medical-equipment

Projects

TRANSFORMing Cancer Outcomes in Yorkshire is a platform that enables research into tackling cancer inequalities in Yorkshire. Through our research, we aim to address key gaps in knowledge related to inequalities in experience of and outcomes from cancer, especially related to age and socio-economic differences.

Our research seeks to address the following key areas:

 

Current projects

AT RISK: Attitudes Towards Risk stratified Bowel Screening

Title: AT RISK: Attitudes Towards Risk stratified Bowel Screening

Contact: Dr Jo Cairns (PI), Professor Una Macleod (Co-I), Professor David Weller (Co-I)

Funder: Yorkshire Cancer Research

Time frame: October 2021 to July 2022

The aim of this project is to explore attitudes towards risk stratified bowel cancer screening among members of the public and healthcare professionals/stakeholders.

There have been growing calls in the UK to adapt national cancer screening programmes to take account of people’s personal risk of developing cancer. Compared to cervical and breast screening, bowel screening has received less attention.

There is a lack of research on the impact of changing the existing bowel screening programme to a personalised approach (e.g. those at higher risk would be screened more frequently). We found limited research around attitudes towards such an approach. For instance, only one UK-based study examined the impact of receiving personalised risk scores for bowel cancer and this showed that it caused some distress. We also found that healthcare professionals did not always agree with risk-based recommendations. If risk-based bowel screening is to be implemented, we need to ensure it is both acceptable and feasible.

In this ten-month project, we will investigate how to make this approach acceptable to inform a future project looking at how to put this into practice.

Outputs and resources

Comic: Did you know your poo could save you?

DAMPen-D study: Improving the Detection, Assessment, Management, and Prevention of Delirium in Specialist Palliative Care Units (SPCUs)

Title: DAMPen-D study: Improving the Detection, Assessment, Management, and Prevention of Delirium in Specialist Palliative Care Units (SPCUs)

Contact: Professor Miriam Johnson and Dr Mark Pearson

Funder: Yorkshire Cancer Research

Time frame: February 2021 to February 2023

The purpose of the study is to assess the feasibility of using an implementation strategy to enable guideline-adherent delirium care in hospices with the aim of reducing patient days with delirium.

We will conduct the following:

  1. Co-design a flexible implementation strategy, drawing on the Creating Learning Environments for Collaborative Care (CLECC), for use in Specialist Palliative Care Units (CLECC-SPCU)
  2. Explore the feasibility of a future effectiveness evaluation study of CLECC-SPCU supported delirium care on clinical outcomes
  3. Assess the acceptability and flexibility of the co-designed CLECC-SPCU in three SPCUs
CANcer BEhavioural Nutrition and Exercise FeasibilIty Trial (CanBenefit II) 

Title: CANcer BEhavioural Nutrition and Exercise Feasibility Trial (CanBenefit II)

Contact: Dr Cindy Forbes and Dr Flavia Swan

Funder: Yorkshire Cancer Research

Time frame: 2020 to 2022

People with cancer affecting the lungs tend to be older and frailer compared to people with other cancers. As a result, they may have poorer quality of life and are less able to tolerate treatments for their cancer, such as chemotherapy. Research to date show that physical activity and nutrition support helps people with cancer, but not many older people are included in these studies. We aim to develop and test a physical activity and nutrition treatment to help older people with lung cancer have best quality of life.

The purpose of the project is to test the feasibility and acceptability of a tailored physical activity and nutrition programme to support best quality of life and help older people with lung cancer tolerate anti-cancer treatments. The study will invite older people with lung cancer who offered anti-cancer treatment to take part in a 12 week home based individualised wellbeing (physical activity and nutrition) programme. The study will recruit from two sites in Yorkshire; Castle Hill Hospital in Hull, and York Hospital.

Palliative care - not just at the end of life

Title: Palliative care - not just at the end of life

Contact: Professor Miriam Johnson and Dr Maureen Twiddy

Funder: Prostate Cancer UK

Timeframe: January to December 2018

The purpose of this project was to develop an educational resource for staff caring for men with prostate cancer and their families.

