UREC or NHS REC ethics approval already received for the intended research project

Evaluation of paediatric non-contact respiration monitor

Main Supervisor:

Professor Heather Elphick

h.elphick@nhs.net

Second Supervisor:

Professor Saatchi Reza

r.saatchi@shu.ac.uk

Other Supervisor(s):

Ruth Kingshott

Type of Project:

Lab/Bench Project - primarily working in a lab environment

Aims and Objectives:

The aim is to carry out a research investigation to effectiveness of a novel paediatric non-contact respiration monitor developed at Sheffield Hallam University.

Objectives:

Devise suitable study protocol that best represent the evaluation.

Accommodate ethical considerations

Recruit suitable participants and carry out respiratory recording according to te protocol

Analyse the recorded data using suitable methods and tools

Interpret results, assist in preparing articles for publications in conferences and journals.

Research Methodology:

There is a medical need for a child-friendly device that can measure respiratory airflow in an accurate and convenient manner. A novel paediatric respiratory monitor has been developed at Sheffield Hallam University. The device needs a scientific evaluation to establish its efficacy in various operational modes. Prior knowledge of using the device is not needed as suitable training will be provided. Also assistance will be provided in recording the data, interpretation and analysis of the related result.

The student will work will clinicians at Sheffield Children's Hospital and Engineers at Sheffield Hallam University. There are excellent opportunities to publish the work in conferences and high impact journals.

Expected Outcome:       

The study is designed to produce scientific data that will assist in further developing the respiration rate monitor. The work should lead to publications in conferences and high impact journals. The ultimate aim of the work is to meet a clinical need for an improved device to monitor respiration in paediatric.

Additional Training:

Training in the use of the related equipment will be provided.

Also assistance in carrying out the necessary data analysis and interpretation will be provided.

Training and assistance in report writing, preparation of reports and publication will be provided.

Guidance on the study's ethics will be provided.

Ethical Approval:

Secondary data or tissue samples that was not originally collected for research - UREC or NHS REC approval required.

Evaluation of paediatric central apnoea monitor

Main Supervisor:

Professor Heather Elphick

h.elphick@nhs.net

Second Supervisor:

Professor Reza Saatchi

r.saatchi@shu.ac.uk

Other Supervisor(s):

Dr Ruth Kingshott

Type of Project:

Lab/Bench Project - primarily working in a lab environment

Aims and Objectives:

This research aims to evaluate a novel paediatric central apnoea monitor developed at Sheffield Hallam University in collaboration with Sheffield Children's Hospital.

Objectives

Devise a suitable study protocol that best represent the evaluation.

Accommodate ethical considerations

Recruit suitable participants and carry out recording according to the protocol

Analyse the recorded data using suitable methods and tools.

Interpret results, assist in preparing articles for publications in conferences and journals.

Research Methodology:

There is a medical need for a child-friendly device that monitors central apnoea in home environment. A novel paediatric central apnoea monitor has been developed at Sheffield Hallam University in collaboration with clinicians at Sheffield Children's Hospital. The device needs a scientific evaluation to establish its efficacy in various operational modes.

Prior knowledge of using the device is not needed as suitable training will be provided. Also assistance will be provided in recording the data, interpretation and analysis of the related result.

The student will work with clinicians at Sheffield Children's Hospital and Engineers at Sheffield Hallam University.

There are excellent opportunities to publish the work in conferences and high impact journals and learn skills in medical field as well as carrying out a scientific research study.

Expected Outcome:       

The study is designed to produce scientific data that will assist in further developing the central apnoea monitor. The work should lead to publications in conferences and high impact journals. The ultimate aim of the work is to meet a clinical need for an improved paediatric device to monitor central apnoea in home environment.

Additional Training:

Training in the use of the related device will be provided.

Assistance in carrying out the necessary data analysis and interpretation will be provided.

Training and assistance in report writing, preparation of reports and publication will be provided.

