Institute for Health Research
Institute for Health Research
News Article | February 2, 2017
Tigerspike develops iPhone app using ResearchKit for the NIHR CRN to simplify clinical research projects LONDON, UK, 2 February, 2017 - Tigerspike, a global digital products company has partnered with the National Institute for Health Research Clinical Research Network (NIHR CRN), launching a pilot programme assessing how the power of mobile can aid clinical research processes. Scientific research is expensive, time consuming and recruiting a large enough cohort is often difficult. The NIHR CRN partnered with Tigerspike to design and build an application for its employees that lets medical researchers gather robust and meaningful data, by making it easier to enrol participants and consequently conduct studies. The application uses the new ResearchKit software framework designed by Apple to make it easy for researchers to gather data more frequently and more accurately from participants using iPhone apps. ResearchKit enables participants to easily complete tasks or submit surveys right from the NIHR CRN app and delivers a simple way to present participants with an interactive informed consent process. The NIHR CRN set up a challenge for their Coordinating Centre staff to walk 10,000 steps over a two-week period, with the application recording the number of steps participants made each day over the course of the study. The captured data was encrypted and sent securely to the Leeds Institute for Data Analytics (a body of the University of Leeds) where it was then reviewed. The results proved that e-consent is a strong option for people to sign-up to research and reduces the time taken to complete compared to traditional paper-based processes. Recruitment to the challenge was also more clear-cut in comparison to traditional research projects. Participants could simply download the application from a link and there was no requirement for specialist equipment or for participants to track information on paper - everything was collected on the mobile device. “Medics and researchers around the world are already using digital technologies to revolutionise the way we think about health,” said Alex Burke, Group CEO, Tigerspike. “Many legacy healthcare systems are increasingly proving to be inefficient as they are simply too large and fragmented to drive rapid digital transformation. Technology is enabling data collection to be more efficient than ever before, for both researchers and participants alike. Through the use of mobile applications, medical researchers will have the power to recruit more participants much quicker, providing more precise data and more accurate insights than ever before. Ultimately, this will provide unprecedented opportunities for patients to gain earlier access to better and new treatments, and we’re looking forward to being a part of this revolution as we look to continue this initiative with the NIHR CRN”. “Tigerspike immediately tied into our culture and enthusiasm to get things done,” said Michael Mullane, NIHR CRN Learning Management Systems Manager. “They handled the process of taking our idea to fruition in a way that was more about partnership than a client developer relationship. Tough and timely project management, good use of workflow tools and good communications meant that confidence was high throughout the project. Tigerspike delivered on time, within budget and to specification. Working with them has shone a light on our internal practices and helped us improve.” About Tigerspike Tigerspike is a global digital products company specialising in strategy, experience design, development and systems integration. We deliver business value, creating products that are differentiated by the experience, the technology and the data derived from both. Founded in 2003, Tigerspike now employs more than 300 people and has presence in New York, London, Singapore, San Francisco, Dubai, Melbourne, Wroclaw, and Tokyo. It has provided leading mobile application experience design, development and integration to a number of key businesses worldwide including Emirates, Shell, Kaiser Permanente, NSW Health, Westpac, Westfield, DIRECTV, Novartis, ADP and DBS Bank. To learn more about Tigerspike go to tigerspike.com or follow @tigerspike on Twitter. About the NIHR The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).
News Article | December 9, 2016
Pets can help people manage their long-term mental health conditions, according to research published in the open access journal BMC Psychiatry. The consistent presence and close physical proximity of their pets was described in this study as providing an immediate source of calm and therapeutic benefit for the pets' owners. The researchers suggest that pets should be considered a main source of support in the management of long-term mental health problems. Lead author, Dr Helen Brooks from University of Manchester said, "The people we spoke to through the course of this study felt their pet played a range of positive roles such as helping them to manage stigma associated with their mental health by providing acceptance without judgement. Pets were also considered particularly useful during times of crisis. In this way, pets provided a unique form of validation through unconditional support, which they were often not receiving from other family or social relationships. Despite the identified benefits of pet ownership, pets were neither considered nor incorporated into the individual care plans for any of the people in our study." Dr Brooks added: "These insights provide the mental health community with possible areas to target intervention and potential ways in which to better involve people in their own mental health service provision through open discussion of what works best for them." The researchers interviewed 54 participants, aged 18 and above, who were under the care of community-based mental health services and had been diagnosed with a severe mental illness. Participants were asked to rate the importance of members of their personal network including friends, family, health professionals, pets, hobbies, places, activities and objects, by placing them in a diagram of three concentric circles. Anything placed in the central circle was considered