NIHRDataInsights/HRCSData huggingface dataset:
Title: Post-Intensive Care Risk-adjusted Alerting and Monitoring (PICRAM).
Funder: Department of Health (England)

Abstract: One tenth of the 85,000 patients discharged annually from UK intensive care units (ICUs) recovering from their acute illness, die before leaving hospital. Frequent visits to the patients' wards by the ICU team reduce this risk, but suitably trained nurses are expensive and in short supply. We plan to develop a comfortable, wearable device to automatically measure vital signs in patients discharged from the ICU. Using the hospital wi-fi network we will monitor the patients' vital signs continuously with a computer system, which will also be programmed with information on each individual patient's risk of deterioration. If the computer detects a change in the patients' vital signs, it will alert medical staff. This approach allows us to monitor far more patients, for a far longer time, than would be possible using nurses alone, whilst minimising false alarms by tailoring the alarm limits to each individual patient. Even modestly reducing these deaths to one in twelve discharged patients would save 1,400 lives annually, equivalent to more than half the road deaths in Great Britain. Compliance with government guidance, reduced costs, improved safety and a reduction in insurance premiums would all be used to persuade healthcare teams to adopt the system.


Research activity codes: 4.1 DISCOVERY AND PRECLINICAL TESTING OF MARKERS AND TECHNOLOGIES
Health categories: GENERIC HEALTH RELEVANCE
Title: Tissue oxygen monitoring for detecting impending shock states and guiding therapy in the critically ill and those at high-risk.
Funder: Department of Health (England)

Abstract: Complications frequently occur following trauma, infection and major surgery. This can lead to failure of organs (e.g. lung, kidney, gut) necessitating admi ssion to intensive care for organ support. Mortality rates are high and long-t erm disability common in survivors. Studies show how early resuscitation of th e circulation in these patients can considerably improve outcomes. We can curr ently gauge how much blood the heart is pumping to the tissues. However, we ne ed better bedside monitors to assess if this cardiac output is actually adequa te for the organs. Patients who are unwell or undergoing major surgery routine ly have a bladder (Foley) catheter placed to drain urine. We can use this cath eter to insert a small, flexible fibre-optic based sensor to continuously moni tor oxygen levels within the bladder wall. This indicates whether or not the l ocal blood supply (perfusion) is adequate and can reflect the situation in oth er parts of the body. We plan to study whether this offers an easy and readily applicable solution to monitoring tissue health during acute insults. If so, we plan to perform a further clinical investigation in which the circulation i s optimised with this device to see if such complications can be significantly reduced.


Research activity codes: 4.2 EVALUATION OF MARKERS AND TECHNOLOGIES
Health categories: GENERIC HEALTH RELEVANCE
Title: Translation of whole genome sequencing into clinical practice
Funder: Department of Health (England)

Abstract: Genetic diseases occur when changes in a particular gene (called mutations) disrupt its normal function. There are many diseases that are caused by mutations in an individual's DNA sequence. However, our knowledge of the causative genes is often incomplete, and many patients remain undiagnosed even when all possible tests have been performed. Furthermore the testing process is slow since genes are often tested one at a time, for technical and economic reasons. This project aims to improve this situation, by working out how new DNA sequencing technology, which can test an individual's whole DNA sequence at once, can be used for genetic testing in the NHS. This should lead to much higher rates of success in diagnosing genetic conditions. However, there are many technological hurdles to overcome in the collection and use of this 'whole genome' sequence data, and the way in which genetic testing is conducted in the NHS will need to adapt. Our goal will be to ensure that this new sequencing technology is rolled out in the NHS in a socially responsible manner so that any patient with a genetic disease can benefit, providing a benchmark for the NHS more widely, and other countries


Research activity codes: 4.1 DISCOVERY AND PRECLINICAL TESTING OF MARKERS AND TECHNOLOGIES
Health categories: GENERIC HEALTH RELEVANCE
Title: Real-time Adaptive & Predictive Indicator of Deterioration (RAPID)
Funder: Department of Health (England)

Abstract: Of the 1.5 million children admitted to UK hospitals every year; 650 suffer cardiac arrests and 3000 die. Most have signs that indicate deterioration before the life-threatening event. Current early warning scores have reduced avoidable life-threatening illness and death, but these systems need to be improved. Deterioration can be missed when vital signs change rapidly, observations are made infrequently and slowly deteriorating trends can occur between alarm thresholds. We propose a system where continuous observations are taken from patients and use this data to understand, in real-time, what is normal for each patient and detect the changing patterns in their physiology. Small chest and hand sensors wirelessly connect patients in the wards. Continuous monitoring allows us to catch the point of deterioration, trigger an alert and provoke timely intervention preventing patients suffering further deterioration and death. The technology is software adapted from Formula 1, Aston University and Birmingham Children's Hospital algorithms that is interfaced seamlessly with NHS IT systems The key goals are to deploy RAPID in two cardiac wards, demonstrate reliable collection and processing of data, provide clinical interpretation of processed data and create new patient pathways for better and more effective utilisation of nursing and doctors.


