Worldwide media coverage for international genetics conference at Kent

An international genetics conference at the University attracted national and international media coverage.

The annual meeting of the Preimplantation Genetic Diagnosis International Society (PGDIS) took place at Woolf College, Canterbury campus from 29 April to 2 May. It was attended by more than 300 experts, including IVF pioneer and television personality Professor Lord Winston.

pgdis

The event was attended by more than 300 experts, including IVF pioneer and television personality Professor Lord Winston.

His keynote address and other conference discussions, such as the impact of IVF on embryonic and long-term health, received media mentions across the globe, including the front cover of the Daily Mail, Guardian online, the i, the Washington Star, ITV and Nursing Times.

The conference reunited many members of the original research team, led by Professor Winston and Professor Alan Handyside (currently an honorary member of Kent staff), which pioneered pre-implantation genetic diagnosis (PGD) in the 1980s. Professor Darren Griffin, now Professor of Genetics in the School of Biosciences, was one of that team.

Darren Griffin, who was also the conference chair, gave a presentation entitled ‘Counting chromosomes: from sexing to Karyomapping’ as part of a session looking at early discoveries in the history of PGD and how they have led to more recent innovations.

Alongside debate and discussion, the conference showcased announcements of advances in the science of PGD – which involves the genetic profiling of embryos prior to implantation and can be used for the diagnosis of specific diseases.

Darren said afterwards: ‘PGD continues to be an exciting, and sometimes controversial area of medicine. This conference addressed the past, present and future of this ever-evolving area of science. We have had a lot of good feedback from this meeting whose legacy will be the place in which a number of “firsts” were announced.’

He added: ‘I am grateful to all the team, particularly my lab and students on the MSc in Human Reproduction for making it happen.’

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Week 6 and I’ve got so much to do!

So it’s the Tuesday of my sixth week of my placement, and we’ve come back to work after the long bank holiday weekend, and let me say, I definitely appreciated it! Last week was a busy one, full of picking up, returning and ordering files. I’m supprised at how quickly I’ve managed to get the hang of the filing system in patient records. Initially it was taking me about 5 minutes to find one file and now it’s much faster!

We ordered a large box of files last week from off site casenote storage, and we thought that it would take us a few days to get through them, but it took us less than a day, so I guess we’re really speeding up! My supervisor had been on holiday for the past few weeks, so when he came back last week, we had a good catch up and it was nice to get conformation from him that we were doing everything correctly. We had a discussion with him about some of the things that we were finding difficult (like the mRS values that I’ve previously mentioned) and he gave us some help and tips to try and sort them out.  On Friday I decided to calculate how many entries we had yet to fill in on the database, and how long it would take us to do them. Annoyingly I discovered that we would have to complete 30 files a day to complete it, which is just a huge number, so it’s lucky that I also found out that I can carry my placement on from the initial 8 weeks in order to complete my project. In the past week we have more than doubled the number of entries that we have put into the database, so we’ve now completed over 200! 

On the OSA-TIA front, we’ve almost completed going through the TIA letters and are going to start looking at out of those who have had TIAs, which ones also have OSA.

The placement has gone really well so far, and I can’t believe that I only have less than two weeks left!

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KSS AHSN Newsletter – 21 August 2014

Health innovations and evolving healthcare sector

The opportunities for us to care more easily for ourselves, or understand our own health better, are increasing rapidly. The Guardian healthcare network reported recently that Google, Apple, and Samsung are all racing to develop wearable technology that could be used to monitor personal health and diagnose disease. The growing number of new healthcare apps is another symptom of the change taking place. We’re never far away from a story about innovative technology built around patient needs and providing a better experience.

Last week the BBC, among others, ran a piece about an American entrepreneur who has apparently become the youngest self-made female billionaire after developing a new system for blood tests. The premise is unassuming: to make blood tests simple, timely, un-alarming, and cheap. Achieving this has required her company to re-invent the chemistry and analytics of blood-testing; enabling fast, accurate and sophisticated tests to be done using only tiny amounts of blood.

