Agency: Department of Health and Human Services | Branch: National Institutes of Health | Program: STTR | Phase: Phase II | Award Amount: 1.20M | Year: 2015
DESCRIPTION provided by applicant By January oncology care providers will be expected to craft Survivorship Care Plans SCPs for all individuals ending active treatment for cancer however there is a lack of systematic study of the impact survivorship planning has on patients providers or healthcare systems The Polaris Oncology Survivorship Transition POST program is a web based system that incorporates recommendations from the Institute of Medicine IOM and American College of Surgeons ACS to assist with cancer survivorship planning It is a patient centered approach that integrates input from both the treating oncology team and the patient Phase I built and iteratively modified N the POST system and Phase II will test whether the SCPs impact patient and provider outcomes using a single blind randomized controlled trial RCT Breast cancer patients n transitioning out of active treatment will be recruited and randomly assigned to receive Treatment as Usual n or the POST n All participants will be assessed at and months by a research assistant blind to baseline status and group assignment Primary outcomes will include quality of life mechanisms of action such as confidence in entering survivorship and other outcomes such as psychological distress adherence to medical and behavioral health recommendations health care utilization patient satisfaction with the SCP and their oncologistsandapos care and oncology provider as well as PCP satisfaction with the POST system The POST will innovate the clinical setting through being the first system to produce computer generated tailored survivorship plans fully reflecting IOM recommendations and the new ACS requirements incorporating information from both the oncology provider and the patient featuring readily available andquot plug inandquot for two way electronic health record integration providing dynamic electronic referrals for specialized support services and facilitating care coordination between the oncologist and PCP This studyandapos s impact will be significant If hypotheses are confirmed clear scientific evidence will exist for supporting survivorship care planning into oncology clinical practice If hypotheses are disconfirmed important lessons will guide future directions for care planning including whether failure to affect outcomes was due to failure to impact several hypothesized mechanisms of action Commercial interest in the POST is brisk as it may facilitate survivorship planning improve care and improve compliance with accreditation standards PUBLIC HEALTH RELEVANCE The POSTandapos s public health impact is likely to be substantial because it will improve cancer survivorship planning which is currently an important deficiency in cancer care recognized by the Institute of Medicine and the American College of Surgeons The POST may have many potential benefits for patients such as improved long term health outcomes improved psychosocial outcomes and quality of life smoother transitions back into old and new life roles and improved continuity and coordination of care between providers Most importantly the POSTandapos s influence may reach beyond the patients it directly serves as it could help scientists and health care providers understand the potential benefits of cancer survivorship planning and how to best design and implement survivorship planning when patients are ending treatment for cancer
Agency: Department of Health and Human Services | Branch: National Institutes of Health | Program: STTR | Phase: Phase II | Award Amount: 1.20M | Year: 2015
DESCRIPTION provided by applicant Significance The USPHSTF SAMHSA CDC and NIAAA have affirmed the importance of screening in medical settings for alcohol consumption that exceeds the NIAAA low risk limits brief educational and motivational counseling for those who screen positive or have other evidence of an Alcohol Use Disorder and when appropriate referral to treatment SBIRT However translation to clinical practice continues to be elusive Polaris Health Directions Small Business and the University of Massachusetts Medical School Research Institute have partnered to solve this problem by creating the Remote Brief Intervention and Referral to Treatment service for alcohol R BIRT a telehealth service for delivering evidence based alcohol brief interventions and referral to treatment during a medical encounter in a cost effective sustainable way Investigators We have extensive expertise in SBIRT for alcohol Boudreaux Bernstein telehealth Boudreaux development testing and marketing of behavioral intervention technologies Boudreaux Harralson Grissom comparative effectiveness trial design and analysis Barton and health economics Sachs Combined the team has over publications related to SBIRT and constituent technology domains Innovation This Phase II STTR will pioneer telehealth delivery of SBIRT for alcohol It will be flexible enough for a variety of medical settings and will develop and expand software capable of facilitating both