most important; the middle circle was of secondary importance and the outer circle was for those considered of lesser importance. Pets played an important role in the social networks of people managing a long-term mental health problem, as 60% placed their pet in the central most important circle and 20% placed their pet in the second circle. The participants stated that one reason for this was that their pet helped by distracting them from symptoms and upsetting experiences such as hearing voices or suicidal thoughts. Participants from the study were quoted as saying: "I felt in a sense that my cat was my familiar in that he understood or was an extension of my thoughts." "When I'm feeling really low they [pets] are wonderful because they won't leave my side for two days." "You just want to sink into a pit and just sort of retreat from the entire world, they force me, the cats force me to sort of still be involved with the world." "I'm not thinking of the voices, I'm just thinking of the birds singing." The interviews supported existing evidence that some participants feel distanced from healthcare and uninvolved in discussions about services. Taking more creative approaches to care planning, such as incorporating discussions about pets, may be one way of helping to better involve participants because of the value, meaning and engagement that individuals have with their companion animals. 1. Ontological security and connectivity provided by pets: A study in the self-management of the everyday lives of people diagnosed with a long-term mental health condition Helen Brooks, Kelly Rushton, Sandra Walker, Karina Lovell and Anne Rogers BMC Psychiatry 2016 During the embargo period, please contact Alanna Orpen for a copy of the article. After the embargo lifts, the article will be available at the journal website here: https:/ Please name the journal in any story you write. If you are writing for the web, please link to the article. All articles are available free of charge, according to BioMed Central's open access policy. 2. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (http://www. ). 3. BMC Psychiatry is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of psychiatric disorders, as well as related molecular genetics, pathophysiology, and epidemiology. 4. BioMed Central is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Nature, a major new force in scientific, scholarly, professional and educational publishing, created in May 2015 through the combination of Nature Publishing Group, Palgrave Macmillan, Macmillan Education and Springer Science+Business Media. http://www.
News Article | December 1, 2016
Cancer Research UK has announced the largest investment to date into its network of Centres across the UK. £190 million has been committed to 13 Cancer Research UK Centres over the next five years. Additionally, Cancer Research UK and the Departments of Health* are investing £36 million over five years into 18 Experimental Cancer Medicine Centres (ECMCs) for adult patients and also a network of Centres for children**. The huge investment will draw together world class research and medical expertise to accelerate advances in research and support clinical trials essential to getting lifesaving treatments to patients. Cancer Research UK Centres*** bring together research teams from local universities, NHS hospitals and other research organisations. They operate as a network that focuses on translational research -- getting cutting edge discoveries from the laboratory to patients and learning as much as possible from patients to initiate new research ideas and programmes. The ECMCs**** aim to bring better treatments faster to cancer patients in the UK through both the adult and children's network of Centres. They are hubs where promising cancer treatments - including small molecule drugs, surgery, immunotherapy, and vaccines - are safely tested for the first time in patients. These Centres help give people with cancer access to cutting-edge treatments and precision medicine by testing new ways of detecting and monitoring the disease and how it responds to treatment. This investment will also train the next generation of cancer researchers by funding PhD students and cancer doctors at the start of a research career, and providing specialist training for ECMC staff involved in the development and delivery of clinical trials. Centre status is awarded to locations performing the highest quality cancer research, and investment is made into infrastructure, funding for technical staff, equipment, training and running costs, developing the breadth and depth of research at each of these Centres. The applications are reviewed by an international panel of experts to make sure that only the best science is funded. Dr Iain Foulkes, executive director of strategy and research funding at Cancer Research UK, said: "This is the largest investment we have ever made into the Centres and we are incredibly proud of that. It's also the first time we have co-funded the paediatric ECMC network with the National Institute for Health Research and the Chief Scientist Office, Scotland, which will help boost research to develop smarter, kinder treatments for children. "This money provides vital infrastructure for bench to bedside research. By strengthening the relationship between scientists and doctors, basic research guides clinical practice as effectively as possible. "This is particularly important for hard to treat cancers like pancreatic, oesophageal, lung and brain tumours. By combining expertise and different disciplines, we hope to ignite much needed momentum into research for these cancers. "The funding is also an investment in the next generation of scientists. We are creating opportunities for PhD students and ensuring that the brightest scientists are attracted and supported in their career in cancer research." Nicola Blackwood, Minister for Public Health and Innovation, said: "We want to lead the world in fighting cancer. The work of Experimental Cancer Medicine Centres is crucial in this fight. This next phase of funding from the National Institute for Health Research will help our world-leading researchers to continue to make new discoveries. "The collaboration between universities, NHS Trusts and the research