Search Results

SOCIAL CARE: Evaluation of Southampton City Council’s Male Engagement Worker (MEW) Project Chief Investigator: Dr Michelle Myall, Principal Research Fellow, University of Southampton Co-Investigators: Dr Sophia Taylor, Senior Research Assistant, University of Southampton; Dr Susi Lund, Visiting Research Fellow, University of Southampton Partners who will collaborate on the research: Anjelica Finnegan, Senior Male Engagement Worker, Southampton City Council; Caroline Bate, Domestic Abuse Coordinator, Southampton City Council; Colin McAllister, Senior Public Health Practitioner, Southampton City Council; Francesca Mountfort, Male Engagement Worker, Southampton City Council Start Date: 19 October 2023 End date: 30 September 2024 Why is this research needed? An estimated 2.4 million adults experienced domestic abuse in 2019 in England and Wales. In April 2021 the Domestic Abuse Act was introduced in England and Wales. This created a new definition of domestic abuse to include “any incidents or patterns of incidents of controlling, coercive, or threatening behaviour, violence or abuse between those aged 16 or over, who are or have been, intimate partners or family members regardless of gender or sexuality. Domestic abuse can encompass, but is not limited to psychological, physical, sexual, financial and emotional abuse”. The Act required local authorities to expand their support and provision available to those experiencing domestic abuse. As part of a review by Southampton City Council into whether it meets the requirements of the new Act it found that alleged perpetrators of domestic abuse are not being effectively assessed or adequately supported. This is particularly true of young (step-) fathers. To address this gap, in 2020 Southampton City Council established a Male Engagement Worker (MEW) Project to work with high-risk male perpetrators of domestic abuse who have (step-) children and have local authority children’s services involved. This newly established service has yet to be evaluated. What are the aims? To evaluate Southampton City Council’s new domestic abuse service focusing around the newly created Male Engagement Worker Project. How will the study be carried out? We will carry out interviews with key informants and relevant stakeholders and analyse audit data collected about the service. What will happen to the findings? We will work with our project partners to identify who we need to engage and how to reach them. We will share findings with stakeholders through a presentation. We will produce a report and executive summary of findings and recommendations for Southampton City Council and share learnings with other relevant local authority and third sector organisations. Findings will also be reported on social media posts for the wider public, publications in academic and professional journals and attendances at conferences.

< Back Traveling back in time: exploring the Netley Red Cross Hospital during World War I Nestor Serrano-Fuentes Nestor Serrano-Fuentes RN, PhD student and Research assistant for the Long-Term Conditions Research Group, Health Sciences, University of Southampton November is remembered as the month in which the First World War ended; a time to remember our loved ones who fell in battle. Between 1914 and 1918, many stories unfolded: stories of life, death, love, births, feelings and emotions. Those feelings flourish today when walking through the green park and woodland at Netley on the Southampton shoreline. I look at the sea, that little orange chapel in the middle of the great esplanade, I close my eyes and visualise the protagonists of this story, talking among themselves, laughing, shouting, touching and hugging… My name is Nestor, I am a young man, nurse and researcher at the University of Southampton. Two years ago, while running on a cold winter morning along the south coast at Netley, something drew my attention. What was a lonely chapel doing here? I stopped to read some information panels and discovered that, in that place had been the Netley Hospital or Royal Victoria Hospital. According to some books, this was the largest British military hospital of all time. Furthermore, with the arrival of the war-wounded its capacity grew yet further Leading to the building of the British Red Cross Hospital just behind the main building and the recruitment of volunteers in the UK and overseas. Netley Hospital in 1918 Sister Harvey and some of the patients from 41 Hut A Japanese