CLAHRC research reveals poor asthma control and knowledge common among London schoolchildren

Newly published CLAHRC research has revealed that nearly half of secondary school pupils living with asthma have sub-optimal control of their condition and gaps in knowledge around symptoms, triggers and treatments.

The findings, published in the Journal of Asthma,  emerged from the results of nearly 800 pupils from across London schools completing questionnaires incorporating the asthma control test (ACT) – a validated tool for assessing control in asthmatic children aged 12 years and older. Using the ACT, we sought to assess asthma control and knowledge in London secondary school children.

Results showed a high prevalence of poor asthma control, poor asthma knowledge, and a high morbidity in London children with asthma.

799 children with doctor-diagnosed asthma completed the questionnaire;

  • suboptimal asthma control was reported by 49.6% of students
  • over a third (42.4%) prescribed a short-acting β2-agonist inhaler felt uncomfortable using it at school, and 29.2% reported not using this inhaler when wheezy
  • 56.4% of those with regular inhaled corticosteroids did not take them as prescribed, and 41.7% did not know what this inhaler was for.
  • suboptimal control was associated with a greater proportion of students reporting that they were “somewhat”, “hardly” or “not at all” comfortable using inhalers at school (52.7% vs 29.1 %) and outside school (22.8% vs. 14.8%)

Since suboptimal control by ACT is a risk factor for future severe exacerbations, and should prompt more intense clinical monitoring, our results suggest a need for interventions aimed at addressing poor asthma control in UK schoolchildren.

Read the full paper below

Asthma control in London secondary school children

Katherine Harris , MSc, Gioia Mosler Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK , PhD, Samson A. Williams , BSc, Abigail Whitehouse , MBChB, Rosalind Raine , MBBS, PhD & Jonathan Grigg , MD

Journal of Asthma

http://dx.doi.org/10.1080/02770903.2017.1299757

Introduction to Economic Evaluation Workshop

On 22 March, the NIHR CLAHRC North Thames Academy held its first face-to-face course of 2017, with a workshop on Economic Evaluation held by Professor Stephen Morris, Dr Elena Pizzo, Dr Estela Capelas Barbosa, Nishma Patel and Nicholas Swart, all from UCL.

The workshop was oversubscribed, and on the day, we had 28 participants with specialists from a wide range of organisations including GPs, hospitals, public health departments, and Clinical Commissioning Groups.

Throughout the day, the tutors guided the delegates through the essential aspects of designing an economic evaluation of a health service or intervention. Session topics included measuring costs, measuring outcomes and measuring cost-effectiveness, with practical exercises to supplement the theory.

 

Tutors (from left to right): Estela Capelas Barbosa, Elena Pizzo, Stephen Morris and Nick Swart

In the afternoon, delegates discussed in groups the economic evaluations they are planning to carry out, and had the opportunity to share ideas with colleagues from across different sectors and organisations. The wealth and range of experience in the room led to many interesting in-depth discussions, and shed light on a variety of issues and perspectives.

Many thanks to all the delegates who attended!

 

Very comprehensive course and very high level of subject knowledge in the teaching team

Excellent coverage and pace. Assumes a capable audience and provides a stimulating day.”

Really helpful introduction to concepts and will really help with own project

We were really pleased to receive positive feedback from participants, and are in the process of planning the next Introduction to Economic Evaluation workshop to be held on 8 November 2017 – details coming soon. Visit our Academy page to find out more about us and our other upcoming workshops.

To find out about future Academy courses visit our website or email clahrc.norththames@ucl.ac.uk to join our mailing list.

Bringing patient and public perspectives to research partnerships

The CLAHRC bought some patient and public perspective to a recent academic event on collaboration in research.
We were invited to the prestigious UCL Qualitative Health Research Symposium which this year focused on effective partnerships in research under the title Engagement, Co-production, and Collaborative Meaning-Making: Collaboration in Qualitative Health Research.

As well as cooperation between researchers from disciplines patients and the public are a vital partner in successful research.

Our Patient and Public Involvement Officer Steven Towndrow was joined at the event by one of our lay Research Advisory Panel Joan.

Both were invited to take part in a panel discussion at the end of the day (see below).


As well as panellists offering reflections on the event involving patients and the public in research, and how to recognise and reward their contribution, was clearly a “hot topic” for the audience of researchers.

Our thanks to Panel member Joan for giving of her time on the day – and for her thoughtful observations –

See the presentation and poster abstracts from the event

Read the story of the day in tweets

 

Introduction to Evaluation Workshop – June 13 2017

 

The NIHR CLAHRC North Thames Academy has just opened applications for its next short course – Introduction to Evaluation, to be held on June 13, 2017.

Do you need to demonstrate the impact of projects in your organisation?
Do you want to improve the design and implementation of your programmes?
Are you tasked with carrying out an evaluation, but don’t know where to start?

This one day, hands-on Introduction to Evaluation workshop addresses these challenges, and covers the skills and knowledge needed to undertake your own evaluation of a local programme or service. Aimed at staff from NHS Trusts, CCGs and Local Authorities, this workshop requires no previous experience of study design, statistics or evaluation.