Ethical Approval:

Secondary data or tissue samples that was not originally collected for research - UREC or NHS REC approval required.

Bone Fracture Screening Using Thermal Imaging

Main Supervisor:

Dr Shammi Ramlakhan

sramlakhan@nhs.net

Second Supervisor:

Professor Reza Saatchi

r.saatchi@shu.ac.uk

Type of Project:

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

Aims and Objectives:

Development of a thermal imaging based method of screening for bone fractures.

Objectives

Devise suitable study protocol that best represent the research.

Accommodate ethical considerations

Recruit suitable participants and carry out thermal imaging of children suspected of bone fracture.

Analyse the recorded data using suitable methods and tools

Interpret results, publications in conferences and journals.

Research Methodology:

There is an outstanding clinical research that aims to devise a non- x-ray method of screening for bone fractures. Suitable training and support in using the tools and required data analysis will be provided. A significant number of x-ray scans taken for bony injuries indicate that that bone is not broken thus incurring an unnecessary cost to the NHS and exposing the patient to harmful radiation. This study aims to reduce the number of x-rays taken for diagnosing bone fractures. It will use a harmless technology that measure infrared radiation from the injury site. This technology is called thermal imaging and a mean of very accurately measuring heat radiation. Sprain or fracture alter the heat radiated from the injury site and careful interpretation of this heat pattern is the basis for fracture screening.

The student will lead the investigation. Tasks involved assistance is dealing with ethics approval, patient recruitment from A&E department, thermal image recording and interpretation of results. Training for varioys stages will be provided.

We have already carried out a number of preliminary studies to indicate the feasibility of the work and this study will continue these developments. We are specifically interested in a type of fracture called Toddle's fractures due to complexities in detecting them using x-ray. Toddler's fractures are bone fractures of the lower part of the shin bone in children aged 9 months to 3 years.

Expected Outcome:       

The ultimate expected outcome of this research study is a thermal imaging based method to accurately screen for bone fractures thus reducing the need for the use of x-ray scan for examination of bony injuries. The work involves a team of clinicians and engineers. We are keen to publish the findings in research conferences and high impact journal papers. The team have supervised several BMedSci students in the past with very successful outcomes.

An important outcome of the study is to train the student doing to work to become a skilled in techniques for carrying out a scientific research, preparing professional reports, and to be able to accurately analyse and interpret research data.

There are opportunities to continue working with the team post BMedSci study. We have applied for research funding for the study and the initial feedback has been very promising.

Additional Training:

Training in thermal imaging, research methods, ethics applications, related data analysis and tools will be provided.

Ethical Approval:

Original research involving human tissues/human participants and/or patient details and information - UREC or NHS REC ethics approval needed.

Monitoring the neonatal coma score in sick term and preterm neonates

Main Supervisor:

Dr Anthony Hart

A.R.Hart@sheffield.ac.uk

Second Supervisor:

Dr Williams Tamanna

Tamanna.Williams@sth.nhs.uk

Type of Project:

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

Aims and Objectives:

To examine how a newly described coma score in neonates changes in both term babies and preterm babies on a neonatal intensive care unit, and how these relate to clinical information, such as examination and MRI results.

Research Methodology:

Ethical approval has already been granted. The student will recruit neonates at the Jessop Wing to the study. They will remind nurses to monitor the coma scale during times of regular observations to evaluate how it changes over time. They will document information from the notes, such as MRI results and examination on discharge, to examine preliminary associations with outcome.

Expected Outcome:       

Examination of how the coma score changes over time, such as how it improves as a term baby with HIE improves and to establish normal values in preterm babies. This will help identify those babies who are most likely to have adverse outcome.

Additional Training:

Basic research methodology. How to perform the new coma score for newborn babies.

Ethical Approval:

Original research involving human tissues/human participants and/or patient details and information - UREC or NHS REC ethics approval obtained already.