nurse who worked at Netley in 1918 - unnamed I needed more information and began to browse the historical archives online. Later I came across a treasure; The Netley British Red Cross Magazine . It was December and I was combing the historical archives in Winchester and there in my hands were prints of those magazines from 1918. They were filled with poems written by soldiers and nurses, cartoons, real photos and countless stories told in the first person. A few days later, I phoned my friend Elena Andina, lecturer of nursing at the University of Leon (Spain). She is a dreamer, humanist, and a person with whom I share a passion for the history of the nursing profession. I said: “You’re not going to believe what I have found! We’ve got some work to do!” We decided to read those six issues of the magazine. We were filled with great affection for the people and stories. We set about starting to analyse and contextualise the data and information, and began to write an article on the history of nursing telling the story of how care was delivered to soldiers during World War I. We were so lucky, it was like travelling in a time machine, an incomparable feeling. After a first analysis, we realised that there was a relationship between what was happening at Netley and the revolutionary thinking and ideas of Florence Nightingale, who is considered the creator of modern nursing. The focus on the environment on care - sunlight, humidity, fresh air, silence during a night shift, empathy, the smallest details that nurses took care of, such as the size of pyjamas for their patients, the use of small boats as a source of leisure for patients and nurses, are just some of the aspects that we glimpsed between those pages. Throughout history, wars and pandemics have shaped and changed the way nursing care has been delivered. If we look back, many of the measures that were applied we continue to use today. During this covid19 pandemic, the importance of open spaces and physical spaces between people, fresh air or sunlight are the same – echoes of the voices speaking from the pages of the Netley magazines in 1918. They say history tends to repeat itself, for better or for worse. What can we learn from it? Let us continue to lovingly preserve it and keep it in mind to acknowledge our ancestors and as inspiration in the search for current and future answers. Nestor Exploring The Netley British Red Cross Magazine: An example of the development of nursing and patient care during the First World War - Nestor Serrano-Fuentes& Elena Andina-Diaz (download below) serranoandina_2020_netley-hospital .pdf Download PDF • 768KB Elena Andina-Diaz - co-researcher Previous Next

Wessex NHS Insights Prioritisation Programme Project (NIPP) Wessex NHS Insights Prioritisation Programme Project (NIPP) National Institute of Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex and Wessex Academic Health Science Network (AHSN) Digital innovations for people living with frailty Read the Health Innovation Network report Project team Nicola Andrews (NIHR ARC Wessex), Cindy Brooks (NIHR ARC Wessex), Cheryl Davies (Wessex AHSN), Linda Du Preez (Wessex AHSN), Richard Finley (Wessex AHSN), David Kryl (NIHR ARC Wessex and Wessex AHSN), Susi Lund (NIHR ARC Wessex), Michelle Myall (NIHR ARC Wessex), Rebecca Player (Wessex AHSN) and Phoebe Woodhead (Wessex AHSN). Background to the project NIPP was funded by NHS England’s Accelerated Access Collaborative to enable ARCs and AHSNs to work together to accelerate the evaluation and implementation of innovations that support post-pandemic ways of working, build service resilience and deliver benefits to patients. The Wessex NIPP project focused on the use of digital interventions to support the care of people with frailty. We worked collaboratively with stakeholders from across the Integrated Care Systems in Dorset and Hampshire and Isle of Wight to identify system priorities in this area. The project had several components: 1 – Evaluation of uptake and use of the myCOPD app by older people We undertook a mixed methods evaluation of the myCOPD app , a digital monitoring and self-management tool, in relation to its use by older people. The findings showed a higher prevalence of COPD in the myCOPD eligible population than the general population, highlighting the importance of understanding the impact of frailty on uptake and use of the app. Those aged 75 and over, or living with moderate or severe frailty, were less likely to register