telehealth and in person SBIRT delivery models It will further innovate SBIRT research and clinical practice by exploring mechanisms of action an objective rarely incorporated into SBIRT studies Approach The design is a two arm single blind outcomes assessor randomized non inferiority trial Emergency department ED patients n who drink above the NIAAA low risk limits or have evidence of an Alcohol Use Disorder will be randomized to the telehealth model R BIRT or a gold standard in person intervention SBIRT and followed for months post visit using a multi method outcomes attainment plan The study will establish the non inferiority of the telehealth model compared to the in person model in reducing alcohol use and alcohol related consequences while showing that the telehealth model is the more cost effective of the two Mechanisms of action including patient knowledge of low risk drinking limits motivation self efficacy substance abuse treatment initiation and self help program engagement will be examined Environment With the success of the R BIRT Phase I and other relevant projects including previous large scale Phase II STTR clinical trials Polaris and UMass have clearly established their capability of successfully carrying out this study disseminating its results and marketing the final product Impact Because alcohol misuse abuse and dependence carries an enormous burden in both human suffering and healthcare costs a strategy that provides high quality evidence based care in a manner that is more cost effective and easier than existing models has potential to exert a substantial impact on public health PUBLIC HEALTH RELEVANCE The traditional paradigm that relies upon training physicians and nurses or uses on site interventionists to perform screening brief intervention and referral to treatment SBIRT for alcohol has proven unsustainable in most clinical settings The Remote Brief Intervention and Referral to Treatment R BIRT for alcohol is an innovative telehealth service model with potential to improve public health through evidence based counseling for patients who exceed the NIAAA low risk drinking limits or have evidence of an Alcohol Use Disorder with professional and self help treatment For those that are appropriate the R BIRT service will provide facilitated referrals to specialized alcohol abuse treatment The service model is being studied in the emergency department ED setting to demonstrate its utility in a medical setting with a very high prevalence of risky alcohol use and Alcohol Use Disorders however the model is relevant and will be accessible to a broad array of healthcare settings including primary care practices Our new model the R BIRT challenges the prevailing paradigm and offers the promise of not only clinical efficacy but increased cost effectiveness as well
Renfree A.,University of Worcester
International journal of sports physiology and performance | Year: 2013
To analyze pacing strategies displayed by athletes achieving differing levels of performance during an elite-level marathon race. Competitors in the 2009 IAAF Women's Marathon Championship were split into groups 1, 2, 3, and 4 comprising the first, second, third, and fourth 25% of finishers, respectively. Final, intermediate, and personal-best (PB) times of finishers were converted to mean speeds, and relative speed (% of PB speed) was calculated for intermediate segments. Mean PB speed decreased from groups 1 to 4, and speeds maintained in the race were 98.5% ± 1.8%, 97.4% ± 3.2%, 95.0% ± 3.1%, and 92.4% ± 4.4% of PB speed for groups 1-4 respectively. Group 1 was fastest in all segments, and differences in speed between groups increased throughout the race. Group 1 ran at lower relative speeds than other groups for the first two 5-km segments but higher relative speeds after 35 km. Significant differences (P < .01) in the percentage of PB speed maintained were observed between groups 1 and 4 and groups 2 and 4 in all segments after 20 km and groups 3 and 4 from 20 to 25 km and 30 to 35 km. Group 1 athletes achieved better finishing times relative to their PB than athletes in other groups, who selected unsustainable initial speeds resulting in subsequent significant losses of speed. It is suggested that psychological factors specific to a major competitive event influenced decision making by athletes, and poor decisions resulted in final performances inferior to those expected based on PB times.
Agency: European Commission | Branch: FP7 | Program: MC-CIG | Phase: FP7-PEOPLE-2013-CIG | Award Amount: 100.00K | Year: 2014
This project is about observing the amount of fungal spores in the atmosphere from harvesting. This will be done by further developing an unmanned airborne vehicle (drone) to sample airborne spores and use this in field studies. These data will be combined with existing data to explain fungal spore emissions from harvesting by developing a mechanistic mathematical model. Afterwards the mechanistic model will be implemented in an existing atmospheric transport model in order to explain the atmospheric transport of these fungal spores in the landscape as well as beyond the landscape.