Despite the high-tech innovation, in some ways there’s a very familiar feel to how they’re making it work. Taking it from a niche service sold to pharma to a mass market product experienced directly by patients, is being achieved through a network of 8,500 retail drug stores.

Proliferation

The story describes this aspect of their development as a sideshow to the main event; it almost slips in under the radar. But I think it shows something really significant. The headline grabbing discovery, development or device is never enough on its own. Without a network to spread them, today’s headliners become yesterday’s news very fast. Sustaining and sharing innovation is how doings differently starts making a difference.

Our Enhancing Quality and Recovery (EQR) collaborative approach is a great example of how the cycle can work well. It’s often clinical teams who are the unsung heroes, adopting the latest best practice and using it to sustain improvements for patients. Without their commitment to collaboration and sharing learning, best practice and innovation would struggle to achieve such widescale impact across Kent, Surrey and Sussex.

Hold that date!

I’m delighted that there is at least one upcoming event where the EQR teams will be headline grabbing – so just a quick reminder that the KSS AHSN Expo and awards will be in London on 13 January 2015. Please save the date in your diary and look out for details about registration which will open in September.

Kind regards,

Guy Boersma Managing Director, KSS AHSN

KSS AHSN Secondment Opportunity: Director (Clinical) for Patient Safety Collaborative

KSS AHSN is hosting the KSS Patient Safety Collaborative, which will develop a culture of continuous learning and sharing data to make a significant reduction in patient harms. This is part of a national initiative of 15 Collaboratives and we need a Director (Clinical) to work jointly with the Director (Operational) to achieve these important outcomes. You will need experience as a Clinical Director in achieving service improvements, along with an exemplar reputation for delivery. Experience of undertaking a regional, cross-boundary role is essential.

This is a two-year secondment starting in September 2014, for five PAs per week. For further information, please contact Kay Mackay on 01293 600300 x1751.

To apply, please send your CV and a one-page supporting statement to: Julie Hall: julie@templetreeconsulting.co.uk

Closing date for applications: 29th August

Selection process: 9th September

KSS AHSN poster accepted for presentation at the BTS Winter Meeting 2014

KSS AHSN’s poster abstract titled A survey of Pulmonary Rehabilitation (PR) Services in Kent, Surrey, Sussex (KSS) has been accepted for presentation at the BTS Winter Meeting 2014.

We believe the survey, and therefore the information obtained, to be unique, not only because of the depth and breadth of service delivery detail obtained from clinicians, thus providing a real-life snapshot of the provision of a specific service – pulmonary rehabilitation, but also since it is from every provider of this service across an entire AHSN region.

The poster has been programmed to be presented on Thursday 4 December 2014. The poster will be in the session titled Clinical Delivery of Pulmonary Rehabilitation and will be displayed in the Whittle and Fleming Rooms on the 3rd floor throughout the day. For more information about BTS Winter Meetings 2014, please click here.

Geneix and IDEA London 15 September Event

Geneix in partnership with IDEA London, we’ll be hosting an evening of talks on the essentials of digital product development. This event is for medical professionals interested in developing their own digital product, or those interested in learning about the process of digital health technology development.

The event will be held on 15th September, if you’re interested in attending, simply send an email to: a.douglassbonner@ucl.ac.uk or you can find out more information and book a place on EventBrite.

Health Innovation Challenge Fund: Call for Proposals

The Wellcome Trust runs a joint funding initiative with the Department of Health. The Health Innovation Challenge Fund (HICF) is a translational funding scheme to accelerate the clinical application of projects that are well advanced along the development pathway. We would like to take this opportunity to inform you that we have just announced a new call for proposals.

Full details and application forms are available from the website. The deadline for preliminary applications is 15 September 2014.

Please contact Tim Knott: t.knott@wellcome.ac.uk, if you would like to discuss the Health Innovation Challenge Fund. Please forward this to any colleagues that may be interested.

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Health Innovation Network Invitation to Primary Care Event on 23 September

The Health Innovation Network would like to invite you to our event ‘Focus on Primary Care in South London’

Health Innovation Network (the Academic Health Science Network for South London) is hosting an afternoon networking and learning event on 23 September to bring together GPs and healthcare professionals from across all aspects of Primary Care in South London – from patient care to commissioning and service improvements.