community is a key reason these centres are successful, and illustrates why the UK is the best place in the world to be a researcher. "I hope this funding will ultimately lead to more timely, life-saving treatments for patients." Sir Harpal Kumar, chief executive at Cancer Research UK, said: "Together, these Centres accelerate the discovery and development of better treatments for cancer patients. They are a unique opportunity for collaboration, both locally across universities and hospitals, and nationally across the network of Centres. "I'm particularly pleased that our international panel of experts, which renewed these Centres, stated repeatedly their view that there is no other network like this, of this quality, anywhere else in the world. "This is an exciting time for cancer research. Emerging treatments like immunotherapy are radically changing the field, we are increasingly able to tailor more treatments to individual patients, and advances in technology mean we can collect and share more research data than ever before. "Cancer Research UK's projections are that we will reach more than 500,000 new diagnoses of cancer a year in the UK by 2035. By that time, our goal is that three in four people will survive their cancer. Funding these Centres is one of the charity's most important strategic priorities and one which will help us reach this ambition. "This huge investment is only made possible through generous donations from the public and the tireless fundraising of our supporters." For media enquiries contact Stephanie McClellan in the Cancer Research UK press office on 020 3469 5314 or, out of hours, on 07050 264 059. * National Institute for Health Research (England), Chief Scientist Office (Scotland), Public Health Agency (Northern Ireland) and the Health and Care Research Wales (Wales). ** The paediatric ECMC network focuses on rare children's cancers and early phase trials that bring new treatments to children. The network is also advancing research in immunotherapy, precision medicine, and collecting crucial samples for research into children's cancers in the future. **** The ECMCs are: Barts ECMC; Belfast ECMC; Birmingham ECMC; Cambridge ECMC; Cardiff ECMC; Edinburgh ECMC; Glasgow ECMC; ICR ECMC; Imperial ECMC; KHP ECMC; Leicester ECMC; Liverpool ECMC; Manchester ECMC; Newcastle ECMC; Oxford ECMC; Sheffield ECMC; Southampton ECMC; UCL ECMC; and a Paediatric ECMC network. About the science at the ECMCs: The adult and paediatric ECMC Networks support some of the best clinical science in experimental therapeutics at the forefront of cancer research in the UK. ECMCs are a partnership between a university and at least one NHS Trust/Board which act as an efficient and effective hub to assist in the delivery of early phase cancer studies across the Network of UK sites to enable faster and more personalised patient benefit. The ECMC Initiative was launched in 2007 as a partnership between CRUK and the DHs collectively. 1,500 new early phase trials over ten years in 35 cancer types were reported within the Network, providing access to innovative treatments to 18,000 patients. In addition, ECMCs have been able to leverage over £155 million from industry towards clinical trials and pre-clinical research in experimental medicine. For further information about Cancer Research UK's work or to find out how to support the charity, please call 0300 123 1022 or visit http://www. . Follow us on Twitter and Facebook. About the National Institute of Health Research The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website.
News Article | July 6, 2016
Zika Virus - What You Should Know Ticked Off! Here's What You Need To Know About Lyme Disease Reduced intake of antibiotics for respiratory tract infections doesn't cause increased risks of serious complications, a new study has found. The news comes amid concerns of the growing antibiotic crisis. Antibiotics are used for the treatment of bacterial infections. While they don't work against viral infections (sore throats, colds), the medicine is still often prescribed to help lower the chances of bacterial complications, which include viral infections. This leads to the increased usage of antibiotics and growing concerns among the medical community that the practice is fueling more cases of antibiotic-resistant bacteria. "Current treatment recommendations are to avoid antibiotics for self-limiting respiratory infections. Our results suggest that, if antibiotics are not taken, this should carry no increased risk of more serious complications," said lead author Martin Gulliford from of King's College London's Division of Health and Social Care Research. In the study, the research team analyzed the medical records of patients from 610 UK-based hospitals. For more than 10 years, the team monitored a participant pool that consisted of more than 4 million patients. The researchers found that general practices with lower antibiotic prescription rates for these infection types did not lead to an increase in the development of more serious bacterial complications such as empyema, meningitis and brain abscess. Co-author and general practitioner Mark Ashworth shared that among his patients with upper respiratory tract infections, he sees "very few" complications among those who choose a treatment approach that doesn't involve antibiotics. Ashworth added that patients are realizing that the majority of these infections are viral and as such, antibiotics will not work. However, the findings also showed that these general practices had slightly increased rates in the development of pneumonia as well as peritonsillar abscess, which is a rare complication of the sore throat. The researchers estimated that if a general practitioner, with approximately 7,000 patients, reduced antibiotic prescriptions by 10 percent, only one pneumonia case will be added annually and one peritonsillar abscess case will be added every 10 years. This estimated reduction could lead to about 2,000 fewer prescriptions of antibiotics for each general practitioner over a 10-year period. A reduced antibiotic intake carries many benefits, which include lowered risks of common side effects such as vomiting, rashes, diarrhea and anaphylaxis. "Our paper should reassure GPs and patients that rare bacterial complications of respiratory infections are indeed rare," said Ashworth. The study was published in the British Medical Journal on July 5. The National Institute for Health Research (NIHR) Health Technology Assessment program funded the study. The research also received support from King's College London and Guy's and St. Thomas' NHS Foundation Trust's NIHR Biomedical Research Center. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