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING
Health categories: GENERIC HEALTH RELEVANCE
Title: Centre for Translational Research in Public Health
Funder: Cancer Research UK

Abstract: Fuse - the Centre for Translational Research in Public Health is one of five Centres funded as part of the UKCRC Public Health Research: Centres of Excellence. Fuse brings together the universities of Durham, Newcastle, Northumbria, Sunderland and Teesside to support the transformation of health across the North East; researching and applying knowledge in policy and practice in the areas of health development, obesity, chronic disease and associated risk factors.


Research activity codes: 8.5 RESOURCES AND INFRASTRUCTURE (HEALTH SERVICES);8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: GENERIC HEALTH RELEVANCE
Title: Healthy Eating and Lifestyle in Pregnancy
Funder: Cancer Research UK

Abstract: Around 1 in 5 pregnant women in the UK are obese. Obesity is linked generally to poor health and also pregnancy complications. Retaining weight gain following pregnancy can lead to long-term obesity. There is evidence that excess maternal weight gain during pregnancy is associated with obesity in the child at 3 years and in adolescence, which suggests there is potential for influencing not only the mother?s lifestyle but the new child?s weight and the family?s health behaviour. Intervening with pregnant obese women and equipping them with the skills, knowledge and support necessary to manage their weight effectively during pregnancy and after childbirth is an important step in tackling overweight and obesity among women of child bearing age. This study is a cluster randomised controlled trial which will examine whether a weight management intervention for obese pregnant women, which targets physical activity and healthy eating, is effective in reducing women?s BMI at 12 months from giving birth and at what cost. Secondary outcomes include; pregnancy weight gain, quality of life, mental health, waist-hip ratio, child weight centile, admission to neonatal unit, diet, physical activity, pregnancy and birth complications, social support, self regulation and self efficacy. Twenty maternity units will be recruited and midwives will be trained in recruitment and the intervention. These units will be randomised, ten to the intervention group and ten to the control group. We will recruit women over 18 with a BMI of =30 between 12 and 20 weeks gestation, 570 women will be recruited allowing for a drop out of 30%. Those women attending the maternity units randomised to the intervention group will attend a weekly, 1.5 hour specialist weight management and physical activity support group run jointly by ?Slimming World? and midwives. At each session weight will be monitored and advice given regarding diet, lifestyle and pregnancy. Slimming World advice is similar to that advised for pregnancy and for breastfeeding mothers and offers a balanced unrestricted diet. Additional exercise recommendations will encourage graded, supervised increases in daily physical activity through a walking programme. Women attending control units will receive usual care and a leaflet giving advice on diet and physical activity. Women will be followed up at 36 weeks gestation, 6 weeks post birth, six months and one year after birth. Positive results are likely to lead to refinement and roll-out of the intervention.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: GENERIC HEALTH RELEVANCE
Title: 'A pilot RCT on the effects of behavioural activation, plus physical activity promotion, for depressed patients.
Funder: Cancer Research UK

Abstract: Obesity is an increasing problem in the UK, affecting 25% of the adult population but modest weight loss can reduce the incidence of chronic disease due to obesity. There are some effective weight loss treatments available, but there is no nationally available treatment service in the NHS and GPs rarely discuss weight management with patients or support behaviour change. Brief opportunistic advice by GPs prompts smokers to stop and problem drinkers to reduce but there is no evidence that brief interventions by GPs are effective for weight management. Two recent trials show that commercial weight management services, which most PCTs have ‘on prescription’, are more effective than primary care treatment. Thus, we propose a controlled trial in which patients will be randomised to receive either the offer of help by referral to a weight management service and follow up to assess progress or advice to lose weight on medical grounds. The primary outcome will be weight change at 12-month follow-up. Additional research questions to be addressed include: What actions do people take to manage their weight in response to the two types of GP intervention? How do obese patients feel about GPs discussing weight management when they have visited for reasons other than their weight and how does this vary by intervention type? How do GPs feel about raising the issue opportunistically and giving the two types of brief intervention? What is the cost per kg/m2 lost of the two types of intervention? The trial would take place in the West Midlands and involve 60 GP practices. Research assistants visiting the GP practices would objectively measure weight and height prior to GP consultations and randomise willing patients (BMI 30+, 18+ years) using sealed envelopes. Based on calculations, we anticipate that full recruitment (n=1824) can be achieved in 46 weeks, requiring no more than 6 sessions of advice-giving per GP. Following intervention, participants will be contacted at 3 months via telephone, to identify the actions they have taken to manage their weight. Further, we will book appointments for participants to be seen again at their own surgeries for a 12-month follow-up. The trial results could make the case for brief interventions for obese people consulting their doctor and introduce widespread simple treatments akin to the NHS Stop Smoking Service. Likewise, the intervention could be introduced in to the Quality and Outcomes Framework and influence practice worldwide.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;8.2 HEALTH AND WELFARE ECONOMICS
Health categories: GENERIC HEALTH RELEVANCE
Title: A randomised controlled trial of the effectiveness of brief weight management for obese adults in primary care.
Funder: Cancer Research UK