with and more likely to decline the app. There was also evidence that follow-up support to promote use of the app could increase activation and help overcome technical barriers. Evaluation of myCOPD app - Summary of findings (ARC Wessex) .pdf Download PDF • 180KB Evaluation of myCOPD app - Full Report .pdf Download PDF • 368KB 2 – Development of a Theory of Change on use of data to enhance care of people with frailty Theory of Change is a method to develop understanding of how an initiative can achieve impact. This is displayed in a Theory of Change map. The development and refinement of the Theory of Change map drew on a review of the evidence and individual discussions with a wide range of stakeholders. Participants were from primary care, community services and acute care working in digital health or care, frailty, commissioning and population health management. Stakeholders identified that a lack of availability of routinely collected data from across organisations to inform decision-making impacted the care provided to people with frailty. Theory of Change map - Use of data to enhance frailty care .pdf Download PDF • 176KB Theory of Change Report - Use of data to enhance frailty care .pdf Download PDF • 461KB 3 - Investigation of the use, applicability and acceptability of digital remote monitoring for older people a) Listening activities with older people’s community groups to understand perceptions of digital remote monitoring We held face-to-face events at six older people’s community group meetings, including a carers’ group, an exercise class and a community group serving a majority black ethnic population. At these events we discussed benefits, concerns and barriers to the use of digital remote monitoring (the ability to monitor aspects of an individual’s health remotely using technology). We also asked group members how they thought their views might change as their health or abilities declined. b) Research study investigating use and acceptability of digital remote monitoring for older people with frailty in the community This mixed methods research study investigated digital monitoring at home approaches among older people with frailty, using Artificial Intelligence (AI)-facilitated sensors to monitor daily activities and routines. c) Evaluation of digitally enabled care within frailty virtual wards The evaluation used qualitative data from two frailty virtual wards ( NHS England » Virtual wards ) to explore the use, decision-making and impact of digital remote monitoring. We combined the qualitative data from the above three work packages (a, b and c) for thematic analysis. We found that a personalised approach is important, with a need to consider practicalities (such as cost and sensor positioning) and design of the technology. Face-to-face care is highly valued and should not be replaced by digital remote monitoring. Users and carers need to know what to expect, how the technology works, who is monitoring and when; this would aid trust. NIPP 2022-23 summary report .pdf Download PDF • 624KB NIPP 2022-23 Full report .pdf Download PDF • 838KB 4 - Co-production, piloting and evaluation of an online Implementation Toolkit Implementation is a complex process. For those tasked with introducing an innovation or a change to practice, service provision or delivery, there are a range of models, frameworks and tools to choose from to support the implementation journey. However, these can be inaccessible, specific to particular user groups, or fail to take implementation considerations into account at the outset. The Web-based Implementation Toolkit (WIT) was co-produced with a range of stakeholders by NIHR ARC Wessex. It is a user-friendly and accessible guide on what needs to be considered when implementing and how to achieve this. WIT can be accessed at: Helpful resources | NIHR ARC Wessex More details can be found at: Implementation | NIHR ARC Wessex Rapid Insights Guide for 2022/23 work A Rapid Insights Guide (with project highlights) was produced for NHS England at the end of the 2022/23 projects (work packages 3 and 4 above). Rapid insights report NHS E_for submission .pdf Download PDF • 322KB

For professionals & researchers Access reports, toolkits and support Read more Meet our interns, PhD, and Post-Docs Read more Case Studies Read more ARC qualitative network Read more

