NIHRDataInsights/HRCSData huggingface dataset:
Title: Investigation of the Clinical and Economic Effectiveness of Direct Transportation of Head Injury Patients to Specialist Neuroscience Care.
Funder: Department of Health (England)

Abstract: Introduction: Epidemiological evidence suggests that early specialist neuroscience care may be beneficial in severe traumatic brain injury. The optimal strategy for obtaining precise estimates of costs and outcomes of this strategy would be through a randomised controlled trial (RCT), however a definitive trial is likely to be expensive and challenging to undertake. The HITS-NS pilot study has been funded by the Health Technology Assessment Programme to investigate the feasibility of conducting such a randomised controlled trial (RCT). • Fellowship objectives: To identify potential barriers, and determine the utility of a RCT examining early NC care. • Design: Stream A: Analysis of pilot study data to identify barriers to a cluster RCT examining early NC care, and surveying patients, family and staff to determine acceptability of treatment arms Stream B. Evidence synthesis, using statistical modelling of existing observational data and pilot study data to investigate the clinical and cost effectiveness of early NC care. • Expected Outcomes: Identification of barriers and potential solutions to pre-hospital TBI trials. Evaluation of sources and magnitude of uncertainty surrounding clinical and economic effects of early NC care, informing future full trial design in selection of setting, study population, and sample size calculation. Evaluation of the expected value of sample information will determine if a full clinical trial represents a cost effective use of resources. • Anticipated benefits: Results will inform NHS trauma system reconfiguration, and guide design of future pre-hospital emergency care trials.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES;8.2 HEALTH AND WELFARE ECONOMICS
Health categories: INJURIES AND ACCIDENTS
Title: Epidemiology of injuries in children with Attention-Deficit Hyperactivity Disorder in the General Practice Research Database (GPRD) and linked databases.
Funder: Department of Health (England)

Abstract: Accidental injuries cause significant childhood illness and death worldwide. Childhood Attention Deficit-Hyperactivity Disorder (ADHD) is common and there is conflicting evidence about whether it increases the risk of accidental injuries. We also do not know whether treating ADHD reduces the risk of accidental injuries. If we can answer these questions, this information can help children and parents make informed decisions about their treatment, and possibly also prevent accidental injuries. I will use routinely collected computerised GP and hospital records. Firstly, I will estimate how many children in the UK have a clinical diagnosis of ADHD. Secondly, I will assess how well GP's record information about childhood injuries and how well this agrees with information recorded by hospitals. Thirdly, I will estimate the risk of a range of childhood injuries by comparing the occurrence of accidental injuries in children with and without ADHD. Finally, to find out if taking medication for ADHD helps reduce injuries, I will compare the occurrence of accidental injuries during times when children are, and are not taking medication for ADHD. This will help children and parents make more informed decisions about their treatment and help health care providers give appropriate advice about preventing injuries


Research activity codes: 1.4 METHODOLOGIES AND MEASUREMENTS
Health categories: INJURIES AND ACCIDENTS
Title: Multisite pain and falls in older people
Funder: Department of Health (England)

Abstract: Pain in more than one part of the body (multisite pain) becomes common with advancing age and is associated with increasing risks of falls. This novel research aims to establish a relationship between multisite pain and falls in a UK population and identify factors that influence this relationship. A unique dataset enables survey response linkage with GP consultations and national health statistics. This research will highlight the importance of GPs identifying their older patients with multisite pain as the first step in preventing falls and provide a basis for future research into falls prevention in older people with multisite pain.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: INJURIES AND ACCIDENTS
Title: EPSRC - NIHR Healthcare Technology Co-operative (HTC) Partnership Award - Unify: A network focused on the treatment of fracture non-unions
Funder: Engineering and Physical Sciences Research Council

Abstract: This proposal is tightly focussed on addressing major unmet clinical needs in the repair and rehabilitation of non-union fractures, in particular for long-bone and cranio-facial trauma. A non-union is a broken bone that fails to heal. These result from both civilian and military injuries including the consequences of cancer and lead to pain, suffering and loss of dignity. Our aim is to create a co-ordinated self-sustaining network linking the Trauma HTC and other major UK clinical research centres, both civilian and military, in order to pull solutions from the science and technology research community and assist their translation to the clinic. The network will link with centres of expertise and research excellence in healthcare technologies supported by EPSRC and others, and to industry and other key stakeholders including patients. This network will ensure, by a programme of activities with both proven and novel components, that these disparate communities are empowered to explore together those areas where new scientific and technological opportunities have the promise to resolve important clinical problems


