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UOA 12 - Allied Health Professions and Studies

University of Glasgow (joint submission with Glasgow Caledonian University and University of Strathclyde)

RA5a: Research environment and esteem

1. Research Structure

 

Since 2001 the research landscape of Nursing, Midwifery and Allied Health Professions (NMAHP) in the West of Scotland has seen radical changes. Substantial investment [£3.2M, Scottish Funding Council (SFC)], Scottish Government Health Department (SGHD) plus £2M from partner Universities] was awarded to ‘enhance the environment for NMAHP research through capacity building’. This investment resulted in ‘HealthQWest’ (www.healthqwest.org), an innovative research consortium established in September 2005. HealthQWest is a unique federal partnership between five Universities [Glasgow Caledonian University (GCU) (lead) and the Universities of Glasgow (UG), Strathclyde (US), Paisley and Stirling], NHS-Scotland and the Chief Scientist Office (CSO) NMAHP Research Unit. This submission represents the integration of activity between GCU, Glasgow and Strathclyde. Collaboration is demonstrated throughout by joint publications and grants. [Paisley and Stirling are submitted in other UOAs].

 

Howe, Founding Director (GCU 2005), has provided leadership in developing and operationalising a multidisciplinary, multi-institutional and intersectoral research strategy and creating an integrated organisational structure to ensure success.

 

Our aim is to maximise the benefits of increased academic critical mass and exploit the medical, scientific and technological strengths of the consortium for the benefit of people with long-term musculoskeletal and neurological conditions and to improve the health and wellbeing of the public.

 

An agreement underpinning governance and management within existing institutional financial and legal structures has been signed by the VCs/Principals of partner HEIs who have joint financial responsibility to the SFC. Our hub and spoke model (Directorate staff, offices and meeting rooms at GCU, and staff located across all partner HEIs) with web-based social networking, provides a vibrant research environment and efficiently uses resources. The institutional commitment to substantial investment has provided the well-resourced and long-term infrastructure necessary for a productive, outward-facing research community. Key capacity-building in strategic areas since 2005 includes:

 

- Five new Chairs to lead key areas of strength, Howe, Woodburn (GCU 2005), Rowe (US 2005), Rochester, Ballinger, (GCU 2005); 2 readerships, Paul (UG 2007), Skelton (GCU 2007); lectureship Cornish (GCU 2005). These built on earlier investment: Chair Granat (GCU 2004); Readership Lindsay (GCU/NHS 2003); Senior Lectureship Booth (GCU 2004).

 

- Additional posts funded by the Glasgow Research Partnership in Engineering to promote advances in biomechanics, bioengineering and rehabilitation engineering and related healthcare areas (£425K SFC, late 2007, Granat to appoint a Reader/SL).

 

- The HealthQWest Graduate School (established 2006, Director Kerr) which provides co-ordinated postgraduate and postdoctoral programmes specific to NMAHP research and mentorship for early career researchers (e.g. Cornish). It is supported by additional inward investment [full-time PhD studentships, GCU 8, US 1].

 

- Infrastructure: £125K, SRIF3 (Granat) for enhanced equipment provision.

 

Investment has also enabled the consortium to achieve the external funding successes and the development of strategic research collaborations necessary for sustainability. These include:

 

- In the period since the formation of HealthQWest (2005-) staff are named on awards totalling £3M, of which £1.6M is administered by partner HEIs, e.g. ESRC (Cornish; Rochester); Arthritis Research Campaign Senior Lecturer in Podiatry (Turner); Research Councils’ UK academic fellow (Wearing).

 

- Memoranda of understanding have been secured with five Cochrane entities: Musculoskeletal Group (Canada), Peripheral Vascular Diseases Group (UK), Rehabilitation & Related Therapies Field (Netherlands), Healthcare of Older People Field (UK), the Cochrane Consumer Network (Australia); and Centre for Evidence-based Physiotherapy, Maastricht (Netherlands) and School of Nursing, Dublin City University.

 

-Alignment with NHS/SGHD R&D policy including: dedicated HealthQWest laboratory space in the newly approved Glasgow Clinical Research Facility; identification of collaborations with HealthQWest as integral to the development of consultant NMAHP job roles; optimisation of service configurations to enhance research eg. orthotic provision following stroke (Rowe); falls service (Skelton); and allocation of NHS-funded PhD studentships to HealthQWest (Howe, Rowe, Woodburn).