Agency: GTR | Branch: BBSRC | Program: | Phase: Research Grant | Award Amount: 192.61K | Year: 2014
The UKs forests, woods and trees are under threat from a growing number of pests and diseases. Many of these threats are alien; historically not present in the UK and having been introduced from overseas. Some of these threats may reach the UK naturally i.e. as wind-borne spores from continental Europe; potentially one pathway for introduction of the disease ash die-back. The alternative and probably more common pathway of introduction is via human activity, especially trade; for example moving infected plants (another pathway identified for ash die-back) or through the shipping of goods associated with infested timber (as was the case with the recent introduction of the Asian long-horn beetle into Kent in packaging crates for stone). These cases clearly demonstrate that we need to do more to improve our nations biosecurity and protect our plants and trees; both cultivated and in the wider environment. In order to do this we need better methods for detecting these pests and diseases that allow us to find them earlier and with greater efficiency. By detecting these threats earlier you can minimize the damage they cause, by either preventing an outbreak occurring in the first place or by finding it early and then stopping it from establishing and spreading further. At present we rely on trained inspectors to find these alien pests and pathogens, mainly via visual inspections of imported plants and plant-based products e.g. timber. However, given the volume of inspections required, the finite amount of resource available and the huge practical challenges associated with these inspections, this task is extremely difficult and the efficiency of detection is low. This project is designed to change that situation by providing better methods for detecting tree pests and pathogens; both moving in trade and in the environment. It will look at new technologies for the detecting changes in infected plants; using either sniffer technology to identify differences in the volatile chemicals given off by diseased and healthy plants or imaging techniques that can detect changes beyond the range of human vision. It will also look at developing and designing novel traps for capturing insects and DNA-based detection approaches that look for air- and water-borne pathogens. This will include better approaches for trapping spores and then applying high-throughput sequencing methods that will allow the identification of not only known pathogens but also new ones too. However, developing these new technologies is only part of the challenge. It is also necessary to make sure these new methods are fit-for-purpose and that they work in a way that meets the needs of those enforcing tree health regulations (e.g. government), those upon who those regulation impact (e.g. woodland owners and industry) and the end-users who would be expected to use these new tools (e.g. inspectors in the field). We will also examine what type of end-users could be involved; this could be trained government inspectors (the traditional approach) or alternatives such as those working in the industry, volunteers or even the general public. So looking to see if a so-called citizen science approach could be used for any of these new approaches. It is also important to ensure that these new approaches can be deployed effectively, for example at locations that pose the greatest risk, and in a way that offers the best cost-benefit (i.e. the best balance between cost of using the technology and the improvements it can offer in terms of better pest and disease detection). In order to do this, we will take an interdisciplinary approach; getting experts from many different fields e.g. biology, mathematics, chemistry, engineering, physics, economics and social science, to work together to come up with the best overall solution that works technically, economically and socially.
Agency: Department of Health and Human Services | Branch: | Program: STTR | Phase: Phase I | Award Amount: 225.00K | Year: 2014
Project Summary Human respiratory syncytial virus (RSV) is recognized as the single most important viral cause of acute respiratory disease in infants and young children worldwide. Elderly populations and immunocompromised individuals are also at significant risk for serious RSV disease. Despite this very substantial disease burden imposed by RSV worldwide, there are no vaccines available. Several problems have impeded RSV vaccine development. First is safety. An early formalin-inactivated vaccine (FI-RSV)predisposed infants to more severe disease upon natural exposure to live virus resulting in concerns about the safety of all subsequently developed RSV vaccines, particularly nonreplicating vaccines. A second problem is a lack of understanding of requirements for stimulation protective responses making efficacy of new vaccine candidates difficult to predict. A third problem is the failure of RSV infections as well as many vaccine candidates to stimulate long-term, protective immune responses. This propos