ADOPTED PROJECT: Developing and testing a Patient Report Experience Measure for patients accessing Acute OnCology services: The PREMAC study Principal Investigator : Dr Richard Wagland, Senior Research Fellow, University of Southampton, School of Health Sciences Co-Investigators : Professor Alison Richardson, Professor of Cancer Nursing & End of Life Care and Director of NIHR ARC Wessex, University of Southampton & University Hospital Southampton John Defty, Advanced Clinical Practitioner in Cancer Care, University Hospital Southampton Dr Emma Brown, Medical Oncologist, Acute Oncology Lead. University Hospital Southampton Start date : January 2023 End Date: May 2024 Funder : University Hospitals Southampton (UHS) NHS Foundation Trust R&D Small Grants Award Lay summary People with cancer often need to access acute oncology (AO) services for serious problems caused by their disease or treatment. This study will co-design a questionnaire, involving patients, staff and researchers, to measure patient experience. Findings from surveys that use this questionnaire can inform service improvements. The research will produce a questionnaire and a protocol on how best to manage data collection processes and do the groundwork for a future grant application to distribute and test the questionnaire in services in Wessex and across England. Findings from exercises that use this questionnaire can establish and compare the quality of patient experience across services and inform improvements. Background Hospitals have established structured pathways for managing patients with oncological emergencies through acute oncology (AO) services. Whilst some Trusts have developed local questionnaires specific to that service there is no survey available to measure and compare patient experience across NHS trusts. This study will co-design a patient-reported experience measure (PREM), intended to be adaptable for use across different AO service models. Advisory Group Members : Andrew Dossett, Lead Clinical Advanced Clinical Practitioner for Acute Oncology Service, University Hospital Southampton Jane Winter, Macmillan Lead Nurse, Wessex Cancer Alliance Laura White, Head of Involvement & Participation, University Hospital Southampton Katie Hudson, Lead Advanced Clinical Practitioner for Cancer Care Wards, University Hospital Southampton Mrs Susan Restorick-Banks (PPI Representative) Mrs Anne Ongley (PPI Representative) Alison Keen, Head of Cancer Nursing, University Hospital Southampton Philippa Jones, Acute Oncology Nurse Advisor, Board Member of UK Acute Oncology Society. Prof. Ernie Marshall, Medical Oncologist, Wirral University Teaching Hospital (Clatterbridge) NHS England national lead for Acute Oncology

ADOPTED: Evaluation & Exploration of Multi-Agency Stalking Partnership Interventions Evaluation & Exploration of the Hampshire & Isle of Wight Multi-Agency Stalking Partnership (MASP) Team: Research Team based at University of Southampton Faculty of Medicine and ARC Wessex Partners who will collaborate on the research: Hampshire & Isle of Wight Office of the Police & Crime Commissioner, Hampshire & Isle of Wight Constabulary, Southern Health NHS Foundation Trust, Hampshire & Isle of Wight Probation Service, & STOP Domestic Abuse. Start date: 1 April 2023 End date: 1 April 2025 Hampshire & Isle of Wight (HIOW) was one of the three pilot sites of the Multi-Agency Stalking Intervention Programme (MASIP), commissioned by the Home Office in 2018. The programme identified positive outcomes from the limited number of case consultations and direct interventions delivered. Funding for MASIP ceased in March 2023 and new funding was sought to refresh the initiative and realise its potential. With two years of funding from the Home Office, from April 2023-March 2025, the partnership has been renewed to address stalking in HIOW. Key partners include the Office of the Police & Crime Commissioner for HIOW, HIOW Constabulary, Southern Health NHS Foundation Trust, HIOW Probation, and STOP Domestic Abuse. This service, called the Multi-Agency Stalking Partnership (MASP), aims to deliver a package of interventions to reduce the impact of stalking. The objective of this partnership is to reduce the risk of further stalking behaviour, and improve the psychological wellbeing of the person using stalking behaviours, whilst keeping the safety of the survivor and their dependents at the centre of this work. The service aims to help up to 160 people who have used stalking behaviours, and their victims, per year. The package to be delivered by this partnership will include: The package to be delivered by