Sheffield Teaching Hospitals Trust projects

Intercalated BSc Medical Sciences Research available projects

The Hallamshire Hospital.

Projects:

Nutritional deficiencies after gastric bypass surgery

Main Supervisor:

Mr Abdulzahra Hussain

abdulzahra.hussain@nhs.net

Second Supervisor:

Professor Linda Wyld

l.wyld@sheffield.ac.uk

Type of Project:

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

Aims and Objectives:

To compare the Nutritional deficiencies after Mini Gastric Bypass[MGB] and Roux En-Y Gastric Bypass[RYGB]

Research Methodology:

Background: both RYGB and MGB are known for nutritional deficiencies, however the magnitude of this complication is not well studied in MGB specifically.The aim is to compare both operations with regards to the nutritional deficiencies.

Methods: All patients who underwent MGB and RYGB during 2015-2017 are included.

The blood tests and clinical notes are reviewed to complete the data set.

The data are including demographic, operative details, complications and nutritional deficiencies in particular.

Statistical analysis will be applied and P value of <0.5 will be taken as significant.

Both procedures nutritional outcomes are compared.

Expected Outcome:       

Studies had shown MGB is associated with nutritional deficiencies , however we don't know the magnitude compared to RYGB at the same setting units.

We anticipate MGB higher nutritional deficiencies rate but this is yet to be confirmed by the study.

Additional Training:

The student will enjoy full training and support in clinical environment with regards to the project setting ,data access,and theatre attendance to observe the types of the operations.The main work will be data collection and analysis .The student will be supported by funding the transport between Sheffield and Doncaster

Ethical Approval:

Non-human tissue - no ethics approval required

Endoscopic Diagnosis of Coeliac Disease

Main Supervisor:

Professor David Sanders

david.sanders1@nhs.net

Second Supervisor:

Professor Mark McAlindon

mark.mcalindon@nhs.net

Type of Project:

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

Aims and Objectives:

Endoscopic Diagnosis of coeliac disease

Research Methodology:

Want to work in the best Gastroenterology Unit in the UK? Do a research project that lets you work in a team and with patients? Be involved in clinical research and look at aspects of coeliac disease or something else of your choice?

Expected Outcome:       

This is an exciting opportunity to work in one of the Premier UK GI units. The unit has won over 15 National and International GI awards for research and clinical services in the last ten years.

What do I get as BMedSci student? Over the 12 years there have been 13 BMed Sci students all receiving either a first class (n=10) or 2:1 (n=3). Every student has presented their work at regional and National meetings and subsequently published their work on Pub Med.

Students are actively involved in the department recruiting (if they wish) for other studies working with our nursing team and supporting endoscopy.

There is regular patient contact in this clinically based project.

We have a weekly academic meeting with lunch and presentations.

A bursary of £1000 is provided to the successful candidate. On some years more than one candidate has been selected. Come and join us it is a lot of fun! www.profdavidsanders.co.uk/

Additional Training:

None - we will help you with anything you need

Ethical Approval:

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

Patient experience of conventional upper and lower gastrointestinal endoscopy and robot-controlled magnet-assisted capsule endoscopy

Main Supervisor:

Professor Mark McAlindon

mark.mcalindon@nhs.net

Second Supervisor:

Professor David Sanders

david.sanders@nhs.net

Other Supervisor(s):

david.tai@nhs.net

Type of Project:

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

Aims and Objectives:

Determine which aspects of endoscopy (upper and lower) concern patients (referred for symptom investigation and for bowel cancer screening) most

Assess patient experience of endoscopy (performed to investigate symptoms and in bowel cancer screening) using patient related experience measures

Determine if the use of sedation has an impact on patient experience of endoscopy

Compare patient experience of conventional upper GI endoscopy with robot-controlled magnet-assisted capsule endoscopy

Research Methodology:

The student will assist patients having conventional and robot-controlled magnet-assisted capsule endoscopy to complete the Universal Patient Centredness Questionnaire (UPC-Q). The patient identifies their three main concerns and ranks them in order of importance which allows calculation of UPC-Q scores of experience and satisfaction.

Basic statistical methods will be used to compare scores of different endoscopic techniques and determine if the use of sedation for procedures has any impact.

There will be an opportunity to learn to perform robot-controlled magnet assisted capsule endoscopy in gastric models. This exercise would be used to set key performance indicators and understand the learning curve for the development of training programmes in the future and although not the main focus of the project, any data produced would be submitted for presentation at national meetings.

Expected Outcome:       

The study will identify factors related to endoscopy which most concern patients, information which will focus efforts to improve patient experience. It will enable health care staff to benchmark experience and satisfaction of their own patient population, information which is crucial to a quality improvement programme. Although robot-controlled magnet-assisted capsule endoscopy is a novel technology (the Sheffield system is the only one outside of China), the future clinical practice of current students is likely to involve more non-invasive diagnostics and this data will determine if the non-invasive approach offers a more patient acceptable experience and train the student in the use of a technology of the future!