Agency: Department of Health and Human Services | Branch: | Program: STTR | Phase: Phase I | Award Amount: 251.92K | Year: 2010
DESCRIPTION (provided by applicant): The proposed project is designed to fill an extremely important yet unmet need by developing an alternative training mechanism that has the potential for reaching all personnel responsible for risk management and quality improvement in programs that provide services to persons with mental retardation/developmental disabilities (MRDD) and the public agency staff that oversee such programs. Pursuing this objective, the applicant organization, Praxis, Inc., and Eunice Kennedy Shriver Center at the University of Massachusetts Medical School will work together to develop, implement, and evaluate a comprehensive training curriculum to provide knowledge and practical skills in the first of a series of on-line courses for training staff in the use of analytic tools for Risk Management in Developmental Disabilities (RMDD). The training curriculum will be an anytime, anywhere training program available to anyone with Internet access. The program, RMDD, is intended to meet the essential needs of public and private agencies to assure the health, safety and welfare of a very vulnerable population that is at increased risk of harm and that is being served in over 145,000 residential settings across the nation, a basic assurance all public agencies must meet to receive federal HCBS and ICF/MR funding. Course work will teach contemporary, evidence-based methods and procedures in RMDD specifically adapted to the unique nature of services directed at individuals with developmental disabilities. The product, RMDD will be a fully hosted, Web-based distance learning instructional program in which lessons will build upon one another, assisting learners to acquire a foundation of knowledge upon which more complex skill sets can be built. Learners who participate in RMDD will apply knowledge acquired through their readings to simulated or real life situations and adverse events that commonly occur in service settings serving the MRDD population. Self-assessments will be built into each module to help them accurately and systematically assess their skills and develop learning plans to improve when needed. PUBLIC HEALTH RELEVANCE: The proposed project and the resulting product will directly benefit individuals who provide services and support to children and adults with intellectual and other developmental disabilities. The project has three major objectives: (1) to Design, develop, implement, and evaluate 6 new on-line training courses in risk management techniques and skills, (2) to develop a commercially viable software prototype, and (3) to evaluate the resulting program to determine the usability of the software and the effectiveness of the curriculum in teaching risk management skills.
Agency: European Commission | Branch: H2020 | Program: MSCA-IF-EF-ST | Phase: MSCA-IF-2015-EF | Award Amount: 195.45K | Year: 2016
The main goal of the proposed project is to provide an advanced mathematical model (WRF-BioChem) for modelling the emission, dispersion and concentration of bioaerosols at the regional scale. The model will with this development be able to handle feedback mechanisms between biology, chemistry and weather. The model is developed to go beyond state-of-the-art by developing the mathematical model for oak pollen and by doing it at the species level. The project supported by a three companion projects on grass pollen, fungal spores (Alternaria) and pathogens all at species level. These projects deliver the needed resources for detection. As such the mathematical model will be a validated model that will be generally applicable for bioaerosols including pollen, pathogens and fungal spores. Detection of pollen will be carried out by supporting staff and projects using both traditional methods based on optical detection at the genus level and next generation sequencing at the species level. This proposal requires multidisciplinary approach to the problem as pollen appearance and behaviour in the air is dependent on many factors, including meteorological conditions, chemical composition of the atmosphere or surface properties as well as feedbacks between these elements. WRF-Chem currently used in air quality modelling will therefore be adapted for studying transport of bioaerosols in a way consistent with the transport and transformation of other air pollutants. Until now, no atmospheric model is used for the simulation of pollen at the species level in either Europe or in USA. Also, it will be the first time simulations of oak pollen will be possible in Europe or in USA. Also, it will be the first time simulations of oak pollen will be possible in Europe. Finally, it will be the first mathematical model that allows for a full feedback between meteorology, chemistry, bioaerosols and the terrestrial biosphere. The model developments will be implemented in forecasting.