this partnership will include: - Three novel models of rehabilitation, using Psychologist-Led Stalking Interventions (PLSI), for individuals who are using stalking behaviours - Advocacy and support for individuals who have been victims of stalking, and - Professional development, support resources, and new ways of working for professionals who are working with people who have stalked Our team at the University of Southampton, Faculty of Medicine, has been asked to conduct an independent evaluation of the MASP’s activities. We will also conduct primary research to determine whether and how the interventions that MASP deliver are effective in reducing the risk of further stalking behaviour and improving the psychological wellbeing of the person who has stalked. We hope to be able to create new evidence, that can be shared with other agencies, about what works (and how and why) to reduce stalking behaviours. What are the aims? The objectives of the service evaluation and primary research are: 1. To determine whether the effectiveness of the MASP activities: have they been successful in reducing the risk of further stalking behaviour and improving the psychological wellbeing of the person who has used stalking behaviours? 2. To explore the mechanisms and outcomes of the MASP activities: how and why might they impact on the risk of further stalking behaviour? How will the study be carried out? We will analyse routinely-collected, anonymised, data from the MASP partners to determine the effectiveness of the MASP activities. We will also conduct data directly from MASP professionals, MASP clients, and SASS clients, via survey and interview, to explore further how and why the MASP activities might have any effects. What will happen to the findings? The findings will directly inform the future of stalking-related work in Hampshire & Isle of Wight, and elsewhere. We will share the results widely, through publication in peer-reviewed journals, reports to the funder, and presentations at local, national, and international conferences. Where can I get more information? Please contact MASPinfo@soton.ac.uk for more information. Service links: Southern Health Link to Police commissioner website

Subscribe for our newsletter

COMPLETED: Shift Pattern Feasibility Feasibility of collecting and using nursing shift patterns data in acute, community and mental health wards Principal Investigator: Dr Chiara Dall’Ora Team members: Dr Chiara Dall'Ora (Senior Research Fellow in Nursing Workforce, School of Health Sciences, University Of Southampton), Professor Peter Griffiths (Chair of Health Services Research, School of Health Sciences, University of Southampton), Ms Nicky Sinden (Head of Nursing Workforce at Portsmouth Hospitals NHS Trust), Dr Sarah Williams (Associate Director of Research & Improvement, and Academy Lead at Solent NHS Trust), Ms Catherine Smith (Associate Director Workforce Research and Innovation, Southern Health NHS Foundation Trust), Professor Jane Ball (Deputy Head of School (Research & Enterprise), School of Health Sciences, University of Southampton), Dr David Culliford (Senior Medical Statistician, School of Health Sciences, University of Southampton), Mr Anthony Austin, PPI contributor Start: 1 October 2020 Ended: 31 December 2022 Partners: University of Southampton, Portsmouth Hospitals NHS Trust, Solent NHS Trust, Southern Health NHS Foundation Trust. UNISON, Royal College of Nursing Lay summary Nurses and care assistants form the largest group of NHS staff. Most work in services that provide care across 24 hours of the day. Research indicates that the organisation of nursing shift patterns might affect the productivity of health services. The introduction of long shifts in nursing was offered as a strategy to maintain service levels while eliminating overlaps. However, research has found that long shifts are associated with higher rates of sickness and poorer patient care. So far, there has been little research exploring individual factors influencing shift work experiences among nurses, and research has been largely confined to acute hospitals. What did we learn/find out? Working long shifts (12-h or longer) leads to more burnout for nursing staff Having little choice around shift patterns leads to more nursing burnout Nurses working 12-h shifts reported lower choice around shift patterns than nurses working 8-h shifts When wards in Mental Health and community hospitals operated with high proportions of long shifts, there