Men living with prostate cancer and their family caregivers have many unmet supportive and palliative care needs. However, most think of palliative care as something for the last days of life only so miss out on support. Our educational resource uses national survey data and patient and carer interviews to help staff identify, assess and manage these unmet needs.

Outputs

Educational resource hosted on Prostate Cancer UK website (available shortly)

2 publications in peer reviewed journals (in manuscript)

Experiences of cancer diagnostic pathways and care during the Covid-19 pandemic (PRIORITY study)

Title: Experiences of cancer diagnostic pathways and care during the Covid-19 pandemic (PRIORITY study)

Contact: Professor Una Macleod and Dr Olufikayo Bamidele

Funder: Yorkshire Cancer Research

Time frame: September 2020 to September 2022

The global coronavirus (COVID-19) outbreak has led to disruptions in cancer care services and resulted in a significant drop in urgent cancer referrals and treatment among patients in the United Kingdom. The implications these diagnostic and treatment delays have for the physical, mental, emotional and social wellbeing of cancer patients and their caregivers are currently not well understood. Our study aims to address this research gap by exploring experiences of cancer diagnosis and care during the COVID-19 pandemic.

We will interview adult patients diagnosed with cancer since January 2020 and receiving care within the Yorkshire region, their informal caregivers and healthcare professionals involved in cancer diagnosis and care within Yorkshire.

Insights gleaned from this study will be used to inform policy and practice for improved patients’ experiences and cancer care during immediate and future pandemics

For further information, email the contact above or: priority@hyms.ac.uk

EPOC Study

Title: Exploring pathways to optimise care in malignant bowel obstruction (The EPOC Study)

Contact: Dr Alison Bravington

Funder: Yorkshire Cancer Research

Timeframe: September 2021 to September 2024

About one in six people with cancer experience blockage of their intestines by a tumour (malignant bowel obstruction, or MBO). This stops people eating and drinking, causing severe pain, nausea and vomiting. Making decisions about treatment can be difficult – there are no nationally agreed guidelines. The recent RAMBO study at the Wolfson Palliative Care Research Centre also showed that people experiencing MBO often feel uncertain about treatment pathways and goals of care.

The EPOC study will begin by conducting a review of existing evidence, and building a panel of patients, caregivers and clinicians to discuss what we find out. These consultations will guide an interview study with patients and caregivers currently facing this condition and the clinicians who are caring for them. In-depth interviews using visual methods will explore patients’ pathways and examine how they might take part in decision-making, and how to decide which treatment would be most beneficial. In the final stage of the project, the patients, caregivers and clinicians from our review panel will meet with us again to help design patient-centred information and on-line clinical training tools. These interventions will explore how to ensure good decision-making in treatment pathways for MBO, how best to share this decision-making with patients, and how to achieve the best outcomes for people with MBO.

Phone App Study: Capturing cancer patient travel burden

Title: Phone App Study: Capturing cancer patient travel burden

Contacts: Dr Charlotte Kelly (PI), Warren Viant, Professor Grant Abt, Professor Una Macleod, and Helen Roberts

Funder: Yorkshire Cancer Research

Timeframe: October 2021 to October 2022

The aim of the study is to develop a mobile phone app that can collect patients’ experiences of journeying to and from hospital. The study will produce a mobile phone app that can be applied in future research with patients attending healthcare settings.

Travelling to hospital can represent a significant time commitment and burden for cancer patients. Difficult journeys have the potential to make patients even more unwell through being uncomfortable and causing stress and anxiety.

Studies have previously used the proxy measure of travel time or distance as the measure of travel burden. This does not capture the experiences of patients when they are travelling and is likely to be unrepresentative of travel times, as it is calculated based on estimated travel times between home and hospital by car.

This study aims to develop a phone app that will collect representative travel times and distances using GPS tracking data and allow patients to submit a voice recording and responses to questions about their journey.  The aim is to have an app that will provide a clearer picture of the travel burden of cancer patients accessing treatment, whilst minimising the burden of patients providing the information.

Outputs

The study will be producing an iPhone app that can be downloaded from the Apple App Store.


PhD projects

Effect of physical activity on quality of life in cancer survivorship: an online delivered, tailored physical activity programme

Student: Jordan Curry

PhD project: Effect of physical activity on quality of life in cancer survivorship: an online delivered, tailored physical activity programme.