News Article | December 8, 2016
In 2014, around seven million women in the UK were classified as obese. By 2025, it is expected to affect 1 in 5 women in the world. Obesity is a major risk factor for gestational diabetes, increasing the likelihood of the disorder three - five fold. Women with the disorder require intensive antenatal care to control blood glucose and to identify other common complications, particularly fetal macrosomia - a newborn who's significantly larger than average. In practice today, all obese pregnant women are categorised as being of equally high risk of gestational diabetes, whereas in reality, only around 25% will develop the disorder. In the study, funded by the National Institute for Health Research (NIHR), the team looked at how to correctly identify obese women with heightened risk, early in pregnancy, and as a result, enable timely targeted intervention to those women most likely to benefit. From the many factors tested, those that predicted gestational diabetes included older age, disease in a previous pregnancy, higher blood pressure and anthropometric measures such as skin thicknesses, waist and mid-arm circumferences. A number of blood tests, such as Haemoglobin A1c also added strength to the predictive tool. Out of the 1303 women in the study, 337 were affected by gestational diabetes. Lead author, Dr Sara White from King's College London said: "There is currently no accepted strategy to identify obese women at high risk of gestational diabetes, early in pregnancy. Today, all those classified as obese are considered high risk. With escalating rates of obesity worldwide, a more accurate way of defining risk is necessary in this group. "In this, the largest and most comprehensive study to date, we have used an extensive range of different measures to develop prediction tools. One of our models focused on a few clinical factors and biomarkers already readily available in clinical practice and which incurred minimal cost. In addition, we have identified a model that does not require blood sampling, which could be developed for low and middle income countries where the prevalence of gestational diabetes and obesity is rapidly increasing. "Clinical use of these tests would enable prompt intervention and correctly target those at highest risk and therefore most likely to benefit." Dr White is continuing her research into gestational diabetes with the support of Diabetes UK. King's College London is one of the top 25 universities in the world (2016/17 QS World University Rankings) and among the oldest in England. King's has more than 27,600 students (of whom nearly 10,500 are graduate students) from some 150 countries worldwide, and some 6,800 staff. King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF) King's was ranked 6th nationally in the 'power' ranking, which takes into account both the quality and quantity of research activity, and 7th for quality according to Times Higher Education rankings. Eighty-four per cent of research at King's was deemed 'world-leading' or 'internationally excellent' (3* and 4*). The university is in the top seven UK universities for research earnings and has an overall annual income of more than £684 million. For further information, please visit the website: http://www. 2. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website. 3. Dr White is continuing her research into gestational diabetes with the support of Diabetes UK.
News Article | October 27, 2016
'The study demonstrated for the first time that a protein called PP5 was significantly upregulated in the lungs of severe asthmatic patients compared to healthy controls. We are extremely excited by this paradigm shift observation.' - Dr Yassine Amrani, University of Leicester An image of Dr Yassine Amrani is available here: https:/ A new study led by the University of Leicester to understand how to improve the health of severe asthma patients has made a breakthrough finding. Researchers have described their discovery as a 'paradigm shift' in understanding the life-threatening condition. The international team from the Department of Infection, Immunity and Inflammation, University of Leicester, and the Department of Pharmaceutical Sciences, Jefferson School of Pharmacy, Thomas Jefferson University, discovered the presence of increased amounts of a protein - called PP5 - in the lungs of severe asthma patients. They found that PP5 blocks the effects of the best medicines in improving the condition. This now provides researchers with a target in order to try and help improve the symptoms of the condition in sufferers. The team has published their findings in the journal Allergy - the European Journal of Allergy and Clinical Immunology. The lead author of the study, Dr Yassine Amrani, Associate Professor in Respiratory Immunology at the University of Leicester, said: "The goal of this study was to provide mechanistic insight into the reasons why our best anti-asthma drugs called 'corticosteroids' provide little clinical benefit in patients with a severe form of the disease. This is an unmet clinical need. "Because of the lack of response to treatment, these severe patients have a very poor quality of life, suffer from recurrent asthma attack and are more likely to be hospitalised and to possibly die from their disease. Severe asthma poses a veritable therapeutic challenge for medical researchers in the field." The researchers first performed test tube experiments using cells from healthy and severe asthma patients isolated using bronchoscopy to identify the proteins that interfere with the beneficial action of corticosteroids in the lungs. This type of laboratory experiment allows the team to make conclusions about cause and effect at the cell level. The study also validated the test tube findings by observing the presence of PP5 in