Primary care treatment of insomnia: study protocol for a pragmatic, multicentre, randomised controlled trial comparing nurse-delivered sleep restriction therapy to sleep hygiene (the HABIT trial)

Dr Stephanie Armstrong, University of Lincoln, College of Social Science, School of Health and Social Care

Prof Niro Siriwardena, University of Lincoln, College of Social Science, School of Health and Social Care, Director of Community and Health Research Unit

 

 

 

 

 

 

Introduction Insomnia is a prevalent sleep disorder that negatively affects quality of life. Multicomponent cognitive-behavioural therapy (CBT) is the recommended treatment but access remains limited, particularly in primary care. Sleep restriction therapy (SRT) is one of the principal active components of CBT and could be delivered by generalist staff in primary care. The aim of this randomised controlled trial is to establish whether nurse-delivered SRT for insomnia disorder is clinically and cost-effective compared with sleep hygiene advice.


University of Lincoln, College of Social Science Research

Simon D Kyle, University of Oxford, Sleep and Circadian Neuroscience Institute

Claire Madigan, University of Oxford, Nuffield Department of Primary Care Health Sciences

Nargis Begum, University of Oxford, Nuffield Department of Primary Care Health Sciences

Lucy Abel, University of Oxford, Nuffield Department of Primary Care Health Sciences

Stephanie Armstrong, University of Lincoln, School of Health and Social Care

Paul Aveyard, University of Oxford, Nuffield Department of Primary Care Health Sciences

Peter Bower, University of Manchester, Division of Population Health, Health Services Research & Primary Care

Emma Ogburn, University of Oxford, Nuffield Department of Primary Care Health Sciences

Niro Siriwardena, University of Lincoln, School of Health and Social Care

Ly-Mee Yu, University of Oxford, Nuffield Department of Primary Care Health Sciences

Colin A Espie, University of Oxford, Sleep and Circadian Neuroscience Institute


 

Eyewitness descriptions without memory: The (f)utility of describing faces

Dr Georgina Gous, University of Lincoln, College of Social Science, School of PsychologyDr Robin Kramer, University of Lincoln, College of Social Science, School of Psychology

 

 

 

 

Eyewitness descriptions provide critical information for the police and other agencies to use during investigations. While researchers have typically considered the impact of memory, little consideration has been given to the utility of facial descriptions themselves, without the additional memory demands. In Experiment 1, participants described face images to their partners, who were then required to select these faces from photographic lineups. Performance was error‐prone when the same image appeared in the lineup (73% correct), and decreased further when a different image of the same face was presented (22% correct). We found some evidence to suggest this was due, in part, to difficulties with recognizing that two different images depicted the same person. In Experiment 2, we demonstrated that descriptions of the same face given by different people showed only moderate agreement. Taken together, these results highlight the problematic nature of facial descriptions, even without memory, and their limited utility.


University of Lincoln, College of Social Science Research

Dr Georgina Gous, University of Lincoln, School of Psychology

Dr Robin Kramer, University of Lincoln, School of Psychology


 

Electronic health records in ambulances: the ERA multiple-methods study

Prof Niro Siriwardena, University of Lincoln, College of Social Science, School of Health and Social Care, Director of Community and Health Research Unit
 

Ambulance services have a vital role in the shift towards the delivery of health care outside hospitals, when this is better for patients, by offering alternatives to transfer to the emergency department. The introduction of information technology in ambulance services to electronically capture, interpret, store and transfer patient data can support out-of-hospital care.

We aimed to understand how electronic health records can be most effectively implemented in a pre-hospital context in order to support a safe and effective shift from acute to community-based care, and how their potential benefits can be maximised

We carried out a study using multiple methods and with four work packages: (1) a rapid literature review; (2) a telephone survey of all 13 freestanding UK ambulance services; (3) detailed case studies examining electronic health record use through qualitative methods and analysis of routine data in four selected sites consisting of UK ambulance services and their associated health economies; and (4) a knowledge-sharing workshop.