 

With our unique combination of expertise covering Allied Health (GCU, UG), Bioengineering (US), and Nursing (GCU, UG), this submission comprises 19 research active staff (18 FTE), supported by 11 FTE RAs (3 of whom are post-doctoral), 31.3 FTE research students, and 16 teaching staff undertaking research degrees. Total grant income detailed in RA4 is £3.8M, excluding awards obtained since July 2007. Inasmuch as HealthQWest as an integrated research consortium started only in 2005, with staff appointments continuing through to the present, it was considered appropriate to identify in this narrative ongoing activity by staff resulting from awards achieved elsewhere during the census period, as well as recent awards where there has been minimal expenditure. In this way we seek to demonstrate the dynamic added value in terms of new research synergies that the network is providing.

 

1.1 Main achievements of research groups

 

Our interdisciplinary research groups in Long-term musculoskeletal conditions, Long term-Neurological conditions and Improving health and wellbeing cut across organisational boundaries, integrating clinical, academic, basic and social scientists and NHS staff. This promotes knowledge transfer and assimilation of patient-orientated research into health improvement and research initiatives and ensures that our portfolio aligns with key national and international health priorities. Collectively we have a broad range of methodological expertise including quantitative, evaluative, systematic review and qualitative paradigms. We use the WHO-ICF and MRC-frameworks for the development and evaluation of complex interventions which provide a unifying international language facilitating communication across disciplines and sectors. Although researchers work mainly within one group there is demonstrable interaction between groups (see publications and future plans).

 

Long-term musculoskeletal conditions

 

Led by Rowe and Woodburn with Howe, Skelton, Turner, Wearing, the group aims to understand the pathways leading from impairment of structure and function through to disability in rheumatic and musculoskeletal conditions to develop and test novel interventions.

 

Woodburn (with Turner) has developed foot and ankle research with a funded programme in inflammatory joint disease, and projects in childhood arthritis and cancer. They have been awarded grants (all 2007): Woodburn, Turner (with Sturrock, UG) £357K, Arthritis Research Campaign (ARC) AHP Academic Post funding scheme; Woodburn,Turner (with Gardner-Medwin, Sturrock, McColl, Lorgelly, UG) an RCT of an intensive foot care programme in juvenile idiopathic arthritis (£89K, ARC); and Woodburn (with vliet Vlieland, Leiden; Rosenbaum, Muenster; Balint, National Rheumatology and Physiotherapy Centre, Budapest; and Steultjens, VU Medical Center, Amsterdam) to develop and validate Dutch, German and Hungarian language versions of their foot outcome tool [JW2] to support European-wide collaborative projects (€30K, The European League Against Rheumatism).

 

Phase II studies Woodburn [JW4] (with Dalgarno, Newcastle; Barnes, Helliwell, Redmond, Emery, Leeds) have been directed towards optimal timing of disease-staged interventions including the development and testing of novel mass-customised orthotic devices in rheumatoid arthritis (£90K, ARC). Woodburn and Turner (with Dalgarno, Newcastle; Hopkinson, Loughborough) are developing personalised orthotic and footwear interventions. The group is a collaborative partner (with Hopkinson, Loughborough) on a £1M, EPSRC project translating customised innovative shoe design and manufacture from elite sports to prevention of musculoskeletal diseases and injury.

 

Woodburn and Turner’s paper [DTu2] (with Davys, Helliwell, Conaghan and Emery, Leeds) an RCT of callus debridement, was awarded the Arthritis Research Campaign Silver medal. Wearing with Turner, Woodburn and McInnes (UG), building on previous work in arthritis [JW1, JW3, DTu1, DTu4], diabetes [DTu3], obesity [SW1-2] and plantar fasciitis [SW3-4] is investigating the biomechanical mechanisms of soft tissue injuries in the foot and ankle with applied projects in psoriatic and rheumatoid arthritis, working closely with NHS Quality Improvement Scotland (NHS-QIS), the Podiatry Interest Group in Rheumatology and the Scottish Society for Rheumatology and collaborating with leading international research groups including the National Institutes of Health, USA (Lohmann-Siegel).

 

Rowe [PR1-4] has applied movement analysis, including enhancement of flexible goniometry as an outcome in RCTs of joint prostheses. A series of commercially-funded RCTs (Depuy Ltd, Zimmer Ltd) investigates surgical management and rehabilitation of knee osteoarthritis [PR1-4] and functional demand on older adults by everyday living activities (£352K, EPSRC/EQUAL). Together with Wall (South Alabama) Rowe has produced a battery of web-based measures of functional ability and (with NHS-Glasgow colleagues) is undertaking an RCT of the effectiveness of navigated knee surgery on functional outcome using electrogoniometry (£357K, Zimmer Ltd). Howe’s portfolio includes electromyographic studies in patients with OA knee challenging current clinical practice concerning muscle activity and exercise. Skelton [DS4] investigates lower limb explosive strength and power and the role these have in predicting falls in women, and [DS1, DS3] the effect of HRT on muscle function and bone mineral density. Howe [TH3] led the first group to determine the accuracy and dispersal of injected media in intra-articular joint injections.