Agency: GTR | Branch: ESRC | Program: | Phase: Research Grant | Award Amount: 314.12K | Year: 2014
MEETINGDEM aims to implement and evaluate an innovative and inclusive approach to supporting community dwelling people with mild to moderately severe dementia and their family carers, called the Meeting Centres Support Programme (MCSP), in three EU countries: Italy, Poland and United Kingdom. This evidence-based, person-centred, approach has been positively evaluated, and implemented in 90 meeting centers in the Netherlands, and is now well-placed to be trialled and implemented in other EU countries. Demonstrated benefits include high levels of user satisfaction, reduced behavioural and mood problems, delayed admission to residential care, lower levels of caregiving-related stress, higher carer competence, and improved collaboration between care and welfare organizations. Project partners in the three countries will utilise strategies and tools developed in the Netherlands and adapt them to country-specific requirements, establish a group of appropriate organizational collaborators in each country, develop an implementation plan and toolkit, implement MCSP, and evaluate the programme in a controlled trial in terms of its impact on the behaviour, mood and quality of life of people with dementia and carers, its cost effectiveness as a result of changes in use of other (more expensive) services, such as hospitals and residential care, and psychotropic medications. An overall evaluation will draw together findings from the three implementation countries to develop recommendations for successful implementation of the MCSP across the EU and beyond. The project will be carried out over a 36 month period. In Phase One (M1-18) activities will focus on establishing an initiative group of relevant organizations and user representatives in each country, exploring pathways to care and potential facilitators and barriers to implementing the programme, and developing country and context-specific implementation plans and materials. In Phase Two (M19-36) training will be provided to organizations and staff, after which the meeting centres will be established and evaluated for impact, cost-effectiveness, user satisfaction and implementation process
Agency: GTR | Branch: NERC | Program: | Phase: Research Grant | Award Amount: 167.41K | Year: 2016
Summary In this proposal, we aim to revolutionise the way that pollen is measured, model the spatial and temporal deposition of different species of grass pollen and identify linkages to human health. In the UK population ~5% suffer from allergic reactions (ranging from hay fever to asthma attacks) and further 22% are sensitised to grass pollen (i.e. they have antibodies capable of causing reactions). Grass pollen is the single most important outdoor aeroallergen closely followed by tree pollen. Similar to tree pollen, sensitivity towards grass pollen varies between species. However, we have no way of detecting, modelling or forecasting the aerial-dispersion of pollen from different species of grass. These limitations are due to complete lack of detailed source maps reflecting both the presence and abundance of different species of grass and because grass pollen, contrary to tree pollen, can not be separated into species using traditional observational methods. Therefore, combinations of the approximately 150 different species of grass pollen that are monitored (using approaches that remain unchanged since World War II) are lumped into a single category and form the foundation of the pollen forecast. In this project we will both develop new models and new methods of detection that address these major shortcomings. The present situation means that hay fever suffers and health practitioners do not know what species, or combination of species cause present symptoms. Individuals can be tested for against particular grass species, but there are ca. 16 million people sensitised to grass pollen, allergic reactions are complex and testing the population against 150 different grass species species is an overwhelming task. The alternative is to take an environmental approach by developing exposure models and identify the environmental conditions that induce the allergic response, which then can be profiled to human health. Recent developments in the generation of a UK plant DNA barcode library and DNA sequencing technologies have provided a unique and timely opportunity to identify the species, or combinations of species of grass that are associated with the allergic response. The important development of the UK plant DNA barcode library now gives us the ability to not only target individual species in molecular genetic analyses, but also assign identities to sequences derived from very high throughput molecular meta-analyses of complex mixtures of pollen grains. Similarly, recent developments in next generation air quality models and the advancement of computing power, has enabled the extension of these models into aerobiology in order to study the release, dispersion and transformation of bioaerosols and how this affects the environment. Here, a group of multidisciplinary researchers specialising in aerobiological modelling, DNA barcoding/molecular genetic identification and environmental health have teamed up with the UK Met Office in order to (a.) develop a novel and high-throughput molecular genetic way of measuring the geographical spread and abundance of different allergenic species of grass across the summer months, (b.) develop novel pollen bio-aerosol models and (c.) identify which species, or combinations of species are linked to the most severe public health outcomes of the allergic response (i.e. asthma). The work will provide information that healthcare professionals and charities will be able to translate into helping individuals live healthier and more productive lives. The information will help those with long term health conditions effectively self-manage their conditions, contribute more effectively to the workplace and be less reliant on the health system with accompanied economic benefits. Employers will benefit from greater employer productivity and pharmaceutical companies will be able to better target the distribution of their products and therapies.