Additional Training:

Training in robot-controlled magnet-assisted capsule endoscopy

Ethical Approval:

Non-human tissue - no ethics approval required, Service Evaluation - NHS Service Evaluation number obtained - UoS Ethics will additionally be required.

New 3D printing and virtual reality in colorectal surgery

Main Supervisor:

Mr Keith Chapple

keith.chapple@nhs.net

Second Supervisor:

Dr John Fenner

j.w.fenner@sheffield.ac.uk

Other Supervisor(s):

Peter Metherall

Type of Project:

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

Aims and Objectives:

To investigate whether 3D printing and virtual reality are useful in routine surgical practice

Research Methodology:

The Sheffield 3D Laboratory has pioneered the use of 3D imaging in the planning of surgical operations. 2D MRI and CT scans can now be easily and quickly transformed into 3D images and are routinely used prior to certain surgical operations, such as bowel cancer surgery. We now wish to extend this application to see if routine MRI and CT scans can be easily transferred into 3D printed models and virtual reality images, enabling the surgeon to obtain an even more realistic view of surgical anatomy and pathology pre-operatively.

Expected Outcome:       

By the end of the project we aim to generate both a virtual reality and 3D printed model of a standard surgical procedure (bowel cancer excision and anal fistula surgery) that is quickly, cheaply and easily available to the operating surgeon. Previous BMedSci and MSc students working on the fore-runner to this work have emerged with honours degrees, prizes, presentations and published work.

Additional Training:

There will be an opportunity to be involved in the development of a virtual reality surgical model. No prior computer expertise is necessary

Ethical Approval:

Non-human tissue - no ethics approval required

Assessing risk perception, behaviours and health beliefs in overseas travellers leaving/returning to Sheffield

Main Supervisor:

Dr Thomas Darton

t.darton@sheffield.ac.uk

Second Supervisor:

Dr Farah Shahi

f.shahi@sheffield.ac.uk

Type of Project:

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

Aims and Objectives:

Determine

  1. Pre-travel risk perception
  2. Post travel alteration of risk and behaviours undertaken
  3. Health beliefs governing these in different age groups of returning travellers. This will be as part of a larger project looking at diagnostic approaches for returning travellers with fever to the UK

Research Methodology:

The student will be involved in an exciting larger diagnostics project, helping to collect data and samples for assessing fever in returning travellers to the UK. This work will complement an ongoing study in Nepal and India that has implications for diagnosing undifferentiated fevers in these populations and worldwide. They will gain an understanding of Infectious Diseases within a Global Health paradigm. Within the UK project, the student will perform qualitative questionnaires to analyse risk behaviours in this cohort, comparing their responses with healthy volunteers presenting to the RHH Travel Clinic.

Expected Outcome:       

Specifically, the student will generate qualitative data that will aid travel health clinicians and local GPs in reducing exposure risks for infection, and contribute to the design of risk stratification tools and disease prevention campaigns. There will be an opportunity to publish their work. They will also aid the collection of data and samples as part of the diagnostics project that ultimately aims to create a rapid diagnostic test for undifferentiated fevers in resource poor settings.

Additional Training:

As part of the project, the student will gain an understanding of the challenges of conducting research on a global platform. They will receive training in qualitative research approaches, as well as real-world experience of conducting quantitative research. They will gain access to Infectious Disease departmental and regional teaching, as well as experience in the travel health clinic and the diagnosis of causes of fever in returning travellers, the approach this currently mandates and the public health/infection prevention decisions that surround their management. Finally, they will have the opportunity to produce first author publications on the topic.

Ethical Approval:

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

Gynaecology: A Virtual Endometriosis Clinic: Patient experience, cost and compliance with a new Virtual Clinic, combining an electronic Personal Assessment Questionnaire (ePAQ) with telephone consultation for women with endometriosis

Main Supervisor:

Miss Mary Connor

mary.connor@nhs.net

Second Supervisor:

Mr Karim Abdallah

k.abdallah@nhs.net

Other Supervisor(s):

Professor Stephen Radley

Type of Project:

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

Aims and Objectives:

To conduct an observational study evaluating the impact of and experience with a new ‘Virtual Endometriosis Clinic’ combining web-based assessment using an electronic Personal Assessment Questionnaire (ePAQ) with telephone consultation

  1. To collect & analyse patient experience data: Accessibility, preference, value and burden of their clinical episode.
  2. To collect & analyse financial data relating to patients’ personal costs of attending both virtual clinics and standard care for women with endometriosis.
  3. To collect & analyse financial data relating to provider costs of delivering both virtual and face to face clinics for women with endometriosis.