 

Howe’s suite of Cochrane reviews examine the role of exercise following conservative or surgical management of meniscal and ligamentous injuries of the knee and rehabilitation for distal radial fractures in adults. They highlight limitations in the evidence, identifying key implications for research and clinical practice.

 

Long-term neurological conditions

 

Led by Rochester including, Ballinger, Booth, Brady, Granat, Hagen, Howe, Kerr, Paul, Rowe, and Smith, the group aims to contribute to an increased understanding of the physical and psychosocial impact of long-term neurological conditions, and to  develop interventions to reduce the impact of these conditions. 

 

This group has an international reputation in Parkinson’s disease (PD) rehabilitation research. Rochester as part of an international consortium (with Nieuwboer at Katholieke Universiteit Leuven (KUL); Kwakkel, Vrije Universiteit Medisch Centrum (VUMC), NL; Jones, Northumbria (UNN); EU F5 £1M) developed and tested an intervention to improve mobility in PD generating first phase I evidence [LR2].  Subsequent development of evidence-based guidelines has impacted on international clinical practice [LR3, LR4]. Rochester and Howe [TH4] have contributed to knowledge on neurobehavioural control of movement in gait, its measurement and application to developing interventions in PD. Rochester (with Burn, Institute of Ageing and Health, Newcastle; Nieuwboer, KUL) is investigating the effect of medication on cueing for improved mobility (£28K, PD Society) and is developing interventions for Dementia and PD (£8K, PD Society). The recent strategic appointment of Ballinger will link her work [CB2] on RCT interventions to prevent falls in PD (with Ashburn, Southampton).

 

In stroke research a range of interventions has been evaluated. Rowe has considered the use of Ankle Foot Orthosis for early mobilisation (£30K, NHSQIS). Howe’s [TH1] work demonstrates that augmented physiotherapy does not improve function. Rochester [LR1] (with Lord, Otago, NZ) has explored the attainment of community ambulation following rehabilitation, its predictors, issues for development of assessment tools and tested an intervention in a RCT. This collaborative work is being progressed by evaluating attention deficit and community gait (NZ$38K, Lotteries Fund). Smith [LS1] has examined; with Kerr [SK3] caregiving (£59K, Chest, Heart, Stroke Scotland (CHSS)); early mobilisation [LS2], and needs analysis (£82K, Stroke Managed Clinical Network (MCN)); and (with Lees, Walters, UG) is testing a model of fast-track TIA identification (£127K, NHS-MCN). Smith (with Legg, Langhorne, Weir, UG) is investigating complex interventions for stroke caregivers (£100K, CSO). Additional stroke work focuses on: secondary prevention (Kerr, Watson); aphasia (Brady [MB3-4]); oral hygiene (Brady [MB2]); and improved stroke rehabilitation nursing (Booth [JB2-4]).

 

The group has expertise in the application of technology for quantifying free living and functional activity to evaluate outcomes of interventions. Granat [MG1] (with Langhorne, UG) has investigated upper limb functional outcome following rehabilitation (£150K, CSO) and [MG3] has demonstrated that augmented physiotherapy leads to increased functional activity (£170K, Stroke Association). His work [MG2] (with Conway, US) on the restoration of locomotion in spinal cord injured patients led to the first application of electrical stimulation combined with supported treadmill training in acute incomplete spinal injury (£150K, CSO). Together with Conway (US) and Hunt, (UG) he is evaluating physiological and functional adaptations induced by combined intervention (£236K, International Spinal Research Trust) and with Conway has investigated the use of virtual reality systems for evaluating wheelchair access to buildings (£120K, EPSRC). Rochester (with Burn, Newcastle; Jones, UNN) is using accelerometery to evaluate behavioural change following deep brain stimulation surgery in PD (£61K, PD Society) and together with Lord Otago, and Nieuwboer KUL, has evaluated the validity of accelerometery for home-based gait analysis.