Investigation in the use of accelerometry to assist with diagnosing Juvenile Idiopathic Arthritis

Main Supervisor:

Dr Daniel Hawley

daniel.hawley@nhs.net

Second Supervisor:

Professor Reza Saatchi

r.saatchi@shu.ac.uk

Other Supervisor(s):

Oliver Ward

Type of Project:

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

Aims and Objectives:

The aim of this research study is to investigate the extent accelerometry can assist with diagnosing Juvenile Idiopathic Arthritis

Research Methodology:

Our team has built a device that uses a movement sensor called an accelerometer to examine joint movement in patients with Juvenile Idiopathic Arthritis. A possible sign of arthritis is restriction in joint movement so analysing this sign through a device that can provide quantitative information related to it could prove valuable to clinicians making the diagnosis.

The accelerometry device can provide through statistical data and plots information such as extent of movement, its velocity and acceleration. Possibility of using artificial intelligence to process the data exists.

The student doing this work does need to have prior information about accelerometry use or its related data analysis as suitable training will be provided. In an earlier study we started doing the necessary recording from patients at Sheffield Children's Hospital. With this study, the aim is to continue the recordings to a suitable number of patients so that statistical analysis related to the efficacy of the method can be performed.

This is an excellent study that allows interaction with clinicians and engineers. There will be training for the tools needed as well as assistance in related data analysis.

Expected Outcome:       

1. Devise suitable study protocol that best represent the research.
2.  Accommodate ethical considerations
3. Recruit suitable patients and carry out accelerometry of JIA patients.
4. Analyse the recorded data using suitable methods and tools.
5. Interpret results, assist in preparing articles for publications in conferences and journals.

Improvement in monitoring and diagnosis of Juvenile Idiopathic Arthritis is the focus of this study. Publishing the work in a high impact journal as well as presenting the work in research conferences are important outcomes of the work. Training and assistance in journal paper writing will be provided.

Additional Training:

Training in the use of the accelerometry device.

Training and assistance in processing the data generated by the accelerometry device.

Guidance and training on related ethics issues.

Guidance and training on preparing publications (poster, conference presentation and journal paper)

Ethical Approval:

Secondary data or tissue samples that was not originally collected for research - UREC or NHS REC approval required.

Comparing the Scale for the Assessment and Rating of Ataxia (SARA score) in children with ataxia, developmental coordination disorder and their peers.

Main Supervisor:

Dr Santosh Mordekar

s.mordekar@sheffield.ac.uk

Second Supervisor:

Dr Anthony Hart

Type of Project:

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

Aims and Objectives:

This study will compare a validated ataxia score used in adults in children with a variety of conditions that may affect coordination or cerebellar function to their peer group. We aim to determine the following:

1. Assess the normal values of the SARA score in children over seven years of age, recruited from a general paediatric clinics or local schools
2. Gain a comparison of the SARA scores of children with ataxia and normal peers to children with developmental coordination disorder, which affects coordination, balance and motor function

Research Methodology:

Inclusion criteria are: Group 1) Children over seven years of age attending the ataxia clinic at Sheffield Children’s Hospital; Group 2) Children over seven years of age without known motor or coordination problems attending a general paediatric clinic, such as constipation clinic; 3) Normal children over seven years of age, recruited from local schools. The student will perform SARA scores in these children and compare between groups.

We will need around 25 children from my Specialist Ataxia clinic; 25 children from our general paediatric clinic and 25 from local school. We have undertaken a similar study in the past successfully. The student will be taught how to do SARA score. It takes around 10 minutes in a child without physical disability to do a SARA assessment. There will be support in place for the student to have access to specific clinics.

Expected Outcome:       

We will determine the normal SARA score for age in normal children.

SARA scores will be compared between groups using the Wilcoxon Signed Rank Test.

Additional Training:

The student will receive training from the supervisor in the following:

• SARA scores
• Statistical analysis
• Thesis / scientific paper writing

Ethical Approval:

Original research involving human tissues/human participants and/or patient details and information - UREC or NHS REC ethics approval needed.