Research Methodology:

Over a period of 3 months, the student will collect postal questionnaire data from women attending virtual and face to face endometriosis specialist nurse clinics, providing in-depth information, particularly relating to personal experience and cost of their clinical episode.

Over the same period, the student will objectively measure & document the dynamics of nurse-led virtual and face to face endometriosis clinics, including:

  1. Consultation times
  2. Compliance with ePAQ completion
  3. Non-attendance rates
  4. Scheduling of further appointments & treatments in primary & secondary care
  5. Ordering of investigations

Providing cost estimates from both patient and provider perspectives.

Expected Outcome:       

Validated questionnaires will identify differences in cost, patient & clinician experience between different models of clinical care (virtual and face to face) for women with endometriosis. There will be 4 clinical scenarios to investigate:

  1. New patient appointments
  2. Follow-up appointments
  3. Patient initiated contact
  4. Case-note review & discussion at Endometriosis MDT

The data will inform the design of future studies, as well as providing information for service providers and commissioners on key aspects of developing novel pathways of care, supporting the NHS digital 1st initiative, reducing unnecessary hospital visits and the environmental impact of healthcare.

Additional Training:

The project will be closely supervised by 3 NHS consultants with a strong track record for clinical research. The student will benefit from additional statistical support and advice from a Professor in Social Sciences, with expertise in questionnaire use and evaluation in medicine.

Ethical Approval:

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

Can information technology and social media enhance the patient experience of surgical outpatient consultations?

Main Supervisor:

Mr Tim Wilson

Tim.wilson1@nhs.net

Second Supervisor:

Miss Rina George

Rina.george@nhs.net

Type of Project:

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

Aims and Objectives:

  • To examine the existing evidence base to determine whether information technology or social media can improve the efficiency or patient experience of clinical consultations
  • To determine the needs and expectations from patients attending the surgical outpatient department and to determine whether these were met
  • To determine patient experience of information technology and social media and to gauge whether these could be used to improve the outpatient experience

Research Methodology:

The study will consist of two parts:

  1. A systematic review of the medical literature to identify previous studies that have examined the use of information technology and social media in clinical consultations to determine whether these have improved efficiency or patient experience
  2. A service review of surgical outpatient consultations, including a large scale patient questionnaire survey to explore patient’s expectations, experiences and satisfaction with their outpatient consultation. A subset of questions will examine patients experience with information technology and social media and explore how these could be used to enhance the patient experience. The relationship between these different outcomes will be explored.

Expected Outcome:       

It is expected that this study would generate the potential for two clinical papers, one relating to the use of information technology (IT) in enhancing out patient care and another relating to the process of assessing patient outpatients needs and looking for novel IT solutions to these. This work has the potential for presentation at national conferences or publication in peer review journals. If the student’s work is accepted for presentation, then expenses will be available for conferences and travel fees. It is hoped that this work will contribute to the eventual quality improvement in surgical outpatient care.

Additional Training:

Doncaster and Bassetlaw is ideally suited to supporting intercalating students in their research. The hospital will pay for travel expenses from Sheffield and accommodation can be arranged is needed. Students will receive orientation to the hospital and department, along with mentoring. Specific training will be provided in conducting systematic reviews and training can also be arranged for writing clinical papers. Weekly supervision meetings will be organised to guide the student through each stage of this research project. Further optional clinical experience in the surgical department can be arranged for interested students.

Ethical Approval:

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

Web-based Pre-Operative Assessment: Analysis of electronic data from 20,000 patients attending Sheffield Teaching Hospitals

Main Supervisor:

Dr Alexa Mannings

alexa.mannings@nhs.net

Second Supervisor:

Professor Stephen Radley

stephen.radley@nhs.net

Other Supervisor(s):

Dr John Andrzejowski (john.andrzejowski@nhs.net)

Type of Project:

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

Aims and Objectives:

To analyse the reliability, quality and value of data collected from patients undergoing pre-operative assessment using an electronic Personal Assessment Questionnaire (ePAQ) in routine clinical practice, in particular:

  1. To critically evaluate ePAQ’s scoring algorithms for BMI and ASA grade; in particular correlation and variance between ePAQ and clinician-based assessments.
  2. To compare patient-entered data with clinician annotations in order to assess the reliability of individual items within the questionnaire.
  3. To produce descriptive statistics including missing data, completion rates and times, floor and ceiling effects, for each item within ePAQ and for different patient groups including different ASA grades and surgical specialties
  4. To analyse patient experience data (value and burden), routinely provided by patients on completion of the questionnaire

Research Methodology:

Following previous research & development conducted at STH, ePAQ has been part of routine clinical care in a city-wide, nurse-led pre-operative assessment service. By September 2020, over 20,000 patients will have completed ePAQ as part of their pre-operative assessment.