Funder: Yorkshire Cancer Research

Start date: October 2019

Supervisors: Dr Cindy Forbes (primary) and Dr Mark Pearson (secondary)

Aim

To develop and assess the feasibility of an online web-based tailored exercise program for lung cancer survivors.

Summary

Within the last 40 years lung cancer has shown little improvement with only 5% of individuals surviving more than 10 years.

Developing an online evidence-based tailored exercise program could improve functional capacity and quality of life while overcoming exercise related barriers within lung cancer survivors.

A sociological examination of socio-economic inequalities in breast screening experiences

Student: Emily Lunn

PhD project: A sociological examination of socio-economic inequalities in breast screening experiences

Funder: Yorkshire Cancer Research

Start date: October 2020

Supervisors: Dr Jo Cairns and Professor Una Macleod 

Aim

This research aims to understand why we see lower uptake of breast screening among women from more deprived areas, and how we can improve this situation by making policy and practice recommendations.

Summary

Breast screening rates for women from the most deprived areas are significantly lower than those from the least deprived. By exploring inequalities in breast screening uptake through qualitative research, this study will provide in-depth understandings of screening barriers and facilitators and test acceptability of interventions to improve uptake.

Parenteral nutrition and venting gastrostomy for the management of inoperable malignant bowel obstruction

Student: Michael Patterson

PhD project: Parenteral nutrition and venting gastrostomy for the management of inoperable malignant bowel obstruction.

Funder: Yorkshire Cancer Research

Start date: September 2019

Supervisors: Professor Miriam Johnson and Professor Michael Lind

Aim

The overarching aim of this thesis is to evaluate the current practice of venting gastrostomy and parenteral nutrition in inoperable malignant bowel obstruction regarding benefits and harms, and the views and experiences of patients, their family carers, and clinicians.

Summary

To meet the aims of the thesis firstly the current evidence for venting gastrostomy and parenteral nutrition will investigated. Then the current management for patients with inoperable malignant bowel obstruction will be observed. Finally the views of experiences of patients, their carers, and clinicians with regards to benefits and harms of venting gastrostomy and parenteral nutrition will be explored. 

Exploring access to specialist cancer centres for patients in coastal areas, an assessment of the psychosocial, socioeconomic, psychological and health implications

Student: Rebecca Price

PhD project: Exploring access to specialist cancer centres for patients in coastal areas, an assessment of the psychosocial, socioeconomic, psychological and health implications

Funder: Yorkshire Cancer Research

Start date: October 2020

Supervisors: Dr Charlotte Kelly (primary) and Professor Una Macleod (secondary)

Aim

To explore access to specialist cancer centres for patients in coastal areas, through an assessment of the psychosocial, socioeconomic, psychological and health outcomes.

Summary

Since the development of specialist cancer centres, the need to travel has become an increasing burden for some patients.

Using both qualitative and quantitative methods, this research will explore the travel experiences of patients undergoing cancer treatments, particularly in coastal communities, along with the psychosocial, socioeconomic and health implications.

Supporting families when a parent has died

Student: Alexandra Wray

PhD project: Supporting families when a parent has died

Funder: Yorkshire Cancer Research

Time frame: July 2019 to November 2022

Supervisors: Dr Jason Boland, Professor Fliss Murtagh and Dr Clare Whitfield

Aim

The aim of this study is to explore how children and families can best support each other following the death of a parent and to understand how those around them can offer a supportive response

Summary

When a child or young person loses a parent, it is often devastating. Children and their family need support from the people around them.

It can be hard for children and families to know how to help each other. It can also be difficult for professionals and those around a bereaved family to know how best to support them.

This project aims to find out what children and their families need at this time and how they can best be supported after a parent has died. The project has been carefully designed with the involvement of bereaved children and families who have experienced the death of a parent, a Young Persons Advisory Group who help design and plan research with children, and professionals working in services offering bereavement support to families.

This project will examine the experiences of a sample of about 30 children and parents who have experienced the death of a parent. Children and their parent will be invited to a virtual or face-to-face interview with the researcher where they will be asked about the death of the parent, what they needed and how they were helped by each other and the people around them.

