Improving papilloedema diagnosis and referral

Posted on September 21, 2023September 21, 2023 by capcbristol

by Dr Denize Atan, Associate Professor in Neuro-opthalmology, Neuroscience and Genetics, University of Bristol

Papilloedema is nerve swelling at the back of the eyes. It is caused by increased pressure inside the head and can be the first sign of a brain tumour or other serious health problems.

As half the people with a brain tumour have no symptoms, optometrists (trained eye care professionals who work at optician practices) may be the first to notice nerve swelling in someone during a routine eye test.

The importance of detecting papilloedema has been highlighted by recent high profile cases in the media.

The ‘Improving the Diagnostic accuracy of referrals for Papilloedema’ (DIPP) Study is funded by the National Institute for Health and Care Research (NIHR) to develop a set of guidelines and educational materials for optometrists and GPs that will help them to diagnose papilloedema more accurately … Read more

Using research evidence to work creatively with people with lived experience of domestic abuse

Posted on August 10, 2023August 10, 2023 by capcbristol

By Dr Natalia Lewis, Senior Reseach Fellow in Primary Care and Cat Papastavrou Brooks, Research Associate, Centre for Academic Primary Care, University of Bristol, and Dr Noreen Hopewell-Kelly, Research Fellow, NIHR Bristol Biomedical Research Centre

The coMforT study

The coMforT study, funded by NIHR Bristol Biomedical Research Centre, developed and tested a trauma-specific mindfulness course for women who had experienced domestic abuse and post-traumatic stress. The study, led by Dr Natalia Lewis, worked with an advisory group of six women with lived experience of domestic abuse who engaged in planning, delivering, analysing and disseminating study findings.

Developing a theatre piece about the impact of involvement in research

Once the coMforT study finished, two of the public contributors involved in it went on to co-produce a play called ‘Hard Evidence’ with support from researchers and the director of acta, a … Read more

Treatment decision-making in advanced kidney disease: an international collaborative workshop on future directions

Posted on July 11, 2023 by capcbristol

By Dr Lucy Selman, Associate Professor in Palliative and End of Life Care, Centre for Academic Primary Care, University of Bristol

On Thursday 8 June 2023, an expert meeting was held at the University of Bristol, on treatment decision-making in advanced kidney disease. The meeting brought together renal and palliative care clinicians and researchers specialising in the area from across the UK with colleagues from Harvard University and Brigham and Women’s Hospital, with two guests from Boston coming to Bristol to attend in person.

The aim of the event was to share research and clinical practice models related to treatment decision-making in advanced kidney disease – an area in which the partnering teams have complementary expertise.

The event was led by Dr Lucy Selman, Associate Professor of Palliative and End-of-Life Care at the University of Bristol in collaboration with Professor James Tulsky, Professor of Medicine at … Read more

Why doing research with domestic abuse perpetrators is challenging

Posted on June 15, 2023 by capcbristol

by Dr Helen Cramer, Senior Research Fellow, Centre for Academic Primary Care, University of Bristol

The importance of providing support for victims and survivors of domestic abuse has long been established and a considerable body of research shows what effective support should look like. How to engage with perpetrators of domestic abuse is less well understood. There are a range of interventions of different lengths and purposes such as shorter ones to assess risk, and containment and disruption approaches for the highest risk perpetrators to try to manage that risk.

For lower risk perpetrators, longer (e.g. six month) group programmes aiming to reduce abusive behaviour and offering support to the partners and ex-partners alongside are recommended by Respect, a UK membership organisation that sets standards and accredits perpetrator programmes. However, the evidence for these group programmes is uncertain and there are extensive methodological challenges to … Read more

ATHENA in the Daily Mail – is all publicity good publicity?

Posted on June 6, 2023June 6, 2023 by capcbristol

By Lorelei Hunt, Patient and Public Involvement Representative on the ATHENA Shingles Study, Centre for Academic Primary Care, University of Bristol

Doctors involved in the ATHENA shingles trial were interviewed by the Daily Mail, under the headline ‘Could taking a depression pill prevent lasting agony of shingles? Scientists launch clinical trial to examine effectiveness of treating post-herpetic neuralgia with amitriptyline‘.

We need to recruit more people to take part in this important pain prevention study, so raising awareness is a good thing. But some comments made on the newspaper’s website about the medication (amitriptyline) were unhelpful or wrong.