An ethically approved protocol will allow analysis and interrogation of this anonymised, prospectively collected electronic dataset. With the support of a statistician and social scientist as well as clinicians (consultant anaesthetists and specialist nurses), the student will undertake in-depth statistical analysis of the data.

Expected Outcome:       

  • Provide evidence to inform updates and refinements to the questionnaire, including identifying items that may require modification, in order to further establish the psychometric properties of ePAQ.
  • Support and inform wider deployment of the ePAQ system through greater understanding of the reliability and clinical application of this web-based assessment.
  • Support novel, efficient and patient-friendly surgical care pathways, and the NHS ‘Digital 1st initiative’.
  • The team have a strong track record in research and the project is likely to lead to further publications in peer-reviewed journals as well as presentation at local, national and international meetings relating to anaesthesia and surgery.

Additional Training:

The project has the support of a Professor of Social Sciences and expert in psychometric testing and analysis of questionnaire data, including the use of specific elements of SPSS, factor analysis and reliability statistics in this context.

The student will be based in the anaesthetic and surgical departments of Sheffield Teaching Hospitals NHS Trust, working with and supported by anaesthetists and surgeons in these clinical areas.

Ethical Approval:

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

Systematic review and service evaluation of transanal resection techniques for significant rectal neoplasms

Main Supervisor:

Mr Athur Harikrishnan

a.harikrishnan@sheffield.ac.uk

Second Supervisor:

Dr Panagiota Kitsanta

panagiota.kitsanta@nhs.net

Other Supervisor(s):

Mr Shwan Amin, Dr Rebecca Denoronha

Type of Project:

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

Aims and Objectives:

Significant rectal neoplasms include large benign and malignant lesions that require complex surgical techniques to treat. Transanal techniques like TEMS and TAMIS are well recognised treatment options. The aims of this project are

  1. to perform a systematic review of the efficacy and long-term outcomes of transanal resection techniques in the treatment of significant rectal neoplasms published in literature, and
  2. to review the outcomes of transanal techniques in the treatment of significant rectal neoplasms in the colorectal unit of Sheffield Teaching Hospitals

Research Methodology:

Stage One: Learn methodology of conducting systematic review.

Stage Two: Conduct systematic review of the efficacy and outcomes of transanal techniques in the treatment of significant rectal neoplasms published in English literature. This will involve detailed literature search on the topic that is followed by data consolidation and analysis. The candidate is expected to write and submit the systematic review for publication to a peer-reviewed journal. This review will form the first part of the dissertation submitted for the BSc intercalated degree.

Stage Three: Learn methodology of conducting data collection and comparative analysis. The candidate will gain knowledge of basic and advanced statistical knowledge required for the project.

Stage Four: The candidate will collect data related to transanal techniques used in the treatment of significant rectal neoplasms in the Sheffield colorectal unit under the guidance of the supervisors. This will involve retrospective and prospective data collection, data analysis, statistical computing and discussion of results. This exercise should generate at least one publication and several abstracts, posters and presentations in regional, national and international meetings. The core data analysis from this stage will contribute to the second part of the dissertation. It is expected that the stages mentioned above will merge to complement each other during the BSc project.

Expected Outcome:       

  1. The project will generate at least two peer-reviewed publications as mentioned above.
  2. The project will also yield several posters and presentations in regional, national and international meetings.
  3. The project will enable the candidate to submit a dissertation to the university as a requirement for the BSc degree.
  4. The candidate will gain knowledge of key academic assets that is required for any medical practitioner e.g., systematic review and clinical data analysis.

Additional Training:

  1. The student will learn research and statistical methodology of conducting and writing a systematic review.
  2. The student will be taught clinical and demographic data collection and analyses.
  3. The student will learn about investigation and treatment of rectal neoplasms

Ethical Approval:

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

Simulation models in surgical training – systematic review and analysis of current simulation environment for surgical training in South Yorkshire

Main Supervisor:

Mr Athur Harikrishnan

a.harikrishnan@sheffield.ac.uk

Second Supervisor:

Mr Paul Skinner

paul.skinner4@nhs.net

Other Supervisor(s):

Prof S Brown, Mrs L Izzard

Type of Project:

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

Aims and Objectives:

Current challenges in surgical training has produced a surge in the different types of simulation techniques to equip the trainees with the most appropriate skills to practice safe medicine. Traditional teaching is supported by a variety of learning environments like dry lab, wet lab, cadaveric lab and software-based laparoscopic and robotic surgery models. More recently virtual reality and augmented reality simulators have entered the realm of surgical training that have introduced a completely new dimension to the surgical learning experience.

The aims of this project are to:

  1. conduct a systematic review of the different simulation frameworks and platforms used in general surgery and colorectal surgery training, and
  2. perform an analysis of the current surgical simulation environment in South Yorkshire.

Research Methodology:

Stage One: Learn methodology of conducting systematic review.