were higher rates of patient incidents This was particularly the case for self-harm incidents and incidents of patient disruptive behaviour What difference can this new knowledge make? It will help nurse managers and those in charge of creating nursing rotas It will help nurses working in inpatient settings choose their shift patterns It will keep patients safer because they will be cared for by nurses who are less tired Why is this important for patients, health and care providers and policy makers ? Nursing burnout is at an all time high, and we provided evidence that can help alleviate burnout Improving patient safety is of paramount importance for any health organisation, and our findings support changes to work organisation to improve patient safety What we are going to be doing next? We will keep disseminating our findings by publishing further papers We are now co-developing feasible changes to shift patterns with nursing staff and their managers as part of our new project We have applied for further funding to maximise analysis of datasets we have created as part of this study Publications https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-022-00731-2 Shift work characteristics and burnout among nurses: cross-sectional survey | Occupational Medicine | Oxford Academic https://onlinelibrary.wiley.com/doi/10.1155/2023/6626585 https://onlinelibrary.wiley.com/doi/10.1111/jocn.16974

The feasibility of community pharmacies testing for Hepatitis C in people who inject image and performance enhancing drugs Principal Investigators: Dr Ryan Buchanan Team members: Dr Ryan Buchanan (Academic Clinical Lecturer Hepatology, Faculty of Medicine, University of Southampton), Professor Salim Khakoo (Professor of Hepatology, Faculty of Medicine, University of Southampton), Dr Charlotte Cook (Hepatology Research Fellow, University Hospital Southampton), Dr Mark Wright (University Hospital Southampton NHS Foundation Trust), Charlotte Matthews (Southampton City Council), Dr Gemma Ward (Public Health England) , Colin McAllister (Southampton City CCG), Stuart Smith ( Hepatitis C Trust ), Mark Wright (NHS England, Wessex Operational Delivery Network for Hepatitis C ), Pamela Campbell (Solent NHS Trust, Homeless Healthcare Team) Start: 1 December 2019 Ends: 1 January 2024 Project Partners : University of Southampton, University Hospital Southampton NHS Foundation Trust, Solent NHS Trust, NHS England, Public Health England, Southampton City CCG, Southampton City Council, Hepatitis C Trust. Lay summary: The people at highest risk of Hepatitis C (HCV) in the United Kingdom (UK) are those who are sharing needles, syringes or injecting equipment. This includes people who inject performance and image enhancing drugs (PIEDs) such as steroids.This population are high users of needle and syringe programmes, however, the risks taken by this population and their access to testing for HCV are poorly understood. The information that is available is not consistent, with the proportion of people with HCV varying widely but may be as high as one in seven PIED users. The study has been discussed in detail with bodybuilders, a gym owner, pharmacists and people who work at needle and syringe programmes (NSPs). The bodybuilders were very keen to be involved in the study as they want to have accurate, scientifically performed studies. They feel strongly that the information that is out there currently is not representative of their community that use PIEDs. They also felt that it was important that to have a focus on HCV but they were keen to be involved in a study that also addresses at other elements of liver health. The methodology for the study were discussed and adapted after patient and public involvement (PPI) meetings.The aim of this study is to see if widening access to testing of HCV based in community pharmacies with a pathway into specialist care is able to provide improved and acceptable access to testing and treatment compared with standard care. We also want to gain a better understanding of the burden of HCV in this group of people who are using PIEDs, and an understanding of risk behaviours. We will also investigate knowledge of liver disease caused by other factors (e.g. alcohol and obesity). This will be done via interviews with bodybuilders to understand more about their behaviour and the risks they take. This will be followed by a survey with an associated HCV test and measurement of liver scarring. The information gained from the interviews, surveys and tests will give a far greater understanding of this population and their risk of HCV. This information can then be used to target at-risk groups and to adapt current approaches with the aim of elimination. The results will be disseminated in medical journals and presented at medical conferences. Publications doi.org/10.1111/jvh.13207 https://doi.org/10.1111/jvh.13554 https://doi.org/10.1093/ijpp/riac064 http://dx.doi.org/10.1136/gutjnl-2022-BASL.130 http://dx.doi.org/10.1136/gutjnl-2021-BASL.40 https://doi.org/10.1111/jvh.13786 https://doi.org/10.1016/S0168-8278(20)32040-7