people. The researchers looked at whether these inhibitory proteins were abnormally expressed in the lungs of severe patients. The team is interested in lung cells because they are the first to encounter the anti-asthma drugs when given as inhalers. Dr Amrani said: "The study demonstrated for the first time that a protein called PP5 was significantly upregulated in the lungs of severe asthmatic patients compared to healthy controls. The test tube study allowed us to show that this protein was playing a key role in suppressing the anti-inflammatory action of corticosteroid, thus identifying this protein as a potential new player in reducing patients' response to corticosteroid therapy." Dr Amrani added that the basic mechanisms explaining the reduced therapeutic response to corticosteroids in severe asthma have not been clearly defined. Dr Amrani said: "Previous studies by experts in this field have provided some possible mechanisms but were done mostly in non-lung cells. The originality of our work is demonstrated in that the blunted response to therapy in severe asthma may derive from a reduced sensitivity of key lung structural cells such as the airway muscle tissue which is responsible for the acute asthma attacks via their ability to narrow the airways. We provide evidence that the airway muscle tissue behaves like an inflammatory cell that is capable of producing different asthmatic factors known to be involved in severe asthma." The researchers say that their study shows that some severe asthma patients - despite being compliant to their treatment - may fail to properly benefit from their corticosteroid therapy because of the presence of heightened inhibitory signals driven by this protein called PP5 which blunts patients' response to their best medicine. Understanding the mechanisms driving this abnormal expression of PP5 in severe asthma could lead to novel treatments. Dr Amrani added: "We are extremely excited by this paradigm shift observation as a recent study from a different group provided additional evidence for a role of PP5 in blunting corticosteroid response in asthma. Whether assessing the expression levels of PP5 could serve as a biomarker to determine patients' response to therapy needs to be further explored." The study was performed in laboratories part-funded by ERDF #05567 and supported by the National Institute for Health Research (NIHR) Leicester Respiratory Biomedical Research Unit (BRC) and by Department of Health and National Institutes of Health grants R01 HL111541 (OT). The National Institute for Health Research (NIHR) Leicester Respiratory Biomedical Research Unit (BRU) is a partnership between University of Leicester and University Hospitals of Leicester NHS Trust. In 2012 the respiratory research department became part of a multi-million pound government investment by the NIHR, to become one of only twenty BRU's within England. The Unit will focus on promoting the development of new and effective therapies for the treatment of respiratory diseases including severe asthma and chronic obstructive pulmonary disease (COPD). The funding has allowed the development of a specially designed unit including clinical space and specialist team allowing first class investigations into lung disease.
News Article | December 20, 2016
The study, led by the London School of Hygiene & Tropical Medicine with Public Health England, found that the fall in visits was biggest among young children (the age group that receives the rotavirus vaccination), but there was also a decrease in visits by older children and adults. This suggests herd immunity from the vaccination programme; individuals were protected even if unvaccinated due to the decrease in circulating rotavirus. Rotavirus is highly infectious and is the commonest cause of acute gastroenteritis in young children, causing diarrhoea, vomiting and fever. Infection with rotavirus results in considerable use of health services in the UK. The UK-wide rotavirus vaccination programme was introduced in 2013. The vaccine is given as oral drops in two doses, to babies aged between two and three months old. Previous research has shown that the introduction of the programme has resulted in a decrease in hospitalisations and Emergency Department visits for acute gastroenteritis among adults and children. The new study used primary care data to look at the impact on GP visits and went on to estimate the visits and healthcare costs averted in England across all healthcare settings. In GP surgeries, rates of acute gastroenteritis in young children fell by 15% overall after the vaccine introduction, and by 41% in the months where rotavirus circulation was historically high. Rates also decreased in older children and to a lesser degree in adults. The researchers went on to estimate that across GPs, hospital admissions and Emergency Departments, 87,376 visits by children under five were averted in the first year of the vaccination programme. This was associated with an estimated £12.5 million reduction in healthcare costs. Lead author Dr Sara Thomas from the London School of Hygiene & Tropical Medicine, said: "This study helps to give a more complete picture of the impact of rotavirus vaccination, and shows the rapid reduction in the burden of acute gastroenteritis seen in GP surgeries. "We found that the expected seasonal peak of acute gastroenteritis in the months when rates historically would have been high completely disappeared. The fact that GP visits for gastroenteritis in other age groups fell provides evidence that unvaccinated older individuals are also benefitting from the vaccine being introduced. "Our new estimates of the tens of thousands of health service visits by young children that have been averted, with a reduction in annual healthcare costs of more than £12 million, also provide important information for assessing the overall benefits of introducing the vaccine." Study co-author Dr Shamez Ladhani, Immunisation Consultant at Public Health England, said: "This is good news and it is reassuring that the rotavirus vaccine is preventing so many cases of vomiting and diarrhoea since it was introduced three years ago. This is thanks to the high vaccine uptake in infants, which has also helped to protect older unvaccinated children and