Stage Two: Conduct systematic review of the different simulation models used in general and colorectal surgery. This will involve detailed literature search on the topic that is followed by data consolidation and analysis. The candidate is expected to write and submit the systematic review for publication to a peer-reviewed journal. This review will form the first part of the dissertation submitted for the BSc intercalated degree.

Stage Three: Learn methodology of conducting data collection and comparative analysis. The candidate will gain knowledge of basic and advanced statistical knowledge required for the project.

Stage Four: The Sheffield Academy of Surgical Skills and Simulation conducts different courses and workshops encompassing various types of simulation models including dry lab, wet lab, laparoscopic skills lab and cadaveric courses. The candidate will collate and analyse the excepted learning outcomes and skill set development from each type of training episode. This will involve data collection, data analysis, statistical computing and discussion of results. This exercise should generate at least one publication and several abstracts, posters and presentations in regional, national and international meetings. The core data analysis from this stage will contribute to the second part of the dissertation.

It is expected that the stages mentioned above will merge to complement each other during the BSc project.

Expected Outcome:       

  1. The project will generate at least two peer-reviewed publications as mentioned above.
  2. The project will also yield several posters and presentations in regional, national and international meetings.
  3. The project will enable the candidate to submit a dissertation to the university as a requirement for the BSc degree.
  4. The candidate will gain knowledge of key academic assets that is required for any medical practitioner e.g., systematic review and data analysis.

Additional Training:

  1. The student will learn research and statistical methodology of conducting and writing a systematic review.
  2. The student will be taught clinical and demographic data collection and analyses.
  3. The candidate will understand the different simulation models and platforms used for surgical training and get a first hand knowledge of benchmarking the simulation courses.

Ethical Approval:

Non-human tissue - no ethics approval required.

Improving foot outcomes in people with diabetes

Main Supervisor:

Dr Rajiv Gandhi

rajiv.gandhi1@nhs.net

Second Supervisor:

Dr Marni Greig

marni.greig@nhs.net

Type of Project:

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

Aims and Objectives:

Diabetic foot ulceration is the commonest cause of hospitalisation in people with diabetes and also the commonest reason for lower limb amputation in the UK. Although there is now strong evidence regarding interventions to reduce ulceration and amputations, the incidence remains stubbornly high.

A key part of the project will be to try and determine factors that result in people with diabetes presenting with recurrent foot ulceration or progressing to amputation. Many also die prematurely. This is still a poorly understood area and better understanding of these factors could lead to the deployment of strategies to improve outcomes. This study will involve prospectively following up people who have presented with ulcers and determining what factors at baseline predict for how they are likely to progress. In particular, it will examine how illness beliefs and psychological barriers contribute to poor concordance and outcomes.

This is an ongoing study and the student will have access to a large database of cases collected by previous students.

Another project will involve working within the Yorkshire and Humber Diabetes Clinical Network to help facilitate, analyse and present the results of a regional root cause analysis (RCA) of all major amputations

Research Methodology:

This study will use both qualitative and quantitative data from a variety of sources including primary and secondary care medical databases, as well as patient interviews.

The study examining factors affecting outcomes of foot ulceration will incorporate factors such as screening practices in primary care, referral patterns, management of risk factors, vascular interventions etc. The impact of interventions on these processes will also be assessed. It will also involve surveying patient attitudes, illness beliefs and other psycho-social factors and the impact these have on clinical outcomes.

Data collected both locally and regionally for the amputation RCA will be analysed using established RCA techniques and presented regionally and nationally.

Expected Outcome:       

Experience gained (in addition to obtaining BMedSci):

  1. Insights into research practices within the NHS including governance
  2. Understanding the role and value of Clinical Networks
  3. Understanding the value of medical databases in conducting research
  4. Recruiting, collecting and analysing data for a clinical study (patient contact). Previous students have commented on the tremendous confidence they have gained in how they interact with both patients and other HCPs
  5. Results of this study have and will continue to be used to national guidelines and policy and the successful BMedSci will gain substantial insight into how clinical research can be used to influence national strategies to improve patient care.
  6. An understanding of how to achieve service improvement and the challenges faced when the service bridges primary and secondary care
  7. It is expected that the work will result in at least 3-4 first author abstracts and 1-2 publications

Additional Training:

The successful BMedSci student will join a vibrant diabetes team with an active research arm and will be jointly supervised by 2 consultants with specialist expertise in the diabetic foot. Training will be provided in all research techniques and students will have weekly meetings with their supervisor to ensure close mentoring and support.