Abstract: The rising prevalence of adult overweight and obesity and the associated burden of disease are putting increasing pressure on NHS resources. There is an urgent need for treatment options for weight-loss that are clinically and cost-effective and deliverable at scale in primary care. Recent trials demonstrate the acceptability and short term efficacy of primary care referral to a commercial weight loss provider. NHS commissioners now need information on the optimal duration of intervention and the longer term outcomes and cost effectiveness of such treatment to give best value for money. The proposed 2 year randomised controlled trial will evaluate the clinical and cost effectiveness of 3 weight loss treatments that can be delivered in primary care (referral to a commercial weight loss provider (Weight Watchers; WW) for 12 weeks; referral to WW for 12 months; and a brief intervention that consists of standard information and periodic weighing with feedback). Participants will be 1200 overweight and obese adults (BMI 27kg/m² and above; Age 18years and over) identified by their GP as benefitting from weight loss and randomised at a baseline assessment by the research team. Follow up assessments will be made by the research team at 3, 12 and 24 months and data reported to the GP. Main outcomes for evaluation of clinical effectiveness will be changes in weight, fat mass, and blood pressure, and the primary analysis will be an intention to treat analysis of differences between treatments. Secondary analyses will include a completer’s only analysis and the proportion of participants losing 5% or more of initial weight. Evaluation of cost-effectiveness will include changes in quality of life and health care usage over the two year period. A within-trial and long term cost-effectiveness analysis will be conducted from an NHS perspective. Qualitative methods will be used to examine the experience of patients and practitioners involved in the trial and their attitudes to weight loss treatment in primary care in general and to commercial partnerships specifically. The quantitative and qualitative research findings will combine to give meaningful information on the implementation and effectiveness of primary care referral to a commercial weight loss provider and will directly inform commissioning of weight loss treatment in primary care. Plans for dissemination of research findings include specific strategies for health professionals, NHS commissioners and policy makers, as well as the general public and academic peers.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: GENERIC HEALTH RELEVANCE
Title: 'An RCT to test the clinical and cost-effectiveness of primary care referral to a commercial weight loss provider
Funder: Cancer Research UK

Abstract: Childhood obesity is an urgent public health problem yet the identification of effective preventive strategies remains elusive. Parents have a key role in prevention strategies; they are central to the development of their child’s health-related behaviours and are relied upon to distinguish between healthy and unhealthy weight. A wealth of data exist which shows that parents are unable to make this distinction. Previous work in Newcastle and by others has shown that, rather than using objective methods, parents tend to use alternative approaches such as assessing their child’s appearance and comparing them with others to identify their weight status, which, in the context of a high prevalence of childhood overweight and obesity means that they rely on extreme cases as a reference point. We have also shown that parents are more sensitive to visual characteristics (skinfolds and waist circumference) than BMI when determining their child’s weight status. Addressing the disconnect between parents’ perceptions and actual child weight status is important. If parents do not perceive their child as deviating from a healthy weight they are unlikely to take action to implement change. Research indicates that parents who perceive their child’s weight as being a health problem are more likely to make changes to their lifestyle. This multistage study will develop and test measures to improve parents’ ability to correctly assess their child’s weight status (in line with the criteria used in the National Child Measurement Programme (NCMP)), as well to increase their knowledge of the health consequences of childhood overweight. In stage 1 we will use portable 3D body scanning technology to create gender specific body image scales for 4-5 and 10-11 year olds (age groups included in the NCMP). In stages 2 and 3 we will use these scales and evidence from previous research to develop three tools to enable parents to better recognise childhood overweight along with supporting information to increase parental knowledge of its consequences. These two stages will include extensive consultation with parents who will inform the development of the tools and supporting information and the approach to delivery. Two tools will be selected to take forward to a cluster randomised trial in stage 4 to determine which works best. Policy and practitioner partners in the study team will ensure that the study outputs are directly transferable to practice and will support the work of the National Obesity Observatory and NHS Choices.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;2.4 SURVEILLANCE AND DISTRIBUTION;7.3 MANAGEMENT AND DECISION MAKING
Health categories: GENERIC HEALTH RELEVANCE
Title: 'Promoting sustained physical activity following retirement: Development of a brief intervention for older adults
Funder: Cancer Research UK