ADOPTED PROJECT: Breast Cancer Choices: Evaluation and implementation of a digital patient-centred decision aid to support genetic testing in mainstream care. ADOPTED PROJECT: Breast Cancer Choices: Evaluation and implementation of a digital patient-centred decision aid to support genetic testing in mainstream care. Principal Investigator: Dr Katherine Morton, Senior Research Fellow Team: Dr Gillian Crawford, Consultant Genetic Counsellor, University Hospital Southampton NHS Foundation Trust, Dr Lucy Side, Consultant and Lead Clinician in Clinical Genetics, University Hospital Southampton NHS Foundation Trust, Dr Jackie Chandler, Evaluation Programme Manager (Qualitative), Wessex Academic Health Science Network, Dr Kate Lippiett, Senior Research Fellow, Wessex Cancer Alliance, Prof Diana Eccles, Dean of Medicine, Professor of Cancer Genetics, Faculty of Medicine, University Hospital Southampton, Prof Claire Foster, Professor of Psychosocial Oncology, University of Southampton, Mrs Lesley Turner, Patient and Public Involvement contributor, Ms Kelly Kohut, Consultant Genetic Counsellor, St George’s University Hospitals NHS Foundation Trust Start date: 1 May 2022 End date: 1 May 2024 Background The demand for genetic testing for inherited cancer susceptibility is rising and services are increasingly being provided in mainstream care. In Wessex last year, more than 180 genetic tests were offered to cancer patients in mainstream care, and this will increase in 2022 as more genetic services become mainstreamed and eligibility criteria are expanded. This means that genetic testing is offered by clinicians such as oncologists, surgeons and cancer nurse specialists rather than Clinical Genetic services. It is part of a move to routinely offer genetic testing to all cancer patients where there may be clinical benefit. The results of genetic testing can improve health outcomes by informing optimal treatment pathways and facilitating cancer prevention or early detection in family members. However, deciding whether to have genetic testing is a complex, personal decision with potentially life-changing implications for the patient and family. Many people with cancer are faced with this decision shortly after diagnosis, at an already stressful time. Without the support of specialist genetic counsellors to discuss the medical, psychological and social consequences of genetic testing, it is essential that these patients are given accessible and appropriate support as a complement to clinical conversations. Mainstream clinicians feel they lack the necessary skills and time to support patients in this complex decision process. Web-based decision aids could offer an effective solution, giving patients the flexibility to reflect on and discuss information about genetic testing in their own time, in light of their own personal values. Breast Cancer Choices is one such web-based decision aid which was developed through a two-year research project funded by Breast Cancer Now involving extensive patient input and a review of evidence. By evaluating the implementation of Breast Cancer Choices in mainstream services, we would not only provide improved support to breast cancer patients currently undergoing this difficult process, but also identify wider-reaching implications regarding how best to support patients with other cancers in the national move towards genetic testing. As 1 in 2 people in the UK are expected to develop cancer in their lifetime, with 5-10% of these cancers estimated to be due to inherited predisposition, a clear implementation strategy for mainstream genetic testing is essential. Overall, the project aims to evaluate the impact of Breast Cancer Choices on patient’s decision making and clinician experiences in mainstream care, and to understand how web-based decision aids can be effectively implemented across mainstream cancer care.