Ethical Approval:

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

The effect of non-intubation airway manoeuvres on cervical spine movement after traumatic injury

Main Supervisor:

Dr Matthew Wiles

matthew.wiles1@nhs.net

Second Supervisor:

Dr John Andrzejowski

john.andrzejowski@nhs.net

Type of Project:

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

Aims and Objectives:

To determine the effect of non-intubation airway manoeuvres on cervical spine movement after traumatic injury

Research Methodology:

Systematic literature review will be undertaken in accordance with PRISMA guidelines and standards (http://www.prisma-statement.org/PRISMAStatement/PRISMAStatement)

A literature review will be undertaken to identify relevant human studies. Cadaveric, healthy volunteer and patient studies will be eligible for inclusion; manikin-based and animal trials will not be studied. All trials must involve airway intervention (e.g. jaw thrust, face-mask ventilation, supraglottic airway device use) but not tracheal intubation.

The endpoint of interest is a surrogate markers of cervical spine movement and potential spinal cord impingement, namely radiological measurement of space available for cord (SAC). Measurement of spinal cord angulation has been measured in numerous previous studies but does not accurate reflect spinal cord impingement. Identified studies will be critically appraised and graded by two different researchers. It is hoped that the results of the study can used to develop a consensus statement on tracheal intubation after traumatic cervical spine injury. The project is anticipated to take 9 months and we intend to submit to Anaesthesia for publication.

Expected Outcome:       

This should determine the optimal method for airway management after trauma, which will be of great clinical importance and interest.

Additional Training:

No additional statistical training required beyond the SPSS training provided in the taught course. Systematic review methodology will be taught to the student.

Ethical Approval:

Non-human tissue - no ethics approval required, Service Evaluation - NHS Service Evaluation number required - UoS Ethics will additionally be required.

Measurement and Analysis of Serial Thoracic Aortic Magnetic Resonance Angiograms

Main Supervisor:

Dr Stephen Goode

stephen.goode3@nhs.net

Second Supervisor:

Dr Mark Regi

mark.regi@nhs.net

Other Supervisor(s):

possible also to include all members of the thoracic aortic MDT

Type of Project:

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

Aims and Objectives:

to measure and analyse serial thoracic aortas using mr angiograms using specialist imaging software

to stratify patients according to different disease processes ie aneurysmal disease/ dissection

to assess the change in aortic lengths over time

to assess the serial changes in thoracic aortic diameters over time

Research Methodology:

Students will carry out the research in the department of vascular radiology at the NGH. day to day working will be on the PACS system looking at MR thoracic aortas and then transfering images to TERARECON software to perform standardized measurements of length and diameters over time. teaching on MR angios and specialist software will be performed.

Expected Outcome:       

We will build up a picture of aortic size change over time + assess if thoracic aortas change in length over time

Additional Training:

Reviewing and analysing MR angiograms + additional training on specialist imaging software for the purposes of analysis and measuring thoracic aortic lengths and diameters

Ethical Approval:

Not known – please contact Fran Oldale in the first instance.

Sheffield Early Lung Cancer Cohort Study

Main Supervisor:

Mr John G Edwards

john.edwards3@nhs.net

Second Supervisor:

Miss Laura Socci

Other Supervisor(s):

Professor Matthew Hatton

Type of Project:

Clinical project - based in the clinical environment with patients/including service evaluation, Qualitative Project/non-lab based - primarily using qualitative methods

Aims and Objectives:

Aim:

Evaluate the outcomes of lung cancer patients managed by surgery or radiotherapy

Objectives:

  1. Characterise primary treatment related outcomes in a large retrospective cohort study
  2. Determine midterm quality of life outcomes after surgery in an on-going prospective study
  3. Investigate post-treatment hospital and primary care utilisation

Research Methodology:

Four previous BMedSci projects have set up very large, high quality databases of over 2000 surgical patients and radiotherapy patients. These have included outcomes of Single Port Video-Assisted Thoracoscopic Surgery, in-depth analysis of histopathological reports and recurrence data. From Jan 18, an ongoing, fully approved prospective quality of life cohort study investigated QoL in surgical patients and further data will be collected and analysed as this cohort matures. Analysis of these databases is ongoing, with different themes of specific interest tailored to individual students.

Expected Outcome:       

This is a comprehensive and ongoing study, involving high quality data. The results have be promoted widely and presented to national and international conferences. Several published abstracts and journal manuscript publications have and will continue to result from this work, in addition to the BSc (Med Sci)

Additional Training:

'Good Clinical Practice' (GCP) in research training will be completed online. Training in the retrieval of patient related data from hospital IT systems. Methods of handling very large datasets. Direct supervision meetings will be offered at least weekly. Training and supervision of statistical analyses will be available.

Ethical Approval:

Secondary data or tissue samples - UREC or NHS REC ethics approval already received for the intended research project, selecting from the choices below Original research involving human tissues/human participants and/or patient details and information.

