Sheffield Teaching Hospitals Trust projects

Intercalated BSc Medical Sciences Research available projects

The Hallamshire Hospital.
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Projects:

Deconditioning and sarcopaenia after stroke study - DECONSTRCKT

Main Supervisor

Dr Ali Ali (ali.ali@sheffield.ac.uk)

Second Supervisor

Dr Liz Williams (e.a.williams@sheffield.ac.uk)

Third Supervisor

Dr Simon Nichols

Aim and Objectives

To characterise the time course of the development of sarcopaenia after acute stroke and its determinants e.g. stroke severity, disability, physical activity, systemic inflammation and nutritional status.

Research Methodology

Twenty four patients with acute stroke will be recruited from the stroke units at Sheffield. Socio-demographic and clinical details will be recorded. Baseline blood tests for inflammatory markers and muscle markers (IL-6, IL-1, TNFa, IL-10, myostatin, irisin, IGF-1) will be drawn. Participants will undergo a weekly assessment (except ultrasound which will be undertaken every 3 days) of the following characteristics until discharge from hospital:

  • Strength and function: grip strength, 5 x chair stand, timed up and go (TUG), gait speed, Barthel Index.
  • Systemic inflammation: modified Glasgow prognostic score [Yoshimura 2018] – serum CRP and albumin.
  • Nutrition: 24 hour food recall, review of nutritional charts for tube fed patients, Malnutrition Universal Screening Tool (MUST).
  • Structural: Bioelectrical impedance analysis (BIA), thigh and humeral circumference, quadriceps thickness (muscle ultrasound).

Expected Outcome

Feasibility of undertaking the longitudinal analysis will be confirmed if > 80% of the intended measurements are completed. Longitudinal analysis of changes to muscle strength and function, structure, nutrition and systemic inflammation will be undertaken. Outcomes will be reported descriptively with statistical analysis using repeated measures along a time course (ANOVA) and comparisons from baseline assessment (students paired T-test). Multiple regression analysis will be undertaken to elucidate factors associated with the largest declines in muscle mass and strength.

Type of Project

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

Additional Training

Student will receive training on the following:

  • Use of muscle ultrasound (Advanced Wellbeing Research Centre)
  • Use of bioelectrical impedance analysers
  • Blood letting and spinning in preparation for freezing
  • Performing ELISA tests on serum
  • Use of nutritional software analysis systems (myfood24)
  • Various statistical analyses
Coeliac Disease and endoscopy

Main Supervisor

Professor David Sanders (david.sanders1@nhs.net)

Second Supervisor

Professor Mark McAlindon (mark.mcalindon@nhs.net)

Aim and Objectives

Diagnosis of coeliac disease assessment using GIP

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 14 BMed Sci students all receiving either a first class (n=11) 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/

Type of Project

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

Additional Training

We will train you to do research, work with patients be part of the team and have fun! We are a supportive and friendly clinical research family. You also attend our weekly lunch meeting and tend to work in the same office as fellows and other students

Validation of Global Limb Anatomic Staging System (GLASS) for Chronic Limb Threatening Ischaemia (CLTI)

Main Supervisor

Dr Stephen Goode (stephen.goode3@nhs.net)

Second Supervisor

Dr Saima Ehsan (saima.ehsan@nhs.net)

Aim and Objectives

This project will investigate patients with CLTI. Patients (n=100) will be identified from existing records who have been investigated for CLTI and have at least 18 months of follow up after first treatment at the start of the project. Data will be collected and collated including their vascular risk factors clinical presentation (WIFI score where available), GLASS score, treatments and vascular interventions and clinical outcomes. A questionnaire based Quality of life assessment will be undertaken using virtual phone based consultation. The aim of this study is to validate the GLASS score and investigate its correlation with clinical outcomes. This validation will have significant important benefits for patients providing high quality evidence to inform treatments and decision making for limb salvage.

Research Methodology

This is a mixed methods study. It will use qualitative and quantitative analysis on retrospectively and prospectively collected clinical, vascular imaging, intervention and quality of life assessment data. The student will analyse the imaging, collate and analyse the associated clinical and intervention data and compare the findings and outcomes with the published recommended GLASS scoring system for the first validation study. Training and teaching will be provided to read the relevant vascular imaging and clinical information and interpretation of findings. This will provide exposure to clinical and radiological vascular assessment, treatments, understanding research methods used in clinical research.

Expected Outcome

The expected outcome is to validate the GLASS scoring system in the local population. The primary outcome is to look at amputation free survival in the study population and compare it with the expected outcome using the GLASS score.

The secondary outcomes will be;

  1. to look for correlation between the GLASS score and the clinical assessment using WIFI score where available
  2. Quality of life assessment for CLTI patients and investigate if a correlation exists between GLASS score and QoLA scores
  3. Chart the patient journey and investigate the time interval from presentation to intervention and if variations exists its impact on outcome. 

Type of Project

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

Additional Training

Students will be trained in vascular imaging analysis required for the completion of the project. Students will observe a number of vascular interventions to understand the clinical component of the study.

Service evaluation refining clinical decision making using multi-modality cardiac imaging and invasive cardiac catheterisation evaluation of aortic stenosis in patients undergoing assessment for transcatheter aortic valve implantation (TAVI)

Main Supervisor

Dr Graham Fent (g.fent@nhs.net)

Second Supervisor

Dr Laurence O'Toole (laurence.o'toole@nhs.net)

Aim and Objectives

Echocardiography derived Doppler assessment is the key diagnostic tool in the assessment of aortic stenosis but agreement with invasive catheterisation derived pressure measurements is poor, making clinical decision making challenging when discordant measurements are obtained.