As the patient representative on the research team, I agreed to read through all of them. There were a lot, so this took a while! Unfortunately, many people did not read past the headline and recalled their own past, sometimes unpleasant experiences of having taken … Read more

What do we know about how GPs are used in emergency medical services?

Posted on June 5, 2023June 8, 2023 by capcbristol

By Dr Alex Burrell, NIHR Academic Clinical Fellow in General Practice, Centre for Academic Primary Care, University of Bristol

CAPC researchers, Dr Alex Burrell, Dr Grace Scrimgeour and Dr Matthew Booker have conducted a systematic review and narrative synthesis to assess the evidence on how GPs are used in emergency medical services.

Emergency medical services in the UK are under significant pressure. A considerable proportion of their workload relates to problems that could be dealt with by a GP. Using GPs in emergency medical services, such as the ambulance service, might reduce the number of people being taken to Accident and Emergency (A&E) and may more appropriately meet these patients’ needs. This could also free up ambulances and paramedics to respond to life-threatening emergency calls.

Different roles

GPs have been used in emergency medical services in a number of countries. In some countries, … Read more

Festival of Teaching 2023

Posted on April 26, 2023April 27, 2023 by capcbristol

By Dr Simon Thornton, GP Engagement Lead, Centre for Academic Primary Care, University of Bristol (left) and Professor Trevor Thompson, GP and Head of Primary Care Teaching, Centre for Academic Primary Care, University of Bristol (right)

For the last two years the teaching arm of the Centre for Academic Primary Care (CAPC) have been doing something a little different when it comes to Continuing Professional Development (CPD): a Teaching Festival, a day of activities that aims to celebrate and entertain as well inform and train.

This year our destination was Clevedon Hall, a stone’s throw from the marine lake on the shore at Clevedon. On display throughout the day was a collection of artwork produced by our medical students as well as photography by a local GP, Dr Jon Rees. The grounds are an absolute delight as was our programme of … Read more

Arts and Sciences – researching the history of antibiotics in primary care

Posted on March 27, 2023March 27, 2023 by capcbristol

This article was originally published by the Elizabeth Blackwell Institute for Health Research. Reproduced here with kind permission.

The prevalence of antibiotic use in modern society is well established. Antibiotics have revolutionised medicine and how society sees – and deals with – disease. Along with concerns regarding the rise of antibiotic resistant bacteria, thought to be exacerbated by their over-use in many areas, there is a need to understand the history of their adoption and use, especially in primary care. Comprehending the many-tendrilled circumstances and behaviours that led to this point might help to inform future choices, and give some insight into future best practice.

Dr Barbara Caddick, Senior Research Associate at the Centre for Academic Primary Care (CAPC) at the University of Bristol, is well qualified for such an undertaking, with a PhD in History and extensive experience in research in … Read more

Contraception: what women (over 40) want

Posted on March 8, 2023March 9, 2023 by capcbristol

by Dr Jo Burgin, Centre for Academic Primary Care, University of Bristol

Over a third of all pregnancies in women over 40 result in therapeutic abortion. This is one of the highest rates of abortion compared to live births in any age group. This suggests an unmet need for contraception. I interviewed women over 40 about their views and experience with contraception to find out more.

“I couldn’t do another child”

Previous studies have attributed the relatively low use of reliable contraception in women over 40 to women’s perceptions of themselves as low risk of pregnancy. However, participants in this study felt pregnancy was a real possibility and that an unplanned pregnancy would have a significant negative impact on their lives. Some had completed their families or had other caring responsibilities. While others knew they did not want any children and did not want to … Read more

Creating a community network to tackle inequities in end-of-life care and bereavement support

Posted on January 26, 2023January 27, 2023 by capcbristol

By Lucy Selman, Associate Professor of Palliative and End of Life Care, Palliative and End of Life Care Research Group and Centre for Academic Primary Care, University of Bristol

Serious illness and bereavement affect us all, but our experiences of them are not equal. People living in the poorest areas of the UK are less likely to get the care and support they need if they become seriously ill or a loved one dies. They are also more likely to be socially isolated and lonely – which can be made even worse by serious illness or bereavement.

The Weston-super-Mare community network for health inequities is a new collaborative research project, funded by the Arts and Humanities Research Council and led by the University of Bristol, which aims to tackle these issues, focusing on Weston-super-Mare, a seaside town in the South West that is socioeconomically … Read more