HEKSS Innovation Challenge Fund

Health Education Kent, Surrey and Sussex has launched the Innovation Challenge Fund to support innovative approaches to workforce development. The £500k fund aims to speed up the introduction of new approaches to training and education that will enable health and care professionals to deliver better, more efficient care for patients.

For more information, and to download the application form and guidance documents, please visit the HEKSS website. The deadline for applications is 17 October 2014.

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Week 1- Discovering Thoracolumbar Fascia.

Today marks the end of my first week working with Kyra De-Coninck. Her PhD is ‘Ultrasound evidence of changes in thoracolumbar fascia in people with lower back pain’. It has been a great week, and I’ve already learnt so much!

The first day I got given tasks to do as Kyra was travelling back from France. This is when I got my first taste of the complexity and diversity of the research involved for this study! I spent the day looking at a directory of studies on the World Health Organisation site that involved ‘lower back pain’. The amount of results that appeared were mind-blowing! Although I only had to look at the studies from the past year- a grand total of 188. I looked at these different trials and collected various bits of information such as the range of how differently the word ‘chronic’ was interpreted, the different interventions used by each trial, how many trials were of the same type as this one, and how many trials included fascia. I was really interested to see exactly how differently the word ‘chronic’ can be interpreted… some studies stated weeks, some stated months, and some stated that it depends on the frequency of occurrence.

The next day I got to meet Kyra and sit down and agree with her what we both wanted out of this internship- we both wanted the same things which was brilliant. We set up my desk and equipment and made a plan for the week- it all felt very real and exciting! We spent the day registering me to a programme which allows us to share interesting research articles with each other and store/categorize them and by the end of the day I had folders full of intriguing articles to read that relate to the study. I’m already thinking this programme will be fab for when I do my dissertation!

I spent the rest of the week discussing my findings with Kyra regarding the World Health Organisation Task and she came up with an interesting avenue to research, that included putting the different studies into current theoretical models to see if we can further confirm the need for fascia exploration and the addition of sub categories to categorize lower back pain.

I also read a huge article regarding the anatomy of the Thoracolumbar Fascia this week. We thought this would be a good first article to read as its important for me to understand the complex anatomy of Thoracolumbar Facia, and gain an appreciation of the importance of this new field of study. It’s amazing how the understanding of this structure has changed over the years and there’s still so much research to be done! This article challenged me as there were so many anatomical phrases I was not familiar with- but that benefited me hugely as I have already expanded my knowledge of the spine.

I really recommend a read if you are interested in spinal anatomy. Here are the details:
Willard, F., Vleeming, A. and Schuenke, M. (2012). The thoracolumbar fascia: anatomy, function and clinical considerations. Journal of anatomy. 221 (6), p507-36.

This experience has already helped me so much with my own understanding of academic writing, it’s almost a narrative that is written. On my last day of the working week I also got my first taster of analysing an ultrasound scan. I took a survey involved in the study just to see my interpretation of ‘unorganised’ and ‘organised’ fascia according to guidelines that Kyra had written. The difference in layer orientation of fascia in different individuals really surprised me. Next week we hope to continue my analysis of the scans, but this time looking at all of the data to see if we can categorize the scans, and correlate these different categories with the level/nature of pain the participants experiencing at the time. This will add a different dimension as the echogenicity and thickness of the ultrasound scans have only been looked at so far. Ultrasound is a treatment modality that I haven’t explored as a student sports therapist yet, so I am looking forwards to getting back to work Monday morning!

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Week 5: File Collection Commences

This week we have finally been able to start collecting patient files from health records for use within the SUTO project. It was quite difficult to get this approval though, with a number of people disagreeing about the type of ID needed for doing so – something that seems to happen a fair bit and unfortunately can thus stall progress. It is of course good to see so much being done to protect patient confidentiality though, something that will hopefully be continued into the future.