Do patients with autoimmune hepatitis (AIH) have an excessive incidence of cardio- and cerebro- vascular disease? Is this related to corticosteroid treatment? A pilot study using a hospital-based AIH database and a Sheffield-wide primary care database

Main Supervisor:

Professor Dermot Gleeson

dermot.gleeson@nhs.net

Second Supervisor:

Dr John Soady

john.soady@nhs.net

Other Supervisor(s):

Dr Jon Dixon j.m.dickson@sheffield.ac.uk. Senior Lecturer, Academic Unit of Primary Medical Care, University of Sheffield.

Dr Barbara Hoeroldt barbara.hoeroldt@nhs.net Consultant Hepatologist, Sheffield Teaching Hospitals.

Dr Laure Harrison laura.harri

Type of Project:

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

Aims and Objectives:

AIH is an immune-mediated liver disease affecting about 16,000 people in the UK. Untreated, it results in liver failure and death within 5 years, but it usually responds to corticosteroid therapy. Because of the unusually high long-term steroid burden, patients with AIH are potentially at increased risk of vascular disease; however this has not been tested. Here, we will estimate the rate of new cardio- and cerebro- vascular disease following a diagnosis of AIH, compare this with (age/gender adjusted) UK population rates and also, assess its relationship to cardiovascular risk factors and the burden of steroid therapy

Research Methodology:

The Sheffield Liver Unit database includes all patients with AIH diagnosed since 1/1/1987 (about 370). Data include corticosteroid therapy and vascular risk factors (smoking, diabetes, BMI, lipids). About 300 patients (being Sheffield residents) are also in the Sheffield Primary Care database, held by NHS Sheffield Clinical Commissioning Group. This includes person-level data, which is updated monthly from linked GP and hospital systems.

In the (about 300) patients with AIH, the student will collect data from the Primary Care database on new diagnosis of (or death from, via linked ONS records) cerebro-or cardio-vascular disease, defined by Read codes

Expected Outcome:       

Rates of new cardio- and cerebro- vascular disease diagnosis (or death) in patients following a diagnosis of AIH, will be compared to published age/gender adjusted UK population rates. We will also assess their relationship to cumulative steroid burden and to vascular disease risk factors. Finally, we will evaluate the feasibility of proceeding to a formal case-control study (using up to 10 matched controls per patient, also drawn from the Primary Care database).

Additional Training:

The student will learn about (a) chronic liver disease, especially autoimmune disease (b) corticosteroid therapy (c) vascular diseases and their risk factors, especially from a primary care and preventative perspective. He/she will also learn to construct and manage a database and to analyse data using SPSS, in particular life-table and regression analyses

Ethical Approval:

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

Assessment of bladder shape changes during urodynamics

Main Supervisor:

Professor Stephen Radley

Stephen.Radley@sth.nhs.uk

Second Supervisor:

Dr Thomas Gray

Other Supervisor(s):

Dr. S Abdi, Dr. J Fenner

Type of Project:

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

Aims and Objectives:

Initial research at Sheffield Teaching Hospitals has shown that the bladder changes shape when it contracts during bladder contractions, becoming more ellipsoid in its outline when imaged using trans-abdominal ultrasound. The aim of this study is to further characterise these shape changes. The objective is to perform ultrasound scanning in patients undergoing urodynamic investigation of their lower urinary tract symptoms, identifying shape changes which occur with bladder contractions and work with a team in gynaecology, radiology and medical physics in refining techniques to measure these shape changes and thereby provide a simple, non-invasive alternative investigation for patients with urinary incontinence.

Research Methodology:

A minimum sample of 20 patients undergoing investigation of their lower urinary tract symptoms with urodynamicswill be invited to participate by the research team.

Urodynamics is a routine test that involves artificial filling of the bladder via a catheter, using measurements of pressure, to assess bladder contractions.Consenting patients will undergo standard urodynamic assessment (carried out by the gynaecology team) and in addition, serial ultrasound scan images of the bladder will be captured, supervised by the gynaecology team, throughout bladder filling. With the support of the research team, these ultrasound images will be analysed; measuring and characterising shape changes and their relationship to bladder volume and pressure, parameters which are routinely recoded during urodynamics.

We will collect a minimum of 10 images from each subject, aiming to acquire 5 images during bladder contractions (events) and 5 images during periods of acontractility (non-events). This will yield a minimum of 100 images during events and 100 during non-events, which will enable adequate power to establish differences in the 2 groups and validate the methodology.

Expected Outcome:       

We expect shape changes to occur when the bladder contracts during episodes of urinary urgency or detrusor overactivity (pressure rises in the bladder identified during urodynamics). Our initial feasibility study involving 22 patients, demonstrated clear shape changes from relaxed, following the contours of the pelvis (approximating to a smoothed rectangle in outline) to tense and rounded, usually occurring within seconds. We expect this study to confirm the shape changes previously identified and through more frequent imaging and the use of continuous ultrasound (including video imaging) allow better characterisation and assessment of these shape changes.