Research activity codes: 6.9 RESOURCES AND INFRASTRUCTURE (TREATMENT EVALUATION);5.9 RESOURCES AND INFRASTRUCTURE (TREATMENT DEVELOPMENT)
Health categories: INJURIES AND ACCIDENTS
Title: Modelling developmental trajectories of novice drivers with high and low crash liability
Funder: Economic and Social Research Council

Abstract: Road traffic crashes are one of the greatest threats to public health, particularly for young people, with a substantial social and economic cost to society. Novice drivers are overrepresented in casualty statistics, with risk being particularly high in the first six months of their driving careers. There is evidence that both deficiencies in driving skills and decisions to adopt risky driving styles (e.g., speeding and overtaking in dangerous places) contribute to novice vulnerability. Averaged over all drivers, the rate of collisions declines rapidly over the subsequent 18-24 months but does not plateau until drivers reach approximately 30 years of age. While the prevalence of road traffic injuries for novice drivers is well documented, there is still relatively little understanding of why crash liability is particularly high in the first three months of driving before decreasing steadily over time. Rather than all drivers following the same developmental pathways, we believe different types of novice driver will follow different trajectories of crash risk and behavioural development. For example, our preliminary analyses of the proposed dataset indicate that crash involvement differs on the basis of risky attitudes at the time of passing the driving test. Participants scoring in the top third of a risky attitudes scale showed an initially high rate of crash involvement that declined steeply after the first 6 months. The participants with less risky attitudes were at lower initial risk of crash and their risk did not show a similar pattern of decline. Our available resources meant our preliminary analysis could only use basic techniques. The full project will employ advanced statistical modelling techniques to identify sub-groups of novice drivers following different developmental trajectories of crash involvement and driver behaviour. We will then explore the extent to which trajectory is predicted by modifiable risk factors such as driving behaviour and experiences in learning to drive. These results will guide policy on education, assessment and management (e.g., graduated licensing) of learner and novice drivers to encourage drivers onto the lower risk trajectories rather than the higher risk.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: INJURIES AND ACCIDENTS
Title: Interdisciplinary Perspectives on Learning from Incidents (IP-LFI)
Funder: Economic and Social Research Council

Abstract: Interdisciplinary Perspectives on Learning from Incidents (LFI) is a seminar series advancing research that informs policy and practice in health and safety. Effective learning from incidents is critical for people working in hazardous environments, to ensure they are safe at work and to protect the environment from catastrophic accidents. This research is interested in improving our understanding of the theories, methods, practices and policies related to learning from incidents. The seminar series is the first of its kind in the world. Learning from incidents is important across a range of industries and is relevant for professional and government bodies and third-sector organisations concerned about Health and Safety. The series brings together practitioners and policymakers with researchers from a range of academic disciplines to provide new theories, methodologies and organisational change methods that can be applied by organisations to improve health and safety across a range of industries. Running for two years, the seminar series comprises six interdisciplinary seminars, including presentations from researchers, practitioners and policy makers from a range of industry, health and commercial contexts, allowing sufficient time for debate and discussion and stimulating co-production of knowledge. Participants are established scholars and early-career researchers from the UK, Finland, Italy, and Spain who have expertise in Adult and Organisational Learning; Sociology (Sociology of Risk and of Work); Industrial Psychology; Human Factors Engineering; and Ethnomethodology. Series' participants include practitioners from a range of industries (BP, Phillips66, Land Securities, Sir Robert McAlpine, FirstGroup plc, McNicholas Construction, Barhale, Balcas Timber, E.ON) and professional and government bodies as well as third-sector organisations (Energy Institute, British Safety Council, Health and Safety Executive for GB). Outputs from the seminar series include an interdisciplinary research agenda in learning from incidents and an edited volume, synthesising scientific contributions from research and relevant case studies from industry.