 

Building on previous work, Paul [LP1-3] is exploring: (with Nijs, Vrije, Belgium) the physiological effects of walking and the pain experience in Chronic Fatigue Syndrome (£27K, ME Research UK); (with Mason, Roy, NHS-Glasgow) the effect of stretching and splinting on knee joint contractures in multiple sclerosis (MS) (£18K, MS Society) and the effect of whole body vibration in MS; and (with Leese, Dundee) the effect of dual tasking on gait parameters of elderly people with diabetes and its association with falls (£22K, CSO).

 

Improving health and wellbeing

 

Led by Granat and Watson including Ballinger, Booth, Cornish, Howe, Kerr, Lindsay, Skelton, Smith, Tolson and Rochester, the group aims to provide robust evidence for the prevention of illness, promotion of health and reduction of inequalities across the life-span. Areas of focus include: physical activity, falls prevention, sexual health, substance use/misuse and coronary heart disease.

 

Granat has developed novel tools and techniques to measure free-living activity (ActivPal: Published Patent and Spin Out Company). With Lean (UG) he is applying them to assess the predictive value of objective physical activity quantification to determine cardiac risk factors (£11K, Scottish Office) and also as primary outcomes in other projects [£150K, Scottish Office; £162K, Stroke Association]. Rochester (with McInnes, Briggs, Little, UNN) is using a combination of new technologies to explore the relationship between mobility and successful ageing (£193K, ESRC).

 

Activity avoidance is a common trait that hampers participation, independence, and therapeutic interventions. Ballinger’s [CB4] exploration of older people’s construction of falls-risk challenges widely held assumptions and approaches to care. Her other work on falls prevention includes; (with Clemson, Sydney, AUS) older peoples’ perspectives [CB3]; and (with Clemson, Mackenzie, Cumming, Sydney; Close, Prince of Wales Medical Research Centre, AUS) a systematic review of environmental interventions. Skelton’s Falls Management Exercise (FAME) RCT formed the basis of the EC Framework-V Better Ageing Project and is a model of good practice in the DHs National Service Framework for Older People. This area of her work (with Iliffe, See Tai, Dinan, UCL; Masud, Derby; Kendrick, Surrey; Oliver, Reading) will be progressed in a 5-year cluster randomised trial on physical activity promotion with people aged 65+ years (NIHR, HTA £1.3M). Howe and Rochester’s Cochrane review [TH2] demonstrates the positive impact of exercise on improving balance in older people.

 

Skelton is the Scientific Co-ordinator of the Prevention of Falls Network Europe (ProFaNE), an EC FP5 funded collaboration involving 13 countries, identified by the EC as exemplary and recognised internationally as leading falls prevention research. Her falls risk assessment tool FRAT (with Nandy et al, Queen Mary’s, London) [DS2] has been reported as the most commonly used screening tool in the UK in a recent report commissioned by the SDO. Skelton and Ballinger have both authored (commissioned by WHO) evidence synthesis policy documents on ‘fall prevention in the community’, and ‘environmental risk factors and interventions to reduce falls’ and Ballinger (with colleagues from ProFaNE) has produced guidelines for promoting the engagement of older people with falls prevention.

 

Cornish, an ECR, is establishing a programme of research in community development approaches to improving public health, in both low-income and high-income countries. She has achieved international recognition for her HIV prevention research [FC1], currently leading a study (with Campbell, LSE, a global leader in HIV/AIDS research) exploring factors leading to successful community mobilisation for HIV prevention in India (£200K, ESRC). Her community development perspective also informed an evaluation of the new WHO Family Health Nurse model in Tajikistan [FC2], and a study of ways of reducing ethnic inequalities in provision of mental health services in the UK [FC3].

 

Kerr, Watson and Tolson’s smoking cessation research focuses on key groups who experience health inequalities and the professionals who have contact with them [SK2, DTo2]. Recent work demonstrated enhanced delivery of smoking cessation interventions for older people by NMAHPs (ASH Scotland) and has informed policy (NHS Health Scotland; Partnership Action on Tobacco & Health). A near complete Phase 0/1 trail Kerr and Watson (with UG; NHS; and service users groups) (£44K, NPRI-National Prevention Research Initiative (MRC, ESRC and all UK Departments of Health)) will inform the content of an intervention for smokers with mental health problems.

 

Watson and Kerr’s studies in primary care and with interagency mental health teams have investigated attitudes, knowledge and practice of those working with people with substance misuse problems. Their tool [SK1] to measure practitioners’ therapeutic attitudes is being used in sixteen countries. A clinical guideline ‘Prevention of Relapse in Alcohol Dependence’ resulted from an HTA to which Watson’s study of users’ perspectives contributed (£16K, Health Technology Board for Scotland). Current mixed methods work is ongoing in occupational health settings with Godfrey, York; Davies, US; Macdonald, UG (£50K, Alcohol Education and Research Council).