Abstract: Regular physical activity (PA) can improve physical and mental health and enhance quality of life among older adults. PA promotion attempts among this population have tended to focus on initiation of activity, but problems remain around activity maintenance after cessation of an intervention period. Maintenance of PA can be aided through the development of ‘habits’, whereby PA becomes a relatively automatic response to settings in which PA is usually undertaken. We propose to develop and assess the feasibility of a brief intervention based on provision of simple advice to older adults, with the aim of prompting the formation of PA habits following retirement from work. Such an intervention would be a potentially low-cost, non-resource-intensive method to promote enduring PA change among older adults, so reducing costs of service provision and promoting self-care, self-management, and independence among older adults. In Study 1, an expert panel will develop a set of recommendations for the performance of simple, non-intensive everyday physical activities likely to benefit health and lead to habit formation. The credibility of these will subsequently be assessed via interviews conducted with a panel of older adults (aged 60+). Feedback will be used to refine the recommendations. In Study 2, we will assess the feasibility of recruiting participants to an intervention based on these recommendations, and explore whether the intervention should be expanded so as to incorporate elements of social or community support. A sample of 30 older adults will receive the recommendations. Analysis will focus on recruitment and retention rates, adherence to recommendations, and changes in health between baseline and eight-week follow-up. Semi-structured interviews will explore experiences of using the recommendations, and whether further intervention content is needed to complement the recommendations. In Study 3, the feasibility of administering the intervention, as refined to address intervention content or recruitment issues identified in Study 2, will be assessed among 50 older adults. We will also assess pre-post behaviour changes. Study 4 will use an exploratory controlled trial design to evaluate the intervention administered in Study 3 among 150 older adults that have recently retired or are due to retire imminently. Changes in physical activity, habit, health and functioning will be explored. If Study 4 were to suggest efficacy, future work would subject the intervention to a definitive RCT to assess efficacy and cost-effectiveness, informed by an effect size estimate generated by Study 4.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: GENERIC HEALTH RELEVANCE
Title: 'How can weight loss be maintained? Development of an intervention for weight maintenance after initial weight loss
Funder: Cancer Research UK

Abstract: Prevalence and incidence of obesity in the UK remain high resulting in considerable morbidity, sickness absence, all-cause mortality and economic costs. Weight loss interventions targeting food intake and physical activity produce initial clinically significant weight loss but people usually regain this weight within 3-5 years. Preventing weight regain is vital in tackling the obesity epidemic. To date, no evidence-based interventions are available in the UK that specifically target weight maintenance. We will follow the MRC framework for the development and evaluation of complex interventions and develop an efficient, scalable intervention to support weight maintenance in initially obese adults who lost a clinically significant amount of weight. The intervention will consist of an initial module providing advice, support and resources on weight maintenance through physical activity and a healthy diet resulting in participants setting specific informed behavioural goals to support weight maintenance. The main intervention will be delivered via an automated digital monitoring system recording weighing and weight on provided scales. The intervention content (e.g. advice, reinforcement, feedback) will be sent to participants mobile phones and will be tailored to weight and regularity of weighing, which has been shown to be a key predictor of weight maintenance. Both the technology and the intervention will be developed using state-of-the art methods including participatory design and open pilot studies to optimise acceptability and feasibility of the intervention. The team of applicants has excellent expertise in behaviour change, digital technology, nutrition science, health economics, evaluation and public health and a considerable track record of successful joint collaboration. The intervention development will be informed by a recent systematic review of RCTs of weight maintenance interventions after clinically significant weight loss and by qualitative interview studies with potential users. We will conduct a randomised feasibility and design optimisation trial testing the feasibility and acceptability of the intervention and trial procedures with initially obese adults who lost 10% body weight in the previous year. Moreover, we will randomly allocate participants to four variations of the new intervention representing different delivery costs and test the impact of these variations on treatment completion over 3 months, a measure that is highly predictive of success in weight management programmes. This will allow a better informed, simpler design for the definitive trial and a more refined economic assessment. This project will result in a protocol for a definitive RCT of the new intervention for which we will seek additional funding.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: GENERIC HEALTH RELEVANCE