Research activity codes: 8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES);8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: INJURIES AND ACCIDENTS
Title: Real-time detection of the onset of secondary brain injury in the intensive care unit.
Funder: Department of Health (England)

Abstract: Traumatic Brain Injury (TBI) - a major cause of death and disability in all age groups, and the most important cause of these outcomes in working people, is now recognised as a silent epidemic' in the United Kingdom and worldwide. Central to TBI's devastation is a delayed secondary' injury that occurs in 30% of TBI patients each year, while they are receiving Intensive Care. Currently, secondary injury is unpredictable, hence unpreventable. This project will deliver a new solution: a real-time Brain Injury Index. This will be produced with a new clinical instrument that will collect electrical and chemical signals from the injured brain, process them and for the first time derive clinically useful risk factors in real-time that will assist doctors with diagnosis and treatment. The healthcare implications are important: The Brain Injury Index will show clinicians when secondary damage is starting and what is causing it. This will allow them to start the best treatment for that patient at the right time. The Brain Injury Index instrument will save lives, and reduce (a) severe disability with its huge personal cost to patients and their families, and (b) costs of care (£1600 per ICU day). This makes a compelling case for widespread adoption.


Research activity codes: 4.1 DISCOVERY AND PRECLINICAL TESTING OF MARKERS AND TECHNOLOGIES
Health categories: INJURIES AND ACCIDENTS
Title: An investigation of measures to reduce dog attacks and promote responsible ownership amongst dog owners with dog control issues in the UK.
Funder: Department for Environment, Food and Rural Affairs

Abstract: Description Some two years ago, Government introduced measures under the Anti-social Behaviour, Crime and Policing Act 2014 that can be used to help prevent incidents involving a dog from escalating to something more serious. Examples of such incidents might include but not exclusively: too many dogs on a property, dogs causing a nuisance, excessive barking, dogs running loose in a park, dogs persistently escaping from a property. The most basic level of the new measures is a Community Protection Notice which can be served on anyone causing anti-social behaviour including where that involves a dog. Government produced comprehensive guidance on the use of the measures in relation to dogs.Defra is in the process of conducting a light touch predominantly closed question survey of relevant representatives from the police, local authorities and social landlords on the extent they use this new legislation and to identify any key barriers. A primary objective of this qualitative research will be to supplement and complement that survey, to provide a more in-depth understanding of some of the challenges faced by authorities in implementing the measures as well as perceptions of current effectiveness and how this might be improved. Objective 1. To explore current use and perceived effectiveness of powers granted to Local Authorities and Police forces to tackle the issue of dangerous dogs, and to identify practical opportunities for improvement. 2. To understand current collection and use of data relating to dangerous dogs by various authorities and to identify practical and proportionate opportunities to improve data collection and sharing.


Research activity codes: 6.6 PSYCHOLOGICAL AND BEHAVIOURAL;8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: INJURIES AND ACCIDENTS
Title: Characterising the burden of organ dysfunction after traumatic injury in older patients
Funder: Dunhill Medical Trust

Abstract: For the first time there are 11 million people aged 65 or over in the UK1. The number of older people suffering traumatic injury is increasing2-5, and many of those who survive the early period after injury will develop organ dysfunction (OD)6. Younger patients who develop OD recover quickly7, whereas in older age it appears to be complicated and persistent8-10, and is associated with prolonged hospital stays, increased late mortality and delayed recovery to pre-injury state11-13. It is possible that older immune systems react differently to injury when compared to younger patients10,14,15. Previously, we have examined relationships between trauma, infection and OD in injured cohorts16-18 but have not focused specifically on older patients. To improve longer-term recovery for older people we wish to conduct a prospective study to evaluate drivers, patterns and outcomes of OD, and determine to what extent it is related to factors associated with ageing or frailty.


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS
Health categories: INJURIES AND ACCIDENTS
Title: Looking in the right places to prevent stair falls in older adults
Funder: Dunhill Medical Trust

Abstract: Falling on stairs is the leading cause of accidental death in older adults and yet little is known about the causes. We do know that: a) looking at environmental features at appropriate times is crucial for safe balance and stepping during walking, b) older adults with high falls risk show altered gaze patterns during level walking compared to lower-risk older and younger adults c) this behaviour is linked to inaccurate stepping and d) optimizing gaze behaviour can improve stepping safety. The proposed study will: 1) Assess the effects of changing stairwell illumination and stair décor on gaze behaviour, balance and stepping accuracy 2)Develop guidelines for optimizing lighting and stair décor in older adults’ homes through consultation with older people, falls prevention services and built environment design experts and 3) Assess the feasibility and acceptability of our proposed intervention to inform the design of a future pilot RCT


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: INJURIES AND ACCIDENTS
Title: Safe in my own home? Investigating the impact of community home modification services on hospital utilisation for fall injuries: a controlled longitudinal study using data linkage
Funder: Health and Care Research Wales (Welsh Government)