adults of all ages across the UK. It is also further evidence that our UK Immunisation programme is playing a vital role in protecting the public's health." Nicola Blackwood, the Minister for Public Health and Innovation said: "This research shows the overwhelming public health benefit of giving young children the rotavirus vaccination. This vaccine is keeping children safe whilst freeing up more of doctors' and nurses' time and saving money for the NHS." The authors say that one potential limitation of the study is that the decrease in acute gastroenteritis observed could be due to factors other than the introduction of the vaccine. Analyses are now underway to compare rates of acute gastroenteritis in vaccinated and unvaccinated infants, to obtain direct estimates of the effectiveness of the vaccine. The study was funded by the National Institute for Health Research (NIHR) Health Protection Research Unit in Immunisation at the London School of Hygiene & Tropical Medicine in partnership with Public Health England. For more information, please contact the London School of Hygiene & Tropical Medicine press office on firstname.lastname@example.org / +44(0)2079272802. Copies of this paper are available to credentialed journalists upon request; please contact Elsevier's Newsroom at email@example.com or +31 20 485 2492. The London School of Hygiene & Tropical Medicine is a world-leading centre for research and postgraduate education in public and global health, with more than 4,000 students and 1,000 staff working in over 100 countries. The School is one of the highest-rated research institutions in the UK, is among the world's leading schools in public and global health, and was named University of the Year in the Times Higher Education Awards 2016. Our mission is to improve health and health equity in the UK and worldwide; working in partnership to achieve excellence in public and global health research, education and translation of knowledge into policy and practice. http://www. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (http://www. ). Vaccine is the pre-eminent journal for those interested in vaccines and vaccination. It is the official journal of The Edward Jenner Society and The Japanese Society for Vaccinology and is published by Elsevier http://www.
News Article | February 15, 2017
Vitamin D supplements protect against acute respiratory infections including colds and flu, according to a study led by Queen Mary University of London (QMUL) Vitamin D supplements protect against acute respiratory infections including colds and flu, according to a study led by Queen Mary University of London (QMUL). The study provides the most robust evidence yet that vitamin D has benefits beyond bone and muscle health, and could have major implications for public health policy, including the fortification of foods with vitamin D to tackle high levels of deficiency in the UK. The results, published in the BMJ, are based on a new analysis of raw data from around 11,000 participants in 25 clinical trials conducted in 14 countries including the UK, USA, Japan, India, Afghanistan, Belgium, Italy, Australia and Canada. Individually, these trials yielded conflicting results, with some reporting that vitamin D protected against respiratory infections, and others showing no effect. Lead researcher Professor Adrian Martineau from QMUL said: "This major collaborative research effort has yielded the first definitive evidence that vitamin D really does protect against respiratory infections. Our analysis of pooled raw data from each of the 10,933 trial participants allowed us to address the thorny question of why vitamin D 'worked' in some trials, but not in others. "The bottom line is that the protective effects of vitamin D supplementation are strongest in those who have the lowest vitamin D levels, and when supplementation is given daily or weekly rather than in more widely spaced doses. "Vitamin D fortification of foods provides a steady, low-level intake of vitamin D that has virtually eliminated profound vitamin D deficiency in several countries. By demonstrating this new benefit of vitamin D, our study strengthens the case for introducing food fortification to improve vitamin D levels in countries such as the UK where profound vitamin D deficiency is common." Vitamin D - the 'sunshine vitamin' - is thought to protect against respiratory infections by boosting levels of antimicrobial peptides - natural antibiotic-like substances - in the lungs. Results of the study fit with the observation that colds and 'flu are commonest in winter and spring, when levels of vitamin D are at their lowest. They may also explain why vitamin D protects against asthma attacks, which are commonly triggered by respiratory viruses. Daily or weekly supplementation halved the risk of acute respiratory infection in people with the lowest baseline vitamin D levels, below 25 nanomoles per litre (nmol/L). However, people with higher baseline vitamin D levels also benefited, although the effect was more modest (10 per cent risk reduction). Overall, the reduction in risk of acute respiratory infection induced by vitamin D was on a par with the protective effect of injectable 'flu vaccine against 'flu-like illnesses. Acute respiratory infections are a major cause of global morbidity and mortality. Upper respiratory infections such as colds and 'flu are the commonest reason for GP consultations and days off work. Acute lower respiratory infections such as pneumonia are less common, but caused an estimated 2.65 million deaths worldwide in 2013. Vitamin D supplementation is safe and inexpensive, so reductions in acute respiratory infections brought about by vitamin D supplementation could be highly cost-effective. The study was conducted by a consortium of 25 investigators from 21 institutions worldwide* and funded by the National Institute for Health Research. Joel Winston, Public Relations Manager (School of Medicine and Dentistry) Queen Mary University of London firstname.lastname@example.org Tel: +44 (0)20 7882 7943 / +44 (0)7970 096 188 * Institutions involved in the research: Edmond and Lily Safra Children's Hospital (Tel Hashomer, Israel), Geisel School of Medicine at Dartmouth (NH, USA), Harvard School of Public Health (Boston, MA, USA), Jikei