 

Lindsay and Smith’s work [LS3-4] on patients’ perspectives on health and expectations of coronary artery bypass grafting (CABG) provide insight into the impact of heart disease on health and reveal often over-optimistic expectations of benefit from CABG and sub-optimal secondary prevention [GL2]. Lindsay(with Ford, Hanlon, UG) has examined 7-year health outcomes of patients undergoing CABG (£87K, CSO) and their design and testing of a new model of nurse-led shared care for patients on waiting lists resulted in the development of a new service (SGHD) [GL1]. Smith and Lindsay are developing and evaluating educational programmes to promote and evaluate best practice in cardiac care (£193K, BHF); evaluating cardiac illness in older people (£7K, MCN); and designing new cardiac rehabilitation models to support long term health and improve understanding of practitioners’ education needs (£74K, MCN). Lindsay [GL3] evaluated the impact of emergency nurse practitioner roles in the treatment of minor injuries and (with Gaw, UG) [GL4] explored older people’s experiences of participating in a clinical trial.

 

 

1.2  Mechanisms for promoting research and building capacity

 

We have approached capacity building in a number of ways:

 

- Recruitment of high quality staff (see 1, 2)

 

- Inward investment for PhD studentships; 9 FTEs and provision of time for staff to undertake part- time PhDs (17). Since 2001 13 staff have been awarded PhDs.

 

- Senior appointments with the NHS (eg. Lindsay, Reader).

 

Active collaboration between our research groups is encouraged. HealthQWest activities are dynamic and nurture a shared purpose and interchange of ideas and expertise as evidenced by our joint publications). Our activities include: annual HealthQWest and Graduate School conferences; quarterly seminar programme with invited international speakers; monthly coffee morning challenges, journal clubs, methodologically-based reading groups, promotion of individual research expertise and achievements on our website and in our e-newsletter Connects.

 

The HealthQWest extended membership is central to our ethos of developing critical mass, providing a rich source of expertise, experience and skill-sets central to developing our research activity. Membership includes strategic advisors (see 1.4), international collaborators with whom we hold joint funding or supervise research students/fellows (eg. Nieuwboer, KUL; Lord, Otago), clinicians as members of research teams, policy makers and the general public.

 

1.3  Research infrastructure

 

To facilitate the research outlined above our groups enjoy:

 

- Internationally recognised expertise in human performance measurement and access to world-class state-of-the art human performance laboratories across 3 sites; UOS (Bioengineering), GCU; and through new capital developments, including the Glasgow Clinical Research Facility.

 

- Excellent library facilities across the consortium and NHS e-library.

 

- Newly refurbished office accommodation and meeting facilities.

 

- Provision of sufficient space, equipment and administrative and technical support for staff in host departments to function effectively and productively at the highest international level.

 

1.4  Governance

 

HealthQWest is subject to external annual review by its funders. The Consortium Management Board (CMB) chaired by a PVC/Vice Principal from a partner organisation (rotating annually) is responsible for the operational management, governance and strategic development of HealthQWest. The CMB meets quarterly, with PVC/VP level representation from each partner organisation and independent strategic advisors: Scutt (Liverpool), Cartwright (Oxford, Patient Involvement Forum), McMahon (RCN), Langhorne and Scott (UG, NHS), Smith (Dundee), Coates (Ulster, NHS) and Badenoch (Director Minervation Ltd). The HealthQWest Executive Group (HEG) reports to the CMB and meets monthly to strategise and monitor HealthQWest activity.  Leadership and direction of our research groups are provided by Management Boards. All institutions are fully compliant with Research Governance and close links exist between the Universities and high-level NHS representatives and groups across the UK in clinical and policy arenas. 

 

 

1.5  Relationships with research users

 

The HealthQWest Consumer Network (www.healthqwest.org/communications/) is proactive in building relationships with research users.  Tolson and Booth’s empowering approach to developing a Community of Practice of older people and family carers leading an aspect of the Gerontological Nursing Demonstration Project (http://www.geronurse.com/en/ageingmatters/home.asp) [JB1] was commended by the European Commission (£293K, ESF EQUAL), and the user guides developed by older people on expectations of care in hospitals and care homes on nutrition and prevention of depression were published by NHSQIS. The associated knowledge translation programme has received the Sigma Theta Tau International Honor Society, 2007 Best of Worldviews on Evidence Based Nursing Award. This work (Tolson) will be extended (£120K, NES).