Additional Training:

The student selected to participate in this research project will receive training in basic ultrasound. They will be trained to operate the ultrasound machine and to scan patients (always under direct supervision) and capture images of the bladder in the transverse plane. They will be taught how to download and manage the images.

Methods of shape analysis and specific techniques to measure shape changes will be taught in conjunction with the medical physics department. As part of the BMedSci placement with our team there will also be opportunities to attend gynaecology outpatient clinics and sessions in the urogynaecology operating theatres.

Ethical Approval:

has ethics approval.

Are young people with inflammatory bowel disease adequately prepared and supported to make decisions relating to their care?

Main Supervisor:

Professor Alan Lobo

alan.lobo@sth.nhs.uk

Second Supervisor:

Mr Matt Lee (ScHARR)

Other Supervisor(s):

Professor Georgina Jones, Leeds Beckett University

Type of Project:

Clinical project - based in the clinical environment with patients/including service evaluation, Qualitative Project/non-lab based - primarily using qualitative methods

Aims and Objectives:

Aim: To determine the decision preparedness of young people with inflammatory bowel disease (IBD) approaching transition to adult services and the relationship to disease outcomes

Objectives:

  • To measure decision-making competence in young people transitioning to care within adult services
  • To determine disease specific aspects of decision-making in IBD
  • To measure the relationship to other patient-reported outcomes including psychological morbidity and healthcare utilisation
  • To understand, in depth the experiences and decision support needs of young people living with IBD and transitioning to care within adult services.

Research Methodology:

  • Systematic review methodology (supported by Professor Georgina Jones, Leeds Beckett University and Mr Matt Lee, University of Sheffield)
  • Application of the Melbourne Decision-Making Questionnaire (MDMQ) of decision-making competence
  • Validated questionnaire assessment of health-related quality of life (Inflammatory Bowel Disease Questionnaire) and psychological morbidity (Hospital Anxiety and Depression Scale).
  • Semi-structured interviews to explore and understand other areas of decision-making support needs specific to IBD and impact of transitioning to adult services on the young people’s quality of life.

Expected Outcome:       

This will continue on from an existing project which will be complete by the time this B Med Sci starts. It will generate follow-up data on those already studied (ethics already approved for this) and extend into a younger age group. Data generated from the questionnaires used in the survey and qualitative interviews will describe how well prepared young people are for transition to adult services. We would expect the systematic review, the survey and interview findings to be presented at national and international meetings. Previous BMed Sci student has been presented at the United European Gastroenterology meeting in Vienna and at meetings of the British Society of Gastroenterology, European Crohn’s and Colitis Organisation and Surgical Students Research Society. 6 full papers by BMed Sci students have been published in the last 2 years from this Department.

Additional Training:

The student will spend their year with a well-established clinical and academic team who have expertise in the field of IBD, systematic reviewing, decision science and quantitative and qualitative methodologies. They will therefore be able to provide all the training and support necessary so that student can successfully complete this project

Ethical Approval:

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

Service Evaluation of concomitant ablation for atrial fibrillation (AF) during cardiac surgery

Main Supervisor:

Mr Steven Hunter

steven.hunter@nhs.net

Second Supervisor:

Justin Lee

justin.lee@nhs.net

Type of Project:

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

Aims and Objectives:

Aim: To review the surgical AF ablation programme at Sheffield Teaching Hospitals over the past 5 years.

  • Describe the population treated – age/demographics/cardiac status
  • Describe the different surgical ablation lesions performed
  • Report the acute success of ablation (at the time of surgery)
  • Report the follow up data (long term success) based on intermittent holter (24h tape) recordings and clinical follow up.
  • To plan a regional follow–up service to be managed by the Arrhythmia team

Research Methodology:

This project will involve a retrospective review of clinical case records – combination of paper and electronic records. Data will be entered into a database and then statistical analysis performed.

The vast majority of information will be on our database. Tuition in the use of the database will be provided. This database contains all patients (cardiac, thoracic and cardiology). We perform around 1000 cardiac operation per year and 80 to 100 include AF ablation surgery.

If paper records are required there will be secretarial support.

Expected Outcome:       

We expect this project to provide very useful descriptive/registry type data about our local surgical AF ablation programme and help to plan future service delivery. There is likely to be potential to publish the data and/or present it at a national meeting.

There will be an opportunity to present the outline of this project at the Heart Rhythm Congress next year(September/October 2019). This will be at the beginning of the project but one of the aims of this project is to identify a standard of follow up care for these patients.

Additional Training:

This project will involve use of basic statistics (SPSS or similar) and training can be provided where required. There will be opportunities to develop skills in ECG interpretation. There will also be opportunities for the student to observe cardiac surgery and electrophysiological ablation in the catheter labs

Ethical Approval:

Service evaluation - UoS ethics not required.

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