University School of Medicine (Tokyo, Japan), Karolinska Institutet (Stockholm, Sweden), Massachusetts General Hospital (Boston, MA, USA), McMaster University (Hamilton, Ontario, Canada), Medical University of Lodz (Poland), QIMR Berghofer Medical Research Institute (Queensland, Australia), Queen Mary University of London (UK), The Pennsylvania State University (Hershey, PA, USA), Università degli Studi di Milano (Milan, Italy), Universitair ziekenhuis Leuven (Belgium), University of Auckland (New Zealand), University of Birmingham (UK), University of Colorado School of Medicine (Aurora, CO, USA), University of Delhi (India), University of Otago (Christchurch, New Zealand), University of Tampere (Finland), University of Tasmania (Australia), Winthrop University Hospital (Mineola, NY, USA). Research paper: 'Vitamin D supplementation to prevent acute respiratory infections: systematic review and meta-analysis of individual participant data'. Martineau et al. BMJ 2017 Queen Mary University of London (QMUL) is one of the UK's leading universities, and one of the largest institutions in the University of London, with 23,120 students from more than 155 countries. A member of the Russell Group, we work across the humanities and social sciences, medicine and dentistry, and science and engineering, with inspirational teaching directly informed by our research. In the most recent national assessment of the quality of research, we were placed ninth in the UK (REF 2014). As well as our main site at Mile End - which is home to one of the largest self-contained residential campuses in London - we have campuses at Whitechapel, Charterhouse Square, and West Smithfield dedicated to the study of medicine, and a base for legal studies at Lincoln's Inn Fields. We have a rich history in London with roots in Europe's first public hospital, St Barts; England's first medical school, The London; one of the first colleges to provide higher education to women, Westfield College; and the Victorian philanthropic project, the People's Palace at Mile End. Today, as well as retaining these close connections to our local community, we are known for our international collaborations in both teaching and research. QMUL has an annual turnover of £350m, a research income worth £125m (2014/15), and generates employment and output worth £700m to the UK economy each year. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (http://www. ).
News Article | March 23, 2016
When he was a teenager, Lee Gonzales could not save his uncle from a heroin overdose. Now he worries that the same drug could kill him after he gets out of jail. As Gonzales remembers, he had rousted his uncle from previous heroin stupors by propping him up and splashing water on his face. But there was no one around to help that day. And there was nothing available like the bright orange prescription bottle the 32-year-old heroin addict held in his hand on a recent morning. "This is enough medicine to save somebody, huh?" Gonzales said, fiddling with the nasal inhaler as a doctor sat with him in a cinderblock interview room in Denver's downtown jail. Similar scenes are unfolding in a growing number of jails and prisons across the country as health officials train soon-to-be-released inmates to use the overdose-reversal drug naloxone to save others and sometimes themselves. Dr. Joshua Blum teaches inmates about the nasal spray, which can undo the effects of an opiate overdose almost instantly. Blum told Gonzales, who was jailed on theft warrants, he could take the antidote with him when he is freed. "I think it's a great idea," Gonzales said. Naloxone, also known by the brand name Narcan, has become a key tool in curbing overdoes resulting from the nation's opioid abuse epidemic. The class of drug that includes prescription painkillers and heroin was involved in a record 28,648 deaths in 2014, and opioid overdoses have more than quadrupled since 2000, according to the Centers for Disease Control and Prevention. Recently released inmates are particularly vulnerable. Naloxone supporters say the opportunity to save potentially thousands of lives outweighs any fears that the promise of a nearby antidote would only encourage drug abuse. Officials already widely distribute the drug to police, paramedics, drug users and their families. The push to equip inmates is new, fueled by research showing former prisoners in Washington state were nearly 13 times more likely to die of an overdose in the two weeks after their release than other people. Heroin tolerance goes down while users abstain behind bars, but they often return to their previous dose when they get out, putting them at greater risk. "They're very anxious. They are released to environments where they have a lot of exposure to drugs. They are triggered to use, and they may not have support systems to help them," said Dr. Ingrid Binswanger, senior investigator for Kaiser Permanente Colorado's Institute for Health Research, who worked on the study. Researchers also found that 8 percent of overdose deaths in Washington state were former prisoners. Inmates set to be released from San Francisco's county jail have been offered naloxone kits since the program started there in March 2013. More than 1,700 inmates in six New York state prisons have been trained to use the antidote, and at least 600 have taken kits with them on their way out. And in Colorado, several county jails began giving certain inmates rescue kits in January, funded in part by the state's recreational marijuana taxes. It's hard to say what happens to the inmates given the drug after they're released, partly because reporting overdoses or reversals is voluntary. A study of 100 Rhode Island inmates who received naloxone found they were able to successfully administer the drug after being released. A few used it to reverse their own overdoses, said Dr. Jody Rich, an epidemiologist and director of the Center for Prisoner Health and Human Rights. The research did not track what happened to the inmates over time. "I wouldn't predict that it would stop people from using, and conversely it wouldn't encourage them to use," Rich said. In New York, two former prisoners have come forward to report three overdose reversals, said Sharon Stancliff, medical director of