Abstract: We will evaluate the effectiveness of home modifications aimed at giving people the choice to stay safe in their own home rather than move to a costly nursing home or remain in hospital “bed blocking”. We will evaluate interventions and compare fall injury rates, for those individuals aged 60 years and over both before and after the intervention, adjusting for age and global trends. Our principal aim of the study is to evaluate impact of home modification interventions on fall-related hospital admissions. Ultimately we will find which home modifications are most effective at reducing falls for different older people. Design: An event history approach with Poisson mixed models used to achieve an estimate of the intervention effect for the mean number of falls. Setting: Individual homes throughout Wales, UK. We are able to retrospectively and anonymously link intervention data to specific homes and link through to individual health. The participants will be the anonymous individuals aged 60 years and over who have received a C&R referral or self-referral from 2009-2017. All persons aged 60 years and over in Wales will be assigned a frailty indes to observe global admission trends, and will use this within an extension of a difference in difference analysis. Interventions evaluated: Advice visits and physical interventions to improve the home as completed by Care & Repair Cymru, and the impact of combinations/types of fall-related interventions on the health proxy of hospital admissions for falls. Measurement of outcomes and duration of follow up: Primary outcome data will be fall emergency hospital admissions obtained from the Patient Episode Dataset for Wales (PEDW) dataset for the period 2009 – 2017. For all individuals matched within SAIL we will extract corresponding individual level data from PEDW. This evaluation will investigate potential delay to move to care home as secondary outcome. Sample size: We will analyse C&R intervention data and corresponding health data in SAIL. We have a total of 83,162 homes and 86,493 people (2009-2012) and will link an additional 4 years of data, providing us with sufficient power to detect a meaningful change in hospital admissions to an overall intervention level; and potentially to type of intervention. We will create event histories at a quarterly resolution containing hospital admissions for each person living in a C&R modified home compared to a group of equally frail people. Data will be analysed


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: INJURIES AND ACCIDENTS
Title: Exploring the economics of hospital care for people with dementia
Funder: Health and Care Research Wales (Welsh Government)

Abstract: This PhD will use a mixed methods approach (questionnaires and interviews) to explore lengths of stay for people with dementia admitted to hospitals in Wales. The PhD will begin with a literature review of what is currently known about hospital stays for people with dementia and the associated economic costs. A quantitative analysis of lengths of stay for people with dementia admitted to Betsi Cadwaladr University Health Board (BCUHB) hospitals in the year 2013 will follow. The student will conduct case studies at a hospital ward in Wales where the length of stay for people with dementia is higher than the Welsh average and a ward where the length of stay is shorter than the Welsh average. Whilst there, the student will talk to hospital staff about current practice to identify what works well and not so well. The student will then conduct an all Wales survey of a sample of NHS hospital staff to find out what best practice initiatives for dementia care in hospitals have already been adopted and how successfully the policies have been implemented. The thesis will conclude with an analysis to explore the effect of changing current funding patterns to make hospital stays a better experience for people with dementia and their carers.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;7.3 MANAGEMENT AND DECISION MAKING
Health categories: INJURIES AND ACCIDENTS
Title: Developing a clinical prediction tool to assist with the diagnosis of Abusive Head Trauma (AHT) in children less than two years of age
Funder: Health and Care Research Wales (Welsh Government)

Abstract: Abusive head trauma (AHT) is considered to be one of the more serious types of child abuse. It is one of the top causes of death from abuse in infancy and early childhood, and the consequences for those children that survive are severe. Of children with an AHT, 13-30% will die and over 50% of survivors will become disabled, compared to 7% of children who experience accidental head trauma. It is thus vitally important that AHT is diagnosed accurately, so that doctors can intervene, refer the child to social services, and prevent any further abuse from occurring. However, it is also important that accidental cases are not wrongly diagnosed as abusive. This can have devastating consequences for the families involved. Unfortunately doctors lack confidence and experience in distinguishing between accidental and abusive injuries in children. This is partly due to the fact that there is no one simple diagnostic test to accurately diagnose AHT. Diagnosis relies on a thorough medical examination and investigation to identify the full clinical picture of the presenting child. The clinician must then piece the evidence together to come to a decision based upon the probability that the injuries sustained are accidental or abusive. This study aims to develop a simple evidence-based clinical prediction tool which doctors can use to help them distinguish between AHT and accidental head trauma. The tool will measure and combine the predictive contributions of the various injuries seen in individual children, to estimate the probability of AHT versus accidental head trauma.


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS
Health categories: INJURIES AND ACCIDENTS