Clinical trials

This project consists of two workstreams, both of which will be mixed-methods and aim to develop a national UK picture of current care coordination for people with MND, including observations of barriers and facilitators. The studies will explore how care is transferred and communicated across MND specialist services to non-specialist community health settings. In workstream 1, the researchers will conduct focus groups with people with MND, Carers, former Carers, Health and Social Care Professionals and managers and commissioners. These focus groups, alongside the analysis of routine data, will create a national picture of MND care and begin a behavioural diagnosis of the barriers and facilitators. In workstream 2, a multi-site ethnography study will be conducted, including observations, interviews, routine data, care plan and document review. This Workstream will observe how care is coordinated between specialist and non-specialist services and continue to explore barriers and facilitators that can not be identified through interviews.

The goal of this clinical trial is to learn if cognitive analytic therapy-guided self-help (CAT-GSH) is comparable to cognitive behavioural therapy-guided self-help (CBT-GSH) in terms of whether it is effective and acceptable for people with anxiety or low mood, who are returning to NHS Talking Therapy services for further treatment. The main questions it aims to answer are: * Does CAT-GSH work well and feel acceptable for people coming back to the Talking Therapies service, compared to CBT-GSH, when taking their characteristics (like age) into account * Does CAT-GSH work well and feel acceptable for people coming back to the Talking Therapies service, compared to those using CBT-GSH for the first time, when taking their characteristics (like age) into account? Participants will: * Choose their preferred treatment * Complete 6 sessions of either CAT-GSH or CBT-GSH * Sessions will be weekly or bi-weekly * Complete routine outcome measures before, during and at the end of therapy

The aim of this study is to implement the Telehealth in MND system as a research database allowing people with MND to take part in research and provide data remotely (TiM-Research). TiM-Research is an online platform that helps people with MND in the UK take part in research. It brings MND research studies together in one place, making it quick and easy to learn about opportunities to get involved. What's involved? Participants will receive information about a wide range of research studies that they can sign up for. This could include filling out questionnaires that help researchers understand how MND progresses, providing biosamples (e.g. saliva), or taking part in interviews and focus groups about their experiences. Participants can choose which studies they want to take part in. Participants will also receive updates on research results from the UK MND Research Institute. Who can take part? People who live with MND and who are based in the UK can sign up for TiM-Research. To join, participants need a computer, phone, or tablet with an internet connection. A family member or carer can help. Participants' information will be kept secure and confidential. How do participants sign up? Visit the website to find out more or sign up. www.bit.ly/ukmndri-Tim-R.

Hypogonadism is the medical name for a condition in which levels of the hormones which control sexual development are lower than normal. There are dozens of different causes of hypogonadism. Many people with hypogonadism have a change in a gene. There are many genes that give instructions for the hormones important for sexual development. Changes in one of these genes that stops the gene from working, can cause hypogonadism. In some of these medical conditions, there are additional features such as learning problems. In this study we will search databases to find all the genetic conditions that can be associated with hypogonadism. We will ask a number of people with changes in certain genes, identified from our search, to come to our research clinic. We will ask them about their health and examine them for signs of hypogonadism. For some, we will take blood samples to test for hypogonadism. This project will help us understand how common hypogonadism is, in people with these genetic changes, which will help with their treatment.

Understanding health information can be difficult. This means some people struggle to know how to manage their health. Also, people may not know what health services to use or when to use them. This can lead to poorer health. It is therefore important health workers can communicate information clearly. This is so people using health services can understand it and know what to do. Having clear conversations with service users could help them to improve their health. More research is needed into this area. This is so we can understand and improve health conversations. In this research project health workers will be provided with training. The training will teach them ways to improve their communication skills. Health workers will also receive support from a Health Literacy Officer. The Investigators want to see if this can improve service user outcomes and reduce health inequalities. The investigators will ask health workers and service users from a Local Authority and an NHS service to take part. Service users will attend the health programmes as normal. Staff who have and have not received the training will deliver the programmes. The investigators will ask service users to complete questionnaires. The investigators will also collect service user data from the programmes. This data will be collected before and after they attend. The investigators will compare this data with the previous year. The investigators will observe health workers delivering the programmes. The investigators will use a check list to see how they use the skills they have learnt. The investigators will ask health workers to complete a questionnaire before and after they attend the training. The investigators will run focus groups with the health workers six months later. The investigators want to understand if the training was useful. The investigators also want to know if the health workers are using the skills they learnt in their practice.

BACKGROUND: Alginate impressions have long been a staple in orthodontics, but with recent technological advancements, digital impressions via intraoral scans are gaining increasing popularity. While much research has focused on patient preference and the accuracy of these techniques, there is a notable gap in the literature regarding chair side time and associated costs. Existing studies on chair side time comparisons between alginate impressions and intraoral scanning yield inconsistent results, underscoring the need for further investigation. This study aimed to evaluate the chair side time and cost implications of intraoral scanning and alginate impressions. OBJECTIVES: The primary objective is to compare the chair side time taken for alginate impressions and intraoral scanning of orthodontic patients aged 9 years and over in an orthodontic department at a district general hospital. The secondary objective is to evaluate the costs associated with alginate impressions and intraoral scanning of orthodontic patients described above. DESIGN, SETTING AND PARTICIPANTS: A prospective, single-centre, parallel-arm randomised controlled trial (1:1 allocation) to be undertaken in a district general hospital. Sixty-eight orthodontic patients aged nine and above, requiring study models, will be recruited during new patient appointments at the Orthodontic Department at Queen's Medical Centre, Nottingham. Patients will be randomly assigned to either the intraoral scan or alginate impression group, with chair side time recorded for each procedure, including retakes. The IOS group will use the 3Shape TRIOS scanner, while the alginate group will follow standard procedures. The costs of each technique will be calculated following the procedure. Ethical approval was obtained from a Health Research Authority Research Ethics Committee. OUTCOMES: N/A CONCLUSIONS: N/A

Acute undifferentiated febrile infection (AUFI) is a common presenting syndrome in low-resource settings and better diagnostics are urgently needed to improve patient management and guide disease prevention interventions. Assessment of the host gene expression response to infection in endemic populations has demonstrated significant promise as a new approach to identifying patients with enteric fever and for potential in differentiating between other causes of AUFI. Signatures identified through new data analytic techniques could be developed into a point-of-care test for use in endemic settings. In this multisite diagnostic evaluation study we will collect prospective clinical, laboratory and diagnostic data from two endemic settings to evaluate host gene expression signatures for detecting enteric fever and for determining the cause of AUFI in LMIC settings.

The study will investigate the use of Electroencephalography (EEG) in understanding mild cognitive impairment (MCI). EEG is commonly used in everyday clinical practice for the assessment of a wide range of neurological disorders. It records the brains spontaneous electrical signals and offers a non-invasive means of visually evaluating brain signals. By analysing these signals, we aim to uncover invaluable insights into cognitive impairments and the ageing brains cognitive processes.