the Harm Reduction Coalition, which runs the training. One of those former inmates now helps train other prisoners to use naloxone. The King County jail in Washington state has trained 221 inmates, 10 of whom reported lifesaving reversals. Officials only learned of those successes when inmates returned to jail, public health spokesman James Apa said. Blum, a doctor at Denver Health Medical Center, took inmates' phone numbers so doctors could reach out to each of them six months after their release. The Colorado program is too new to have yielded quantifiable results. "We're telling this group of people that is highly stigmatized and not well-liked that they're good enough citizens that they might be able to go out and save a life," Stancliff said. "It's empowering." Naloxone is not addictive and does not cause a high. Big pharmacy chains like Walgreens and CVS now sell the antidote, also available as an injection, over the counter. And the Obama administration in February proposed $90 million more in federal spending for programs that help states and local governments to, among other aims, improve access to naloxone. Critics say it provides only temporary relief without combatting drug use. Maine Gov. Paul LePage, for example, has consistently opposed efforts to make the drug more accessible, saying that giving the antidote to family members of drug users would discourage people from seeking treatment. Blum acknowledged that naloxone isn't a cure. But overdose reversals can offer a chance to seek more comprehensive treatment, he said. Gonzales agreed to let his cellmates know about the drug and pledged to give it to friends and family when he gets out. And he recalled his own efforts to revive his uncle. "I wish I had that at the time when that all happened," he said. "I sure wish I did."
News Article | February 21, 2017
A new study led by the University of Glasgow reports on key barriers and facilitators to implementing a digital health programme - and provides recommendations to move the field forward. The study, which is published in the Journal of Medical Internet Research today, suggests that while there are many challenges, these are not "insurmountable". The authors write that the current UK healthcare system, as well as the wider population and market, are not entirely ready for a wide scale digital health programme or digital health platforms. Alongside revealing barriers and facilitators, the authors of the study also reveal their ten key recommendations to aid and accelerate uptake in the digital health field. The researchers found that while there is receptiveness to digital health, key barriers remain at every level: market and policy level, organisational level and within the general professional and public population but intensive engagement, clinical endorsement and upskilling efforts can prove beneficial. Factors hindering implementation included a lack of IT infrastructure (including universal broadband); uncertainty around information governance; and trust in the security of digital health platforms. The commercial market was perceived as difficult to navigate, with concerns over accountability and liability voiced from within the commercial sector. The authors' recommendations include further commitment and investment in digital healthcare at a national and local level, and support for those who are not digitally fluent. The researchers also suggest training the next generation of health professionals to make them more digitally able and upgrading the technical capabilities of the health service. The study lead, Professor Frances Mair, Professor of Primary Care Research from the College of Medical, Veterinary and Life Sciences, said: "Given the current self-care agenda, the drive towards more personalised medicine and person-centred digital health solutions, this study is timely and has the opportunity to make an important contribution to understanding the implementation of digital health innovations." The study, which was conducted in collaboration with researchers from the University of Strathclyde and Newcastle University, evaluated the £37m digital health programme 'Delivering Assisted Living Lifestyles at Scale (dallas)' between 2012 and 2015. The dallas programme aimed to develop and implement a range of digital health products to enable self-care and preventative care. To understand the barriers and hurdles faced during the programme the researchers interviewed people involved and examined a vast quantity of documentary evidence over the course of the three year project. Researchers took care to include representatives from all the types of organisations involved, including private, public and voluntary, along with persons from all levels of the project from management to those delivering it to patients. There were also focus groups held with digital health users including patients and health professionals to gain their insight. Dr Marilyn Lennon, first author, from the University of Strathclyde's Department of Computer & Information Sciences, and co-lead of the study, said: "Digital health is a huge market with the potential to make a massive impact on society, but making it a part of routine care delivery has been much slower than expected. "This is not due to any lack of technical innovation, but to uncertainty over the role of technology in delivering care. There's also uncertainty about managing and using health data - many people go online to do banking or to use social media but seem wary about doing the same for health. Sharing this data with doctors or friends and family for example could avoid GP visits or prolonged stays in hospital. "Our research responds to calls for exploration of current barriers to the wide scale adoption of digital health, and offers recommendations that could help to realise its full potential." The dallas programme was funded by Innovate UK, The National Institute for Health Research, the Scottish Government, Scottish Enterprise and Highlands and Islands Enterprise. The paper, 'Readiness for Delivering Digital Health at Scale: Lessons From a Longitudinal Qualitative Evaluation of a National Digital Health Innovation Program in the United Kingdom', is published in Journal of Medical Internet Research. The study is funded by Innovate UK.