by Dr Yvette Pyne, GP and Academic Clinical Fellow, Centre for Academic Primary Care, University of Bristol
Coronavirus has completely changed how we work across most professions including in academic research. While those impromptu conversations around the coffee machine at work, or over drinks at academic conferences seem both a distant memory and a far-flung future dream, there have been some wins for collaborative working as well. Lockdown has brought both technological improvements and culture-change around the use of video conferencing and collaboration tools. A colleague – Dr Stuart Stewart based at the University of Manchester and I (based at the University of Bristol) have been “meeting” once a week to discuss the creation of a concept paper covering ideas that have been percolating for years after a fortuitous meeting at a conference in 2018. Both of us are tech-adept and we often discuss ways … Read more
by Emma Le Roux, GP with a dermatology special interest. Formerly Senior Clinical Research Fellow (NIHR-in-Practice) at the Centre for Academic Primary Care, University of Bristol
Skin problems are among the most common reasons patients to go to the doctor. As a GP, I often reflect on the patients I see, such as the 35-year-old man who suffers with psoriasis. Over 15 years he has struggled with managing his itchy skin symptoms but of more concern to him is his related low self-esteem. Because of the appearance of his skin he felt unable to take part in leisure activities, such as taking his son swimming. He lacked understanding of treatment options and was unaware of the condition’s associations with arthritis and cardiovascular disease. His experience reflects the evidence that skin problems are known to have a heavy physical and psychosocial burden.
Most patients with skin problems … Read more
by Kelly Cheng, Medical Student, University of Bristol
“Cancelled due to COVID-19” – a rare opportunity to practise lifesaving pre-hospital emergency medicine skills in the French Alps was abruptly transformed into another cancellation email, as with many other glorious plans for 2020. Before I knew it, hospital placements had also been suspended until further notice. Instead, I found myself back home, huddled before my laptop, about to embark on a 6-week long student choice project working with highly-experienced academics for the first time – over Zoom, of course.
In this post, I share my experience as a third year medical student undertaking a research project alongside Dr Lorna Duncan from the Centre of Academic Primary Care (CAPC), and explore the methods we used to successfully gather primary data from all regions of England amid a national lockdown. Ironically, the chance to carry out a project focused on … Read more
By Sue Davies-Jones, Research Nurse, Faculty of Medicine and Health Sciences, Nottingham University
I have worked as a research nurse at the Centre of Evidence Based Dermatology for 13 years, working on various dermatology research projects. The Best Emollients for Eczema (BEE) study aims to answer the important question of whether some types of emollient (moisturisers) are better than others in the treatment of childhood eczema.
In an ideal world, patients would be able to sample different emollients before deciding which one they preferred, but this is not usually practical. The BEE Trial has been designed to help doctors and patients to decide which types of emollient are best to try first.
GPs are under pressure to prescribe on cost, but we don’t know whether a more watery or cheaper moisturiser is as good as a thicker or more expensive one. Helping families find the “right” moisturiser … Read more
by Dr Alex Burrell, Foundation Year 2 doctor, North Bristol NHS Trust and Dr Lucy Selman, Senior Research Fellow, Centre for Academic Primary Care, University of Bristol
Restrictions on funeral attendance have been put in place to try to prevent the spread of COVID-19. We conducted a rapid systematic review to try to understand what impact these restrictions might have on the bereaved. We found that the impact of funeral practices was not clear-cut: observational studies assessed different outcomes and their results varied. However, there were important lessons from qualitative research. What seems to be most important is helping people create a meaningful personal ritual which provides a sense of social support however they mourn, whether together in person or virtually.
COVID-19 has caused hundreds of thousands of deaths around the world, with over 45,000 confirmed deaths in the UK as of 23 July … Read more
by Dr Rachel Johnson, GP and NIHR Clinical Researcher in Primary Health Care, Centre for Academic Primary Care, University of Bristol
Together with colleagues at the Universities of Bristol, Oxford, Birmingham, Cambridge and Lancaster, I recently completed a James Lind Alliance Priority Setting Partnership for advanced heart failure, funded by the NIHR School for Primary Care Research.
Priority setting partnerships (PSPs) are an established method for involving patients and the public in the first, crucial stage of research – deciding which research questions should be tackled by research studies. The results have just been published in BMJ Open Heart and include a list of the final top 10 priority research questions.
Briefly the process involved:
- conducting a survey to elicit priority questions from a wide range of stakeholders, including patients, carers and clinicians
- excluding questions that had already been addressed in the literature
- ranking the
… Read more
by Dr Sophie Turnbull, Senior Research Associate, Centre for Academic Primary Care, University of Bristol
Digital interventions have become increasingly popular due to their potential to increase access to healthcare for people with chronic conditions and reduce the burden on a stretched healthcare system.
This has been amplified during the COVID-19 crisis, where much face-to-face support has been reduced or is no longer available. However, there are concerns that digital health provision may exacerbate existing health inequalities.
Chronic or long-term conditions, such as diabetes, are estimated to account for 87% of deaths and have a significant impact on an individual’s quality of life. Even in high-income countries, people with lower socioeconomic status experience chronic illness more commonly and with greater severity than average for the rest of the population.
We also know that people with existing health conditions, in low paid or insecure work and … Read more
by Dr Eszter Szilassy, Research Fellow, Centre for Academic Primary Care, University of Bristol
GPs and other primary health care professionals play a vital role in addressing domestic violence and abuse (DVA). This is especially true during the current coronavirus pandemic, when individuals and families are isolated from potential sources of help and support.
Home during lockdown may not be a safe place for those affected. In England, the National Domestic Abuse Helpline, run by Refuge, has seen a 50 per cent increase in calls compared to pre-COVID-19, along with a 400 per cent increase in web traffic.
We know that the pandemic is having a detrimental impact on the health and wellbeing of people affected by DVA and their children. Extensive periods of self-isolation and social distancing compounded by increasing uncertainty over jobs and financial security for families may be a dangerous and profoundly … Read more
by Zoe Wilkins, Trial Administrator, Centre for Academic Primary Care, University of Bristol
It’s safe to say that I knew little about eczema before working as an administrator on the Best Emollients for Eczema (BEE) trial and even less so about emollients, the different types of moisturiser used to treat the condition.
My own children occasionally suffered with very mild eczema; tiny patches here and there that would clear up with a couple of days of moisturisation. So, it was only after starting work on the trial that I began to understand the complexity of this condition. Some suffer seasonal ‘flare-ups’, for others year-round torment, which can be triggered by many different factors.
Although I knew that if you had eczema it was important to keep skin moisturised, I had not heard of the word ‘emollient’ before. Emollient is the medical word for moisturiser and comes in … Read more
by Gemma Lasseter, Research Fellow, Centre for Academic Primary Care and NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol
In the UK, government policy on whether to fund new vaccines, or modify their availability, is based on advice from an independent scientific advisory group. This involves weighing up the benefits and costs, and then deciding whether a vaccine is value for money.
The idea is to find a balance between the cost of doing something (such as routinely vaccinating all children against a particular disease) and how much benefit you get from doing it (such as health gains by preventing disease and the associated economic savings).
Yet the current approach does not take into account many of the benefits that vaccinations offer and which set them apart from other health interventions. The fact that vaccinations are preventative rather than curative, for … Read more