To find out more about this one day course and how to apply, please click here.

Success for CLAHRC Fellow Emma Dunphy

Physiotherapist and CLAHRC HEE NCEL Fellow Emma Dunphy has been successful in her application for a prestigious Clinical Doctoral Research Fellowship with the National Institute for Health Research (NIHR).

Emma’s proposed research will develop an E-Health intervention to improve rehabilitation for anterior cruciate ligament injuries.

After spending a year with the CLAHRC on our fellowship scheme honing her research skills Emma successfully applied to the NIHR scheme against stiff competition.

The HEE/NIHR Clinical Doctoral Research Fellowship (CDRF) Scheme is aimed at registered non-medical healthcare professionals sited in England with at least 1 year’s experience of clinical practice, sufficient research experience or training to prepare them to undertake a PhD, and who wish to obtain a PhD by research whilst continuing to develop their clinical skills.

The full title for Emma’s research under the scheme will be Development of a model of service delivery to standardise anterior cruciate ligament rehabilitation in the NHS and testing the feasibility of an E-Health intervention to support delivery of this model.

See a poster outlining Emma’s work below or download a PDF here.

 

Leading the campaign against pollution caused by diesel engines

The Doctors Against Diesel campaign that was launched in December 2016 and has already received widespread media coverage with ongoing interest from the health community, local government and media. The campaign is led by health professionals and is calling for the use of diesel fuels to be banned in urban areas and progressively phased out elsewhere. On February 22nd the CLAHRC’s Professor Jonathan Grigg led a workshop of nurses, doctors and allied health professionals to formulate health messaging and decide next steps in the campaign to reduce diesel use.

Child Health Theme Lead Professor Jonathan Grigg is a prominent member of the campaign group and co-author of the Royal Colleges Report Every Breath We Take. Professor Grigg is a practising paediatrician with experitse in respiratory health, seeing first hand how pollution damages young and developing lungs. He also leads our School Asthma project which aims to improve management of the condition among children and young people.

Diesel engines are the single biggest source of nitrogen dioxide, which accounts for the vast majority of breaches of legal air pollution limits in the UK. Exposure to pollution can impact children and young people’s current and future health as strong evidence suggest it impairs lung growth in children.

 

 

 

 

A research trial with a difference

CLAHRC Researcher Professor Jonathan Grigg has been part of the ever largest study of the effects of a biomass-fuelled cookstove intervention on health outcomes. The intervention comprising two biomass-fuelled cookstoves, a solar charger, repair and maintenance service, and user training.

Many people in low- and middle-income countries do not have access to reliable energy sources such as electricity and therefore till cook and heat their homes using solid fuels (i.e. wood, crop wastes, charcoal, coal and dung). Around 3 billion people are obliged to use such inefficient cooking fuels and technologies which produce high levels of household air pollution with a range of health-damaging pollutants, including small soot particles that penetrate deep into the lungs.

Professor Grigg, Leader of our Child Health research Theme, was part of a team investigating whether replacing open fires with cleaner burning biomass-fuelled cookstoves would reduce pneumonia incidence in young children.

The results, published in the Lancet found no evidence that an intervention comprising cleaner burning biomass-fuelled cookstoves reduced the risk of pneumonia in young children in rural Malawi. Researchers called for effective strategies to reduce the adverse health effects of household air pollution.

 

The World Health organisation (WHO) estimates exposure to air pollution from cooking with solid fuels is associated with over 4 million premature deaths worldwide every year including half a million children under the age of 5 years from pneumonia.
http://www.who.int/mediacentre/factsheets/fs292/en/

Read the full paper:

A cleaner burning biomass-fuelled cookstove intervention to prevent pneumonia in children under 5 years old in rural Malawi (the Cooking and Pneumonia Study): a cluster randomised controlled trial

Dr Kevin Mortimer, PhD’Correspondence information about the author Dr Kevin MortimerEmail the author Dr Kevin Mortimer, Chifundo B Ndamala, Dip, Andrew W Naunje, Jullita Malava, MPH, Cynthia Katundu, Dip, William Weston, MBChB, Deborah Havens, DO, Daniel Pope, PhD, Prof Nigel G Bruce, PhD, Prof Moffat Nyirenda, PhD, Prof Duolao Wang, PhD, Amelia Crampin, MPH, Prof Jonathan Grigg, MD, Prof John Balmes, MD, Prof Stephen B Gordon, MD

Published: 06 December 2016

DOI: http://dx.doi.org/10.1016/S0140-6736(16)32507-7

Lancet Volume 389, No. 10065, p167–175, 14 January 2017

Making the Jump….to improved asthma management

Our Asthma Schools project is investigating asthma control among young people in schools and developing interventions to help them manage the condition better.

The project worked with Greenwich and Lewisham Young People’s Theatre (GLYPT) to produce a short film – Behind the Jump – about the importance of asthma awareness among young people. It carries an important message for all young people living with the condition.

The film was shot at the LEAP Parkour Park in Westminster, London.