PhD Research

We host a number of PhD candidates, and you can read summaries of their research here.

 

Mary Feeney, Research Associate, NIHR Pre-Doctoral and Allergy Dietician

Project: Dietary adherence and dietary outcomes on allergy studies: development and validation of template questionnaires.

Aim: to describe current approaches to dietary data collection in allergy research, identify factors that influence data completeness and to develop validated prototype questionnaires acceptable and feasible for use in future studies.

The project will use a mixed-methods approach across three work packages and engage patients with lived experience of food allergy as well as stakeholders from allergy research and health care professionals. The review has been registered with Propero, see link below.

Link to the PROSPERO registration

 

Rosie Vincent, Research Associate, NIHR Pre-Doctoral and Dermatology Registrar

Project: What is the optimal way to stop or reduce topical steroids in eczema?

Eczema (otherwise known as atopic dermatitis) is common, affecting around 20% of children and 5% of adults worldwide. The signs and symptoms of eczema can have a significant impact on quality of life, sleep and daily activities, as well as self-esteem and confidence. Although newer targeted treatments have revolutionised outcomes for those with moderate-to-severe eczema, in the UK most people are managed in primary care with emollients and topical corticosteroids, with the minority referred into secondary care dermatology services.

Topical corticosteroids have different potencies, with a UK system classifying them into mild, moderate, potent and ultra-potent. There is good evidence for their use once daily to treat flares, with the recommended potencies depending on various factors such as body site, severity and age. There is a lack of consensus on how to stop the topical steroid once the flare has settled, with multiple methods used in clinical practice.

My PhD project’s aims are

  1. To find out the evidence for the different ways of stopping or reducing topical steroids
  2. To explore the current guidance given to people with eczema
  3. To provide clear and standardised information for clinicians and patients.

 

Anna Gilbertson, Research Associate, NIHR Pre-Doctoral and Qualified Nurse

Project: Exploring the impact of maternal dietary changes for infant symptoms attributed to cow’s milk protein allergy

Background: Cow’s milk protein allergy is commonly reported in infants under 1 year. Symptoms can overlap with normal symptoms and for mothers who breastfeed, the treatment is to exclude milk from their own diets or stop breastfeeding.

There is limited evidence of the value of this and the impact on mothers has been questioned but not yet thoroughly explored.

I will explore the impact of maternal dietary changes in this mixed-method project, which will include a systematic review, cross-sectional survey and qualitative interviews with mothers.

Visit PROSPERO using this link to read about Anna’s work entitled: Global prevalence of maternal dietary changes during breastfeeding: a systematic review and meta-analysis.

 

Hannah Wainman NIHR Doctoral Fellow and Dermatology Consultant 

Project: Improving the diagnosis and care pathways for hidradenitis suppurativa in primary care (ID-HS)

Background:

Hidradenitis suppurativa (HS) is a devastating, painful, long-term skin condition. It causes red swellings in the armpits, groin, bust, and buttocks. These discharge pus and join to form larger areas, leading to scarring.

HS affects at least 1 in 100 UK people, costs the UK economy £3.83 billion annually, and has a direct annual cost of £4900 per person to the NHS.

HS is linked to other conditions, such as heart disease, depression, anxiety, joint problems, and bowel disease. People with HS are more likely to die from suicide, heart disease, and cancer. The longer treatment for HS is delayed, the worse it is for patients’ physical and mental health. Starting treatment later makes it less effective and increases the risk of scarring.

It is unclear why the diagnosis is often delayed and appropriate treatment is not started earlier. On average, patients see a healthcare professional (HCP) five times, have the disease for 7-10 years, and receive three wrong diagnoses before being diagnosed correctly. Wait times to see a dermatologist on the NHS are long (average 14.4 weeks), but antibiotics can be started in primary care during this time.

The overall aim of this project is:

To improve the diagnosis and management of patients with HS in primary care

Additional aims are:

  • To identify what is already known about the diagnosis of HS in primary care
  • To identify the barriers and facilitators to the diagnosis of HS in primary care
  • To develop and test a tool to assist in the clinical diagnosis of HS in primary care

Design

Workstream 1

I will comprehensively review the scientific literature and policy documents about HS diagnosis in primary care and summarise what is already known.

Workstream 2

I will create and send questionnaires to patients and HCPs to get their views and opinions on things that help and hinder diagnosing HS in primary care. I will get patients and HCPs to take part through primary care research networks.

I will interview some of the patients and HCPs who respond to the questionnaire, to gain more in-depth insight into the issues.

Workstream 3

I will use a large primary care database to identify the symptoms, signs, clinical codes, and patterns of consultations associated with an HS diagnosis. Items to search for will be identified from workstreams one and two. These will be used to develop a tool to help HCPs identify HS, which will be tested on a different dataset.

Sharing the findings

The project’s results will be shared in scientific journals and at conferences. The project patient group will co-design infographic(s), short videos, and plain English summaries. These will be shared on social media and presented to HS support groups and elsewhere. I will have a website for the study which will provide regular updates.

My research will:

  • Increase the awareness of HS in primary care
  • Inform management guidelines
  • Act as a catalyst for improving treatment and outcomes for HS patients