We found limited literature on electronic health records. Only half of the UK ambulance services had electronic health records in use at the time of data collection, with considerable variation in hardware and software and some reversion to use of paper records as services transitioned between systems. The case studies found that the ambulance services’ electronic health records were in a state of change. Not all patient contacts resulted in the generation of electronic health records. Ambulance clinicians were dealing with partial or unclear information, which may not fit comfortably with the electronic health records. Ambulance clinicians continued to use indirect data input approaches (such as first writing on a glove) even when using electronic health records. The primary function of electronic health records in all services seemed to be as a store for patient data. There was, as yet, limited evidence of electronic health records’ full potential being realised to transfer information, support decision-making or change patient care.


University of Lincoln, College of Social Science Research

Alison Porter, Swansea University,  Swansea University Medical School

Anisha Badshah, University of Greenwich, Department of Human Resources and Organisational Behaviour

Sarah Black, South Western Ambulance Service NHS Foundation Trust

David Fitzpatrick, University of Stirling, Faculty of Health Sciences and Sport

Robert Harris-Mayes, Independent service user

Saiful Islam, Swansea University,  Swansea University Medical School

Matthew Jones, Swansea University,  Swansea University Medical School

Mark Kingston, Swansea University,  Swansea University Medical School

Yvette LaFlamme-Williams, Welsh Ambulance Service NHS Trust, Pre-Hospital Emergency Research Unit

Suzanne Mason, University of Sheffield, School of Health and Related Research (ScHARR)

Katherine McNee, South Western Ambulance Service NHS Foundation Trust

Heather Morgan, University of Aberdeen, Health Services Research Unit

Zoe Morrison, Robert Gordon University, Aberdeen Business School

Pauline Mountain, Independent service user

Henry Potts, University College London, Centre for Health Informatics and Multiprofessional Education

Nigel Rees, Welsh Ambulance Service NHS Trust, Pre-Hospital Emergency Research Unit

Debbie Shaw, East Midlands Ambulance Service NHS Trust

Niro Siriwardena, University of Lincoln, School of Health and Social Care

Helen Snooks, Swansea University,  Swansea University Medical School

Rob Spaight, East Midlands Ambulance Service NHS Trust

Victoria Williams, Swansea University,  Swansea University Medical School


 

Evaluating follow-up and complexity in cancer clinical trials (EFACCT): an eDelphi study of research professionals’ perspectives

Dr Ffion Curtis, University of Lincoln, College of Social Science, Lincoln Institute for Health
Prof Graham Law, University of Lincoln, College of Social Science, SChool of Health and Social Care

 

 

 

 

Objectives To evaluate patient follow-up and complexity in cancer clinical trial delivery, using consensus methods to: (1) identify research professionals’ priorities, (2) understand localised challenges, (3) define study complexity and workloads supporting the development of a trial rating and complexity assessment tool (TRACAT).

Design A classic eDelphi completed in three rounds, conducted as the launch study to a multiphase national project (evaluating follow-up and complexity in cancer clinical trials).

Setting Multicentre online survey involving professionals at National Health Service secondary care hospital sites in Scotland and England varied in scale, geographical location and patient populations.

Participants Principal investigators at 13 hospitals across nine clinical research networks recruited 33 participants using pre-defined eligibility criteria to form a multidisciplinary panel.

Main outcome measures Statements achieving a consensus level of 70% on a 7-point Likert-type scale and ranked trial rating indicators (TRIs) developed by research professionals.

Results The panel developed 75 consensus statements illustrating factors contributing to complexity, follow-up intensity and operational performance in trial delivery, and specified 14 ranked TRIs. Seven open questions in the first qualitative round generated 531 individual statements. Iterative survey rounds returned rates of 82%, 82% and 93%.