Having got approval we have now been able to start collecting patient files in order to find and fill in patient information that wasn’t available on the online databases. Having both a plentiful supply of incoming requested paper files, as well as those we now collect each day, our work is certainly speeding up. This is further aided by us having already filled in as much patient information as possible in our spreadsheet by using the online patient databases. Usually only a few key points of information therefore has to be found in each paper file. However, sometimes the databases and files do not always showing matching figures. For example, sometimes a patient’s BP may fluctuate a number of times after admission and so a recording retrieved from the online databases may need to be replaced with one from the paper file in order to better match the time at which the rest of their information that we are entering was measured. I still feel as if I’m improving at knowing where to look for all of this information though, especially with how to calculate factors such as patients’ weight using their medication levels. To illustrate, I can now recall that the thrombolysis treatment Alteplase is given at the rate of 0.9 mg (bolus & infusion) per bodily kg.

We are also still going through the TIA letters for the OSA project, recording patients’ TIA presentations, risk factors and medication. It’s now getting easier to categorise these presentations because the symptomology terms used within patient descriptions are generally re-used by the same clinicians. There are still a few terms that I need to record and check at the end of the week though. For example, someone described as having ‘heavy’ limbs should be categorised as having motor loss (weakness), unless the term ‘dead’ feeling limbs is also used which would further indicate paraethesia (numbness). I have also begun to notice a fair number of the TIA patients who have undergone sleep studies and had Epworth scores recorded which will hopefully be useful for later on in the project. The Epworth scale can indicate people’s levels of sleepiness by asking how likely they are to fall asleep in different circumstances (see below). This is thus a valid way of detecting OSA due to the disorder often causing daytime sleepiness and fatigue. The AHI (Apnea Hypopnea Index) scale can then also be used to record their actual amount of apneas per hour during a night of sleep, indicating the disorder’s severity.  I’m really looking forward to seeing how this project progresses and to finding out how prevalent OSA really is in the neurovascular clinic.

epworthSS

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CHSS to research integrated service development for NHS

NHS Thanet CCG and NHS South Kent CCG* have invested £30,000 in CHSS to provide research and evaluation support to take forward their integrated care agendas.

This investment will fund a part time researcher for one year to undertake an agreed programme of activity. This is likely to include rapid reviews of the evidence-base to underpin service development, and evaluation of pilot schemes. The project is being led by CHSS Reader in Applied Health Research, Jenny Billings.

For more details go to the CHSS Current Projectspage.

Notes:

For more information on the Clinical Commissioning Groups, please visit http://www.thanetccg.nhs.uk/home/# and http://www.southkentcoastccg.nhs.uk/homepage/#

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Visiting HTS Teams – Week 7

This week I was quite content as I managed to stretch my legs and get out of the office on a wild goose chase to get the missing data needed to finish my report. Ironically this actually involved having to get in a car for two small road trips lasting from 30-45 minutes to Swale and Thanet , so not much leg stretching was actually involved. Since I had to visit two teams to collect their data which in hindsight could be seen as a paltry amount of data (involving around 40 entries) but to go travelling and learn about other parts of Kent I could appreciate and more importantly, all the data adds up in the end and I wanted my report to be as accurate and reliable as possible. I was also very happy to get the chance to visit other HTS sites and teams.
They were all very warm and welcoming, offering us refreshments upon arriving and happily chatting about their jobs, their lives and up and coming leaving do’s. I recognized most of the professionals from the open day in my first week. After the trips input the rest of the data, ready to start evaluating for the report which in my opinion is where the real work begins as it involves the most maths.

Melissa

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Week 5 and we’re very busy

It’s the start of my sixth week here and the ID card sitution has finally been sorted! This meant that on Friday we were finally able to return all of the files that we had collected (over 50) and pick up some new ones. Returning the files turned out to be the easy part. In patient records there are shelves and shelves of files and whilst they’re ordered by patient number, finding the ones you want is not as easy as you’d think it would be. It was a good job that we returned all those files as just after we returned from patient records we were presented with a trolley full of files that we had ordered. This coming week we should have another batch of 20 files arriving, so we won’t be running out anytime soon. We’ve gone from worrying about running out of work, to being rather busy!