 

We have active evidence translation work with industry, charities and voluntary organisations including; strong established links and knowledge transfer relationships with industrial partners Zimmer, Depuy (Rowe); PAL Technologies Ltd, Biomedical Monitoring Ltd (Granat); Help the Aged, Age Concern (Skelton, Ballinger); National Coalition for Active Ageing, EXTEND (Skelton); Chest Heart & Stroke (Lindsay); British Heart Foundation (Skelton, Lindsay); Parkinson’s Disease Society (Ballinger, Rochester); and ASH (Kerr, Watson, Tolson).

 

2.  Staffing policy

 

Central to our strategic plan has been the appointment of individuals with established research profiles who can collaborate with leading research networks and attract major long-term funding in areas of work that will strengthen our portfolio. In appointing academic staff, the principal criteria were evidence of research excellence, a capacity to interact with colleagues in specific research areas, and an ability to foster clinical-scientific cohesiveness. These staff and existing senior staff are expected to contribute to, and benefit from, our research portfolio; to mentor less-experienced researchers, to attract research fellows of the highest research potential and translate basic research advances into therapeutic approaches in their field. Joint appointments at senior level with NHS promote links between our clinical strengths and research groups.

 

2.1 Developing and supporting staff

 

To provide the highest quality-training environment and mentorship ECRs work alongside more experienced researchers. Individual progress and personal career development is cultivated by regular staff appraisals (jointly with institutional line manager and group leader) to include setting and monitoring realistic targets, encouragement to undertake peer-review activities, eg. refereeing and serving on grant-review and conference committees.

 

Staff are encouraged to learn new experimental techniques and investigative methods with research groups outside the HealthQWest Consortium; e.g. Turner (with Sturrock, UG as mentor) PgC training in Diagnostic Medical Ultrasound to provide image-based outcomes for projects related to inflammatory joint disease; Woodburn (with Udupa, Pennsylvania) has absorbed advanced medical image processing techniques (3D MRI and CT segmentation and reconstruction) to quantify pathological structures in the foot and ankle. Research students and research assistants have undertaken Basic and Intermediate Rasch Analysis training, for advanced Item Response Theory to support the development of questionnaire based outcomes; and advanced motion analysis techniques with Wall (Alabama).

 

The HealthQWest Graduate-School (Kerr, Director) enhances healthcare research training across the consortium, eg. access to expertise, resources, supervision and peer support (‘buddy scheme’ and student champions), and presentation opportunities at the annual Student Conference. The HealthQWest e-journal Care (www.healthqwest.org/care) provides experiences, from novice-to-editor, of the publishing process. Transferable skills are delivered in collaboration with the Scottish Universities Research Training Alliance and UKGrad (Scottish Hub) and other collaborating institutions (Dublin City).

 

The Research Leadership Programme affords opportunities to ECRs (including contract researchers) across the consortium capitalising on generic leadership development programmes using specific examples and situations related to research. The focus of the programme is around contemporary issues experienced by the research community. Other more specialist research skills, methodological developments and techniques and development opportunities and requirements are provided through bespoke master classes. This programme is delivered by the HealthQWest Readership and Professoriate (Smith, lead) and outside experts.

 

Such cooperation across the consortium and collaborating organisations creates a unique approach for postgraduate and ECR training in which critical mass for niche topics can be reached. Importantly, added value for both post-graduate research students and post-doctoral researchers comes from access to our formal collaborating organisations, distinguished visitors from abroad and other events organised by partner institutions. This approach reduces isolation that is often felt by non-clinical scientists in clinical departments and vice versa, exposing each to different perspectives, encourages interdisciplinarity and provides a level of training that would be difficult to achieve on an individual departmental basis.

 

2.2  Succession planning

 

We are cognisant of impending retirement of senior staff (Watson). Key appointments to continue the leadership of our strategic areas have already been made (Ballinger, Skelton) and further appointments will be made at GCU following the agreement by Senate of a new research strategy prioritising investment in the next three years in health research. The majority of new appointments are research leaders in mid-career (Howe, Woodburn, Rowe, Ballinger, Skelton, Paul, Rochester) and are, therefore, well placed to develop further those international and network collaborations, as well as to lead long-term funded research projects, that form the basis of our future direction. They are central, too, to delivering our priority of developing our ECRs, the next generation of research leaders, through both mentoring and involvement in collaborative research.

 

2.3  Multidisciplinary work; career progression

 

All our work is inherently interdisciplinary and mainly intersectorial (working across academia, public, private and voluntary healthcare industries). Clear career progression opportunities are available across all universities and through their internal promotions schemes (Kerr and Paul have been promoted to Readerships).

