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Research Groups/Research areas within CPH • Health Services Research/Methodological Research Group • • • • Eye Health/Eye Disease Oral Health Cancer Mental Health • Public Health Research Group • • • • • • Physical Activity Research Public Health Interventions Renal Disease Ageing research Social epidemiology Data linkage • Cancer Epidemiology • Nutrition and Metabolism (with Institute of Global Food Security) Cancer Epidemiology Group • Studies focussed on premalignant to malignant transition • The Northern Ireland Barrett’s Oesophagus Register • Colorectal polyp register • Cancer progression studies • Pharmaco-epidemiological studies in relation to cancer • Population-based Molecular Oncology • Aetiological studies • The Finbar study • Early life influences on cancer risk • Case control study of myeloproliferative neoplasms Cancer Epidemiology Group • Cancer awareness and early detection • International Cancer Benchmarking Partnership • Population awareness and beliefs about cancer • Delay in the pathway to treatment etc. • NAEDI research • Comparison of patient, clinical, disease and service related factors in cancer patients with long and short term cancer survival • Cancer services/survivorship • Late effects of cancer treatment • Patient reported outcomes in prostate cancer patients Global Eye Health Research (Nathan) • Research areas: • Novel methods to prevent myopia and improve the delivery of high-quality, low cost refractive services to children in rural China • New approaches to assessing cataract surgical outcomes in areas of limited resources • Novel treatments for glaucoma and diabetic eye disease in rural China • Funding: • Government: US NIH, UK MRC, Chinese and HK governments • Private: Standard Chartered Bank, Fred Hollows Foundation • International : World Bank, WHO Global Eye Health Research • Collaborators: • Rural Education Action Project, Stanford University • Zhongshan Ophthalmic Center, Guangzhou China • Various NGOs: Fred Hollows Foundation, Orbis International, SightLife • Johns Hopkins University School of Medicine • Wenzhou Medical College, Wenzhou China • HCM City Eye Hospital, HCM City Vietnam • Tongren Hospital, Beijing China Health Services Research Group 1. Methodological research (Prof Mike Clarke) 2. Eye Health/Eye Disease (Professor Azuro-Blanco) 3. Oral Health Care (Dr Gerry McKenna) 4. Cancer Care (Michael D) 5. Mental Health Care (Michael D) Some examples of HSR studies… Health Services Research Group Example of cancer care research in the CPH • Population needs assessment eg Cancer survivors with selfreported late effects: health status, care needs and service utilisation • Cochrane Reviews eg Non-pharmacological interventions for cognitive impairment due to cancer treatment • Outcome measurement eg A methodological review of the SF36 among breast cancer patients. • Intervention studies eg Intervening to reduce cognitive impairment and maintain cognitive functioning due to cancer treatment. Health Services Research Group Example of mental health services research in CPH • Population needs assessment eg The mental health needs of people detained in custody • Systematic Reviews eg How effective are CJ Liaison and Diversion Services for people with mental disorder? • Outcome measurement eg. Factor structure of the Alcohol Use Disorders Identification Test (AUDIT) • Intervention studies eg A non-randomised controlled evaluation of a police station-based mental health service. UKCRC Translation and Impact highlights • ESRC Knowledge Exchange grant (KESUE – Knowledge Exchange Spatial Analysis and Healthy Urban Environments) • Physical Activity Loyalty Card Potential for scalability and Social Enterprise • CVD IMPACT and trend modelling; • NISRA secondee, Dr John Hughes • Pedometer Self Monitoring for people with diabetes (KE grant from HSCRDO) (with South Eastern HSC Trust) EuroHeart II • Team Med Trial; Food in Schools Trial • Capacity development: eg Dr Mark O’Doherty, Ruth Hunter, Dr Lynsey Patterson • Community wide initiative to improve CVD health with the West Belfast Partnership • Roots of Empathy Trial Renal Research - Background • Chronic kidney disease (CKD) is a non-communicable disease affecting 5-10 % of adult population • Associated with ill health, reduced quality of life and premature death • CKD is a major public health problem contributing to health care costs in both developed and developing countries • Diabetes is the major cause of CKD • • • • ~40% people with diabetes develop diabetic kidney disease Current clinical screening methods identify the unlucky Treatment for kidney disease is only partially successful W3; GENIE; diabetic nephropathy collaborative research initiative (DNCRI) Renal Research – Typical experiments • Clinical phenotyping; long-term international collaborations • Patient cohorts (UK; ROI; Europe; Worldwide); multiple registries • Environmental risks: smoking, diet, blood sugar control etc. • Inherited genomic factors: candidate gene studies, genome-wide association studies, common and rare variants, copy number variation, whole genome ‘next generation’ sequencing, and transcriptome analyses • Epigenetics: interaction between genes and environment; early life exposure • DNA methylation; histone modifications; microRNAs Renal Research – retinal vascular calibre as a potential biomarker for early renal and retinal diseases • • • • Microcirculation pathology underpins renal and retinal diabetic complications Use of routine NHS diabetic retinal screening images and clinical chemistry Case-control study (progressive CKD vs. stable GFR) Does change in retinal vessel calibre predict CKD? Nutrition and Metabolism Biomarker identification and assessment: Dietary intervention studies: 1) Whole foods/diets 1) Disease risk 2) Nutritional status 2) Supplementation studies Achieving behaviour change Peer support to encourage adoption of the Mediterranean diet • Explore feasibility of peer support as a strategy to encourage adoption of the MD in those at high risk of CVD • Peer support intervention, specific for the target group, developed through direct interaction with the intended target group McKinley, Kee, Young, Woodside National Prevention Research Initiative MRC guidelines: Developing and evaluating complex interventions Centre for Public Health 14 What are effective and appropriate interventions for weight loss after pregnancy? Group-based – limited success Challenges - engagement, reach, sustainability Exploit SMS technology? e.g. txt 2 stop – smoking cessation