The aim of the project is 1) to assess the statistical agreement between echocardiography Doppler and invasive catheterisation using traditional and newer post-processing derived parameters in a retrospective cohort of ~50 patients previously evaluated for TAVI and 2) identify key sources of non-concordant measurements and their impact on patient selection for TAVI.

In completing the project, it is expected the student will learn how patients are clinically selected for TAVI, gain a deep understanding of cardiac physiology in relation to aortic valve disease and develop skills in post-processing evaluation of echocardiography, cardiac CT and invasive cardiac catheterisation derived parameters.

Research Methodology

The student will spend the first months of the project obtaining baseline demographic and outcome data for the patient cohort. Having established this, the next step will be to build a small database examining the echocardiographic, invasive catheterisation and cardiac CT parameters for each patient and assessing the cross-modality statistical agreement of these parameters and there relative influence on patient outcome. The final stage will involve write-up of the project and accompanying research output with the aim of conference and/or journal publication.

Expected Outcome

We have pilot data showing excellent agreement between catheter aortic valve mean pressure gradient and echo Doppler derived mean pressure gradient and anticipate this being a much more robust parameter than the traditional invasive peak 'pullback' pressure gradient. We also feel that relying on traditional invasive peak pressure gradient as a means of defining aortic stenosis may inappropriately reclassify patients as not having severe aortic stenosis which may negatively impact their longer term morbidity and mortality. It is expected that integrating newer invasive and non-invasive assessments of aortic stenosis will lead to better patient selection for TAVI.

Additional Training

Students will receive formal teaching in echocardiography techniques and post-processing software as well as formal teaching on the use of post-processing techniques in invasive cardiac catheterisation.

The student will also be given access to a wide array of online in-house teaching materials on echocardiography and aortic valve disease assessment using echocardiography. The student will have the opportunity to attend MDT meetings relating to patient selection for TAVI.

Type of Project

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

Development of Standardised Guidelines in Thoracic Aortic Imaging

Main Supervisor

Dr Stephen Goode (stephen.goode3@nhs.net)

Second Supervisor

Miss Saima Ehsan (saima.ehsan@nhs.net)

Third Supervisor

Dr Mark Regi

Aim and Objectives

The aim of this project is to develop definitive follow up guidelines for thoracic aortic imaging in patients with aneurysmal disease. We will collate long term imaging follow up data on patients with aneurysmal thoracic aortic disease and also those with treated ascending aortic aneurysmal disease for the purposes of interpretation and analysis.

Research Methodology

We will being using mixed qualitative and quantitative methodology. We will identify patients with long term follow MR angiographic imaging in 2 main cohorts:

  1. Patients with ascending aortic aneurysmal disease
  2. Patients with operated ascending aortic disease

We will then collate their imaging follow up parameters from MR angiographic thoracic aortic imaging measurements. As well as this demographic data, vascular risk factors, operations, short and long term complications will be recorded. A questionnaire based Quality of life assessment will be undertaken using virtual phone based consultation to look at the impact of long term imaging follow up.

Expected Outcome

This project will provide important long term data on thoracic aortic disease and will help us to develop and publish national guidelines to help guide national imaging follow up. We plan to present these findings at national and international conferences on thoracic aortic disease and also to publish our data into peer reviewed publications.

Additional Training

This project is a mixed method clinical study with emphasis on thoracic aortic imaging as well as a phone based questionnaire. This project will predominantly be office based image interpretation and analysis, data collation and statistical analysis. Students taking up this project will be trained in thoracic aortic imaging interpretation and analysis on basic PACS imaging workstation and but also high level Terarecon reformatting software.

Type of Project

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

The effect of prewarming on inadvertent perioperative hypothermia (IPH) rates and anxiety scores in patients undergoing anaesthesia for urological procedures

Main Supervisor

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

Second Supervisor

Dr Matthew Wiles (matthew.wiles1@nhs.net)

Aim and Objectives

  1. Determine if the rate of inadvertent perioperative hypothermia can be decreased by prewarming.
  2. Determine if this prewarming period affects patients' anxiety scores

Research Methodology

Patients due to undergo urological surgery will be consented and randomised to receive a period of prewarming in the anaesthetic room or standard practice (no warming). After 3 minutes of prewarming they will be asked by an observer to rate their anxiety and comfort levels. All patients will receive standard intraoperative warming. Primary outcome measure will be incidence of IPH < 36degC perioperatively. Secondary outcome will be preop anxiety and comfort levels.

Expected Outcome

The incidence of hypothermia is high in certain urology cases (@50%) We expect to be able to halve the incidence of IPH in this group by instigating preop warming. Our power calculations estimate that @ 120 patients will need to be recruited to show statistical significance (80% beta, 5% alpha errors)

Type of Project

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

Additional Training

Students will be in theatre for a larger proportion of their project. They will learn to cannulate and control patients' airways. They will learns the basic physiology and pharmacology and practical skills needed to be an anaesthetist.

Finding Joy in Medicine

Main Supervisor

Professor Ian Sabroe (i.sabroe@nhs.net)

Second Supervisor

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

Aim and Objectives

Burnout and moral distress are common amongst practicing doctors. Much research has focused on these issues, but little work has examined the nature of the positive experiences that support a positive life-long experience of working in the medical profession. This project will examine the nature of positive experiences, how they are described, and attempt to examine what clinicians claim are the reasons that give professional fulfilment.

Research Methodology

To examine clinician narratives and research spanning the last one hundred years, examining clinician experience of practice, and focusing specifically on positive experiences of the giving of care and working in medical systems.

Expected Outcome

This project will generate a positive voice examining the experience of medical practice, which is extremely important at a time of huge clinician stress.

Type of Project

Medical Humanities

Additional Training

The student will receive training in humanities research, literature searching and reviewing, narrative theory, and historiography.

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)

Aim 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.

Type of Project

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

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.

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