 

3.  Research Strategy

 

As HealthQWest is a new and young initiative, the focus of this section is inevitably largely forward looking. HealthQWest’s 5-year key performance indicators have been agreed and will be monitored by our funders, partner organisations and our international advisory board (to be formalised 2008). Our research groups will compete in major funding initiatives, will focus on our research themes and exploit our existing collaborations.

 

We will continue to exploit the opportunity for collective strategic investment between HEIs and the NHS including; new appointments, shared facilities, expertise, supervision and investment.  Plans for the NHS Glasgow Clinical Research Facility are well-developed through Board Members (Howe, Rowe, Woodburn) including a HealthQWest-led clinical human performance laboratory and other infrastructure to support clinical trials. Ongoing discussions with SFC relate to Phase-2 HealthQWest funding. Applications will be submitted to continue to develop our research infrastructure; e.g. additional equipment, joint-funded posts (NHS/HEIs), programme grants.

 

Our three research groups will continue to work together towards programmatic research. Over the next five years we intend to increase the proportion of bids submitted to European and UK Research Councils (target success £2M pa 2008, rising to £3M pa by 2012).

 

Examples of applications made and awaiting decision include:

 

- EC-F7: Parkinson’s Interventions; Rochester lead (with KUL; Vrije Universiteit; Institute of Ageing and Health, Newcastle; Radboud; Justus-Liebig-University, DE; Charles University, CZ).

- CSO: programme grant, CRF delivery; Lindsay (with Gaw, UG).

- ARC: equipment grant; Woodburn.

- CSO: Activity and osteoporosis; Granat

- CSO: Pedometer and counselling physical activity; Granat, Skelton (with Mutrie, US; collaborators at GU and Dundee).

- CSO: MRI and ultrasound outcomes for psoriatic arthritis; Woodburn, Turner.

- CHSS: An international multi-centre RCT of very early mobilisation after stroke; Smith(with Langhorne, Bernhardt, UG).

- Diabetes UK: Falls Prevention in Diabetes; Paul, Skelton (with Kennon, NHS-Glasgow; Leese, NHS-Dundee).

- Bailey Thomas: Physical activity/inactivity of adults with learning disabilities; Granat.

 

Applications under development include:

 

- HTA: Early mobilisation and rehabilitation in stroke; Ballinger, Skelton, Rochester, Smith, Rowe.

- ESRC: Partnerships between community/voluntary sector and health services; Cornish (with Campbell, LSE).

- EPSRC: Personal mobile technology for self-management of chronic disease; Granat (with Leeds, Lancaster, Warwick, Newcastle, Coventry and Kingston/St Georges).

- NPRI: Phase II/III study of smoking cessation; Kerr, Watson (with Hunter, UG; NHS Boards).

- BHF: Novel interventions for cardiac patients; Lindsay (with Gaw, UG).

- CSO: Smoking cessation services for people who are housebound or physically disabled; Kerr (with ASH Scotland, Health Scotland, NHS).

- Burdett Trust: Phase II/III Secondary prevention of stroke; Kerr, Watson.

- ZIMMER: Functional outcome in orthopaedics; Rowe, Wearing.

- PD Society: programme grant; Rochester, Ballinger (with Burn, Newcastle).

- Programme Grant Scottish School Primary Care: Health improvement in primary care (Invited to re-submit). Kerr, Cornish, Howe, Skelton.

 

Our Graduate School provides a platform for capacity and capability development at all career levels across our research themes.  We plan to extend to a pan-Scotland Graduate School by 2010. Our doctoral and post-doctoral training is being conducted in line with Roberts’ recommendations towards international academic excellence. Applications in progress to support this include:

 

- EU F7 Marie Curie Initial Training Networks in:

   - Musculoskeletal, Rowe, lead; Howe (with Maastricht; Dublin City).

   - Parkinson’s, Rochester, lead; Ballinger, Howe (with KUL, Vrije Universiteit; Newcastle; Radboud (NL)).

- Post-doctoral fellowships and studentships to CSO; ARC; PDS.

 

Finally we are committed to partnerships with users, practitioners and the scientific community through our dissemination strategy and our aspiration to influence practice nationally and internationally. Examples of knowledge translation and strategic dissemination include:

 

- Establishing HealthQWest as a ‘Joanna Briggs Institute

   - Evidence Synthesis Group’ (Howe)

   - International Collaborating Centre for Evidence-based Care of Older People, Tolson lead (with Gibb, Adelaide)

- Leading the Network of NMAHP systematic reviewers in Ireland and Scotland, Howe (with O’ O'Mathuna, Dublin City).