ADOPTED PROJECT: Happier Feet ADOPTED PROJECT: Happier Feet Disrupting the vicious cycle of healthcare decline in Diabetic Foot Ulceration through active prevention: The future of self-managed care Chief Investigator: Dr Andrew Weightman – University of Manchester Project Team Members: Dr Katherine Bradbury – University of Southampton, Professor Helen Dawes – University of Exeter, Mr Andrew Eccles – University of Strathclyde, Dr Safak Dogan – Loughborough University, Dr Glen Cooper – University of Manchester, Professor Frank Bowling – University of Manchester, Dr Xiyu Shi, Loughborough University, Professor Ahmeet Kondoz– Loughborough University Organisations Involved: Diabetes UK Background: There is a significant unmet clinical need for an adaptable, acceptable and adoptable technology to identify and prevent diabetic foot ulcer (DFU) formation, to enable self-management and timely clinical intervention to improve outcomes and reduce the economic burden of healthcare provision. Our primary purpose is to develop and implement an adaptable, acceptable, and cost- effective smart sensing insole technology which can detect when a DFU is likely to occur and can adapt plantar tissue loading to prevent formation, thus enabling self-management. This project proposes to build and expand on current smart insole technologies for the detection of DFUs, utilising a sensor fusion approach for their identification. A smart insole with integrated pressure (normal, shear), temperature, gait (IMU) and mechanomyography (acoustic) sensors will identify early indicators of ulceration and when movement is appropriate/inappropriate. The smart insole will respond to these inputs and adjust the foot (and gait), through an array of artificial muscles, to support better (safe/ comfortable) movement. This project aims to co-develop this new smart sensing insole with people living with diabetic foot ulcers. We hope to establish: What patients think of the idea of a smart sensing insole for early detection of DFUs which includes the provision to adjust the foot to reduce pressure on areas of likely ulceration. A prototype insole and optimised this with patient feedback. Early safety testing of this device. Security protocols to enable secure storage and sharing of data from this insole (e.g., between patient and clinicians).

Pharmacological And Non-Pharmacological treatment of ADHD in Pre-schoolers: a systematic review and network meta-analysis: the PANPAP study Lead applicant: Professor Samuele Cortese Co-applicants: Andrea Cipriani, Corentin Gosling, Luis Farhat, Cinzia Del Giovane Background: Children with Attention-Deficit/Hyperactivity Disorder (ADHD) have problems with attention and need to move more than most children. About 5% of school-aged children and 2% of pre-schoolers have ADHD, respectively. This translates into almost 10,000 pre-schoolers with ADHD in the South West England area. Interventions for ADHD include pharmacological and non-pharmacological treatments. When not treated, ADHD entails a significant burden to society, estimated at more than £20,000 per year. Therefore, it is important to detect and treat ADHD in the early years to prevent the negative consequences of ADHD later in life. Experts and ADHD support groups agree that the NHS does not meet the needs of pre-schoolers with ADHD. Currently, there are either long waiting lists or no services for pre-schoolers with ADHD in the NHS. To provide the best care for pre-schoolers with ADHD, we need to make sure that the NHS offers treatments that work well and are safe. In 2018, the National Institute for Health and Care Excellence (NICE) recommended mainly non-pharmacological interventions (behavioral interventions) for the treatment of pre-schoolers with ADHD. Back then, there was a paucity of studies on other non-pharamcological interventions and on medications for ADHD in pre-schoolers. Since 2018, there has been an increasing number of studies on other types of interventions (e.g., family-based interventions and diet) and on medications. There has also been an increasing trend in some countries (e.g., USA) to use medications for pre-schoolers with ADHD. Therefore, we need to understand which is the best intervention for pre-schoolers with ADHD. Aim: To compare the efficacy and safety of pharmacological and non-pharmacological interventions for ADHD in pre-schoolers. Methods: We will not do a new study, which would be very expensive. Rather, we will use a new type of research, called “network meta-analysis”. This approach uses data from available studies to compare different types of treatments even when they have not been compared directly in the individual available studies. Therefore, we will first systematically search for published and unpublished studies of any pharmacological or non-pharmacological treatment for pre-schoolers with ADHD. We will then combine the information from these studies with a state-of-the-art statistical approach. We will finally assess the quality of the studies included in the analysis and the strength of the evidence that we will generate. We are well known experts in this type of research. The study will be conducted at the University of Southampton, in collaboration with international researchers, including a statistician with renowned expertise in this type of analysis. Impact: The findings of our research are expected to inform future regional, national and international guidelines on the treatment of ADHD in pre-schoolers. As such, our results will be disseminated to local commissioners and policy makers, NICE, and international guidelines groups such as the European ADHD Guidelines Group. We will also disseminate our findings to associations of families with children with ADHD in the Wessex area, at the national (for example, National Attention Deficit Disorder Information and Support Service, ADDISS), and international level (ADHD Europe).