Children and families will be asked if they would like to look at the findings. If they want, they can help plan how and where the findings from this project should be presented and how the findings can be used to help other children and families when a parent has died.

Recruitment opened for the study in September 2021 and is anticipated to finish mid 2022.

Outputs and resources

Wray, A. (2021) Alex’s blog: a nurse’s honest experience of navigating a PhD. British Journal of Child Health. Published Online: 12 Aug 2021.

Wray A, Seymour J, Greenley S, Boland, J (2022) Parental terminal cancer and dependent children: a systematic review. BMJ Supportive & Palliative Care Published Online First: 28 January 2022. doi: 10.1136/bmjspcare-2021-003094 

Socio-economic inequalities in the diagnosis and treatment of bowel and ovarian cancer

Student: Dr Benjamin Pickwell-Smith

PhD project: Socio-economic inequalities in the diagnosis and treatment of bowel and ovarian cancer

Funder: Yorkshire Cancer Research

Time frame: November 2021 to November 2026

Supervisor: Professor Una Macleod

Bowel cancer is the fourth most common cancer in the United Kingdom (UK) with around 110 new cases diagnosed every day. Ovarian cancer is the sixth most common cancer affecting women in the UK, with around 20 new cases diagnosed every day.

Research has shown that cancer survival (the percentage of people still alive after a particular amount of time following a diagnosis of cancer) is lower for patients living in less affluent areas of England. The reasons for this are not fully understood. This research study aims to look for inequalities (differences) and their causes in cancer care. This might help explain what we can do to reduce these inequalities.

We will explore whether patients diagnosed with bowel or ovarian cancer living in less affluent areas:

  • Experience more delays in reaching a diagnosis, compared with other patients
  • Receive different treatments, compared with other patients

This project will use cancer registration data which is routinely collected by the National Cancer Registration and Analysis Service (the cancer registry in England, part of Public Health England). We will seek to access cancer registration data about all patients living in England who were diagnosed with bowel or ovarian cancer between 2016- 2017. This data will include details about each patient’s: 

  • Characteristics (such as their age at diagnosis, presence of other medical conditions, or their ethnicity)
  • Their cancer (such as how advanced it is)
  • Information about their treatment and how they came to be diagnosed.

We will look at the extent to which any differences in diagnostic or treatment times, or in the treatments received, can be explained by patient demographics such as age, number of medical conditions and the affluence of their area of residence. 

We will only have access to de-personalised data. It will be kept in a secure environment with strict controls over who is able to access it. After the study, all records will be securely destroyed.

Download the Privacy Notice for the project (PDF)

A complex intervention study evaluating the effect of a digitalised, patient-centred comprehensive geriatric assessment on clinical decision making and patient experience when utilised by a head and neck cancer multidisciplinary team

Student: Dr Gordon McKenzie

PhD project: A complex intervention study evaluating the effect of a digitalised, patient-centred comprehensive geriatric assessment on clinical decision making and patient experience when utilised by a head and neck cancer multidisciplinary team

Funder: Yorkshire Cancer Research

Timeframe: Expected completion early 2021

This project will develop a website and mobile app to enable older people with head and neck cancer to get a complete assessment of their day to day functioning and overall health.

We will develop, validate and implement a digitalised, cross-platform and integrated web and mobile service for undertaking comprehensive geriatric assessment in head and neck cancer patients.

Production of a single validated screening tool for the identification of malnutrition, cachexia and sarcopenia in older people with cancer

Student: Alex Bullock

PhD project: Production of a single validated screening tool for the identification of malnutrition, cachexia and sarcopenia in older people with cancer

Funder: Yorkshire Cancer Research

Timeframe: September 2018 to September 2021

Supervisor: Professor Miriam Johnson

Weight loss is common in people with cancer and is difficult to assess. This research aims to produce a screening tool to help medical teams assess older cancer patients more effectively, to identify issues regarding poor nutrition and causes of weight loss.

This research will develop a clinical tool that can identify the elements of malnutrition, cachexia and sarcopenia within a single screening tool. This will enable professionals identify the best treatment to manage these symptoms.