In total we’ve added over 80 enteries into the SUTO spreadsheet and almost 140 letters into the TIA-OSA database! Hopefully in these next three weeks the number will continue to grow and we’ll get closer and closer to having a complete database!

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Week 2: Lab observations and Data handling

Lab observations: Not a ‘must-do’ part of the placement, but for me it was exactly this! As someone hoping to go onto lab work I couldn’t wait to gain some experience and snapped up the opportunity straight away! I spent the day (9:30 – 5:30) in the Biochemistry lab at K&C Hospital. I was purely observing (I don’t have qualifications that allow me to touch anything unfortunately!) yet at the end of the day my head felt close to exploding with everything that I had learned. It was quite different to what I’d expected and I think completely different to what the general public, without an interest in science, would imagine. The level of automation is high and I was told in fact even higher at the William Harvey Hospital where it’s fully automated. I spent time in the reception area first where the samples are received, bar coded and entered into the hospital’s system. The arrival of new samples was continuous and endless and I gained an appreciation of the importance of the organisation skills of the staff. If new samples were labelled Urgent they have to drop everything else they are doing and process these straight away, in order to hit their 1 hour turn around limit. In fact, samples that come from A&E bypass the reception and travel, via a shoot in the ceiling, straight to the lab where they can be labelled and tested immediately. Though there are peaks and troughs throughout the day the workload is endless and 24/7, with no tolerance for error. Upon arriving in the lab the samples are checked with their paperwork again and then positioned in the correct place for their required tests. Some samples are transported straight to William Harvey as they require tests not carried out in K&C. Once inputted into the correct analyser results appear on the computer system. If results are normal they are automatically authorised and sent back to the ward/GP/patient. However, if results fall outside of the normal range they must be authorised by one of the Biomedical Scientists within the lab. This is so that they can see if the result is reasonable or not for that patient, and it is this skill that differentiates the Assistant Healthcare Staff and the registered Biomedical Scientists. The job is a constant rotation of receiving samples, analysing them, receiving results, releasing results and maintenance of the machines whilst making sure the priorities are always correct.

Although the majority of the tests are automated there are multiple ones that are completed manually via the staff, when needed. For example, when I was there, a sample for a ‘sweat test’ was sent over and needed to be analysed. (For those not from a scientific background the sweat test is gold standard for diagnosis of Cystic Fibrosis. In a CF positive patient the sweat will contain higher than normal levels of chloride.) The test was fiddly to carry out and required precision from a Biomedical Scientist in the lab. It was great to watch and understand the process, followed by the calculations used to determine the amount of chloride present. Thankfully the result was within the normal range and results were sent back on the same day to confirm a negative result. I also spent a little bit of time in the blood bank/transfusions lab and the blood analysis side. The day as a whole was fantastic and I think really emphasises the difference between learning through experience and learning through a textbook. Whilst I am really enjoying my Uni course I think that more practical work/experience of the real world would be extremely beneficial. It was suggested that I could volunteer at the Hospital for the remainder of my course, so this is something I will be sorting out in the near future hopefully! So overall a brilliant day and great experience.

After meeting separately with both Dr Strutt and Dr Doulton to discuss the worked I’d produced, which they were pleased with (thank god!), it was onto the next stage; sorting and selection of relevant data from that collected by the ward staff. This consisted of staring at spreadsheets for many hours. But it really wasn’t as bad as it sounds! Seeing the progression from hundreds of patients and all their data to the ones that compromised our group of interest was very satisfying.

I will be working on this until I meet with Dr Doulton again on Wednesday where I will be sitting in on an Advanced Kidney Care Clinic and a short X-ray session. Looking forward to this and will let you know how it goes in my next blog!

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Finishing Touches – Week 6

This week, once I finally entered all the data from the evaluation forms, I went through all the entries and noted what parts of the data were missing whilst, paying particular attention to entries about mental health bed admissions and referral goal or CANE need scores. Then the more social side of my week involved having to liaise and interact with the assistant psychologists to retrieve their missing data for each of the HTS teams. It took most of the week for everyone to get back to me and in the end, David and I arranged to go visit two teams to get their missing data and it gave me a chance to get out of the offices after weeks of entering data!

More to come,

Melissa

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