 

 

4.  Esteem indicators

 

All staff submitted routinely referee for a wide range of international academic journals and research funders and examine PhD candidates across the UK and internationally. 

 

4.1  Editorial activities

 

Howe: Joint Co-ordinating Editor, Cochrane Bone, Joint & Muscle Trauma Review Group. Skelton: Associate Editor, Journal of Aging and Physical Activity (IF=1.218)

Cornish: Associate Editor, Journal of Community & Applied Social Psychology (IF=0.883); guest editor special issue ‘Integrative Psychological and Behavioural Science’ (IF=0.417).

Lindsay: Co-Editor, International Journal of Coronary Health Care

Ballinger: Associate Editor, Physiotherapy.

 

Membership of editorial boards:

 

Watson:  Alcohol and Alcoholism (IF = 2.016), Journal of Substance Use.

Smith: Clinical Rehabilitation (IF=1.50); Nurse Education Today (IF=0.962); Journal of Psychiatric and Mental Health Nursing; Journal of Clinical Effectiveness.

Tolson: Journal of Advanced Nursing (IF=1.342); World Views on Evidence-Based Nursing; International Journal of Older People Nursing.

Woodburn: Musculoskeletal Care; The Foot.

Ballinger: British Journal of Occupational Therapy; Critically Appraised Papers, Australian Occupational Therapy Journal.

 

4.2  Activity for grant-awarding bodies

 

Howe: National Research Workforce Capacity Programme NMAHP Awards, DH.

Rochester, Granat, Rowe, Howe (Chair): Scientific Panel, Chartered Society of Physiotherapy (CSP).

Howe, Smith: Medical Advisory Board, MRC.

Rowe: Action Medical Research.

Paul: Multiple Sclerosis Society.

Tolson: Partnerships in Practice Awards, Queen’s Nursing Institute Scotland.

Ballinger: National Institute for Health Research, Research for Patient Benefit (London).

 

 

4.3  Examples of membership of national and international research committees; professional and policy-making roles

 

Howe: Sub-panel 12 RAE 2008; R&D Advisory Committee, NICE; Advisory Committee for Topic Selection for NICE (Ministerial appointment England & Wales); Council of Scottish Intercollegiate Network Group; HEFCE/DoH NMAHP Policy Committee; R&D Priorities Steering Group and Expert Panel for Neurology research, CSP;

Paul, Rochester and Howe (Vice Chair): Research & Clinical Effectiveness Committee, CSP.

Skelton: National Coalition of Active Ageing Board; British Geriatric Society (BGS) Falls and Bone Health Section Committee; BHF National Centre for Physical Activity and Health – Older People Scientific Advisor; Quality Improvement Scotland Falls Steering Panel.

Paul: Cross Party Committee for ME, Scottish Parliament.

Woodburn: Health Sciences Panel, Arthritis Research Campaign.

Watson: Nursing Council on Alcohol Executive; Advisory Board, Medical Council on Alcohol; Steering Group Alcohol Alliance.

Smith: First Chair, Workgroup of European Nurse Researchers; Convenor RCN Nursing Research Society; Fellow of European Academy of Nursing Science; Research Advisory Board ICN; Cyprus University of Technology.

Lindsay: Nursing & Midwifery Research Task Force Steering Group.

Kerr: Scottish Tobacco Control Alliance Co-ordinating Group, Nursing Council on Alcohol Executive.

Ballinger: Steering Group, National Audit of Falls and Bone Health, Royal College of Physicians; Associate Member ProFaNE.

 

4.4  Examples of keynote lectures at international scientific meetings:

Woodburn: Grand round, NIH, Bethesda, Maryland, USA; European League Against Rheumatism (EULAR); British Society for Rheumatology.

Rowe: European Congress on Prevention of Diseases through Physiotherapy, Austria; IVth World Congress in Biomechanics.

Rochester: International Congress of Parkinson’s Disease and Movement Disorders, Japan; International congress on Gait and Mental Function, Spain.

Ballinger: 7th International Conference on Falls and Bone Stability Falls and Bone Health Section of the British Geriatrics Society, UK; ProFaNE, Poland.

Watson: International Medical Advisory Group, Brussels; American Nursing Association; SMITH: European Symposium on Obesity, Copenhagen; International Nursing Research Conference, Spain.

Skelton: Integrated Musculoskeletal Trauma Conference, Belfast; International Association of Physical Therapists working with Older People, Dublin; upcoming - International Active Ageing and Health Conference, Taiwan.