Research Fund Awards - 2020

Respiratory

Dr Anna Bibby

Award  £19,979 : Can we diagnose cancer of the lung lining (mesothelioma) by testing cancerous fluid for a gene called BAP1?

Mesothelioma is an incurable cancer that affects the outside lining of the lung. In the UK, 2500 people die from mesothelioma every year, which is equivalent to one person dying every four hours.

Anna will use her funding to establish whether it is possible to diagnose mesothelioma on the fluid when it is first removed.  This could allow us to make the diagnosis within two weeks of the patient’s first appointment.  This would shorten the anxious, uncertain time and potentially mean patients didn’t need to have additional tests. 

Anna will test a gene called BAP1, which is part of the DNA building blocks found in every cell in our bodies that make up who we are and how our bodies behave.  In normal cells, the role of BAP1 is to stop tumours appearing and, if they do appear, prevent them growing.  However, when mesothelioma tumours take over normal cells, the BAP1 gene disappears, which is why mesothelioma tumours can grow inside the body. 

We can currently test biopsy samples for BAP1. If it has disappeared, then the diagnosis is definitely mesothelioma.   We want to find out whether we can test BAP1 in fluid as well as biopsies and whether this will be a reliable test for mesothelioma. 

Respiratory

David Arnold

Award  £5000 : Rapid Diagnostics in Pleural Infection

Pleural infection is the collection of infected fluid around the lung. It affects around 15,000 adults in the UK every year. The usual length of hospital admission for this condition is over 2 weeks. Part of the need for such extended hospital stays is due to difficulty for doctors in working out which patients might get better with antibiotics alone, who will need the infected fluid draining and who will require surgery.

David is testing to see whether testing levels of a protein called suPAR in pleural fluid can help us to predict which patients will require hospital admission, a chest drain or surgery,

If this marker could show that some patients could be managed less invasively then this has the potential to reduce the need for procedures and hospital admissions which would be beneficial to patients and the health service.

Intensive Care Medicine

Matt Thomas

Award  £19,688 : Early beta-blockade in severe traumatic brain injury: a pre-randomised controlled trial qualitative study

Damage to the brain following an accident has two forms. Primary injury happens at the moment of impact and cannot be altered. Secondary injury happens in the minutes, hours and days after the event and can be improved by medical treatment. Less secondary injury means patients are more likely to survive, and to survive with less disability.

One cause of secondary injury is adrenaline, a natural hormone released at times of stress. Too much adrenaline can make blood vessels leaky. This causes brain swelling which leads to secondary brain damage.

For this funded research, Matt will be investigating the challenges that researchers face when carrying out this type of research in intensive care to ensure that future trials into beta blockers and traumatic brain injury are successful.

Vascular

Shona McIntosh

Award  £19,986 : Is prognosis discussed with adult patients who have peripheral arterial disease?

Peripheral arterial disease (PAD) is a disease of the circulatory system affecting both sexes and increases in occurrence with age. It happens when arteries narrowed by calcium, cholesterol and fat deposits prevent adequate blood flow to the legs. Patients with inadequate blood supply to limbs are also likely to have narrowed arteries in other areas of their body putting them at increased risk of stroke, heart disease and kidney disease.

Patients with PAD who are facing amputation are likely to have a reduced life expectancy: four in ten patients undergoing amputation die within a year after surgery, and approximately seven out of ten will die within five years. This is a poorer life expectancy than for many people with cancer. Physical and psychological needs may be overlooked in patients with PAD in the last 6-12 months of life by clinicians looking after them because their declining health is difficult to predict.

The aim of Shona’s research is to understand the factors affecting discussions about life expectancy for patients who have PAD, and whether the barriers to having these conversations lie with the patient, the clinician or both.

Psychology

Dr Jo Daniels

Award  £13,805 : A study establishing need and experience of high impact users in A&E with abdominal pain

People who attend the Emergency Department (ED) between 5-10 per year classed as high impact users and over 31,000 people attend ED over 10 times a year. The third most common reason for visiting the Emergency Department is abdominal pain which can be difficult to accurately diagnose or treat. Additionally, there is often no medical cause for the pain.

This is problematic for ED doctors, because although they do not want to overlook a serious medical emergency, they also want to avoid prioritising and spending excess time on patients who could be treated by GPs or self-manage at home There is no clear plan of action yet developed for doctors to treat abdominal patients effectively; there are no treatments that work and very little in terms of guidelines. This is surprising given how distressed these patients are and how much they cost the NHS.

Patients often find it difficult to hear that there is nothing medically wrong when they are in so much pain and distress. This can make them more worried (thinking perhaps something has been missed) which can cause symptoms to worsen by focussing on them, which then for some gives panicky symptoms such as feeling hot and palpitations which may be taken as evidence that something is really wrong

Jo aims to understand the needs and experiences of these patients attending A&E. She plans to use this information to help develop treatments in the future, improve quality of life for these patients and also benefit the NHS through expected cost savings.

Women's Health

Katharine Gale

Award  £19,992 : The Working Lives of Menopausal Women in the NHS

The overall aim of Katharine’s research project is to investigate the working lives of women in the NHS, focusing on the menopause to discover what women describe as supportive management and explore how the organisation can improve support & guidance for their female staff within the organisation.

The menopause is the time in every woman’s life when her periods stop and usually occurs between the ages of 45 and 55, with the UK median age of the menopause being 51. The average duration of moderate to severe hot flushes is 10 years but symptoms include night sweats, poor concentration, tiredness, poor memory and lowered confidence, with 25% of women experiencing symptoms they describe as severe. There are over 3,000 female employees in NBT aged between 41 and 60 years and therefore either likely to be affected by the menopause or have a lived experience of dealing with the impact at work.

 The aims of Katharine’s research project are

  • To identify the unique health needs of menopausal women
  • To explore the experiences of these working women during the menopause
  • To identify any barriers to accessing health care, support and advice
  • To make recommendations on how women’s working lives could be improved in our organisation