Conclusions Clinical trials operate within a dynamic, complex healthcare and innovation system where rapid scientific advances present opportunities and challenges for delivery organisations and professionals. Panellists highlighted cultural and organisational factors limiting the profession’s potential to support growing trial complexity and patient follow-up. Enhanced communication, interoperability, funding and capacity have emerged as key priorities. Future operational models should test dialectic Singerian-based approaches respecting open dialogue and shared values. Research capacity building should prioritise innovative, collaborative approaches embedding validated review and evaluation models to understand changing operational needs and challenges. TRACAT provides a mechanism for continual knowledge assimilation to improve decision-making.


University of Lincoln, College of Social Science Research

Helene Markham Jones, University of Lincoln, Lincoln Institute for Health and United Lincolnshire Hospitals NHS Trust, Lincolnshire Clinical Research Facility

Ffion Curtis, University of Lincoln, Lincoln Institute for Health

Graham Law, University of Lincoln, School of Health and Social Care

Christopher Bridle, University of Bedfordshire, School of Psychology

Dorothy Boyle, NHS Lothian, South East Scottish Cancer Research Network (SESCRN)

Tanweer Ahmed, United Lincolnshire Hospitals NHS Trust, Lincolnshire Clinical Research Facility


     

    Understanding how Eastern European migrants use and experience UK health services: a systematic scoping review

    The UK has experienced significant immigration from Eastern Europe following European Union (EU) expansion in 2004, which raises the importance of equity and equality for the recent immigrants. Previous research on ethnic health inequalities focused on established minority ethnic groups, whereas Eastern European migrants are a growing, but relatively under-researched group. We aimed to conduct a systematic scoping review of published literature on Eastern European migrants’ use and experiences of UK health services.

    An initial search of nine databases produced 5997 relevant publications. Removing duplicates reduced the figure to 2198. Title and abstract screening left 73 publications. Full-text screening narrowed this down further to 10 articles, with three more from these publications to leave 13 included publications. We assessed publications for quality, extracted data and undertook a narrative synthesis.

    The included publications most commonly studied sexual health and family planning services. For Eastern European migrants in the UK, the most commonly cited barriers to accessing and using healthcare were limited understanding of how the system worked and language difficulties. It was also common for migrants to return to their home country to a healthcare system they were familiar with, free from language barriers. Familial and social networks were valuable for patients with a limited command of English in the absence of suitable and available interpreting and translating services.

    To address limited understanding of the healthcare system and the English language, the NHS could produce information in all the Eastern European languages about how it operates. Adding nationality to the Electronic Patient Report Form (EPRF) may reveal the demand for interpretation and translation services. Eastern European migrants need to be encouraged to register with GPs to reduce A&E attendance for primary care conditions. Many of the issues raised will be relevant to other European countries since the long-term outcomes from Brexit are likely to influence the level of Eastern European and non-Eastern European migration across the continent, not just the UK.


    University of Lincoln, College of Social Science Research

    Viet Hai Phung, University of Lincoln, School of Health and Social Care

    Zahid Asghar, University of Lincoln, School of Health and Social Care

    Milika Matiti, University of Lincoln, School of Health and Social Care

    A. Niroshan Siriwardena, University of Lincoln, School of Health and Social Care


     

    Crisis, deliberation, and Extinction Rebellion

    Dr Mike Slaven, University of Lincoln, College of Social Science, School of Social and Political Sciences

    The environment is one of the political issue areas identified earliest in the post-Cold War context as susceptible to securitisation (see Deudney 1990), defined as a way of treating an issue that emphasises existential stakes and licences exceptional ameliorative measures (Wæver 1995). In global environmental politics, such a quality has become unmistakable, amid developments increasingly represented as a climate emergency or crisis, deepening through inadequate response. This sense of crisis and a corresponding need for urgent action has ballooned as a topic of mass activism. In the past year, commutes in London and elsewhere have been disrupted by the direct action of Extinction Rebellion (XR), a transnational social movement organisation most active in the United Kingdom which campaigns for action against this ‘unprecedented global emergency’ (Extinction Rebellion 2019b).


    University of Lincoln, College of Social Science

    Mike Slaven, University of Lincoln, School of Social and Political Science

    James Heydon, University of Nottingham, School of Sociology and Social Policy