Can you tell us a bit about yourself and research and/or career to this point?
I am a PhD student in Infectious and Tropical Diseases at the LSHTM and a Research Associate at the College of Medicine and Health, University of Exeter. I hold an MSc in Health Economics and Decision Science from UCL and a Bachelor’s in Engineering obtained abroad. My current research focuses on infectious diseases, particularly quantifying and understanding the transmission patterns and population spread of antimicrobial-resistant bacteria (AMR) within different settings of low-and-middle-income countries (LMICs).
What are you aiming to do through your fellowship/new post?
During my fellowship, I plan to work alongside different professionals to collaboratively help enhance the design of targeted policies to tackle antimicrobial resistance by involving various stakeholders and organisations in Argentina and the UK. This might help strengthen the Argentinian National Action Plan against antimicrobial resistance while understanding the relevant decision-making actors to minimise its transmission pathways and attributed burden.
What are you looking forward to most in starting your fellowship/new post?
I look forward to understanding the Argentinian context to help localise opportunity venues to tackle antimicrobial resistance by using an intersectoral perspective towards better population health. The research also opens new platforms to guide the design and implementation of similar research protocols in other LMICs to finally improve AMR indicators regionally while integrating multidisciplinary action within-country settings in the animal-human interface.
Tell us something about yourself that may be less well known
I am originally from Latin America – Chile—and like the outdoors and natural landscapes, grinding and brewing my coffee, getting creative in the kitchen, and jazz gigs.
Can you tell us a bit about yourself and research career to this point?
I’m an academic GP, which means I spend part of my week working as a GP and the other part undertaking research at the University of Exeter. My career started with my medical degree which I completed in Cambridge, along with an intercalated degree in natural sciences. I then went off to work in London as a doctor for my first foundation year, followed by a second foundation year out in New Zealand. I’d always been interested in research and while out there took the opportunity to get involved in a project looking at babies born with a condition known as gastrochisis and I got to present my findings at my first international conference in Queenstown in New Zealand. After a year of trying more specialties I came back to the UK with a really strong desire to do more research and I took a post as a clinical research associate in the group of Professor Roger Barker in Cambridge, researching Parkinson’s Disease. This well and truly got me addicted to research but I had to decide on a specialty to work in and where in the country to work! I decided to become a GP as I find the work varied, interesting and challenging and of course there are so many options for research. We decided on Exeter as it is the place most like where we lived in New Zealand with a good university and transport links. Since then I’ve completed my GP training and an academic clinical fellowship in primary care. I’ve experienced lots of aspects of research before deciding to focus long term on early cancer diagnosis. This is an area of research I am passionate about from both personal and professional angles and Exeter has a leading research group in the field.
What are you aiming to do through your Fellowship?
My NIHR SPCR GP primary care progression fellowship expanded on the work of my academic clinical fellowship, estimating the impact on patients of reducing the threshold for urgent cancer referrals. I am now writing up the results of this 1 year fellowship for publication. It also allowed me time to develop a doctoral fellowship application. My next step now is a Wellcome primary care clinician PhD fellowship starting in September 2022, this programme is also administered by the SPCR.
In my PhD I am planning to develop and validate risk prediction models for cancer diagnosis in patients presenting to their GP with symptoms. I want to use all the data that is held within a GP record to help me build the most accurate prediction model. I also plan to compare traditional statistical techniques with newer machine learning techniques to find which gives the most accurate (and most usable) models. Finally I want to test the models to find out what their impact might be on patients and healthcare systems.
What are you looking forward to most in your Fellowship?
This is an opportunity for me to work on a project that I have developed myself and am very passionate about. I will have the opportunity to learn new skills, develop new networks and complete an in depth project that I hope will have a positive impact on patient outcomes in future.
Tell us something about yourself that may be less well known
I’ve probably already had my highest impact publication… I think it was my appearance in Hello! magazine in a full page feature showing my sister, artist Emily Powell, and I painting the front entrance of Great Ormond Street Hospital.
I’m an early career research fellow, and have held a number of both research and clinical posts since graduating in psychology. Clinically, I’ve worked in medium-secure mental health settings and most recently as a low-intensity CBT therapist/Psychological Wellbeing Practitioner in IAPT (Primary care psychological therapies service). As a researcher, I developed through my MSc in Psychological Research methods, which I completed part time alongside a Research Assistant Post on the ADepT trial: A pilot trial for a novel, wellbeing focused depression therapy https://www.exeter.ac.uk/departments/mooddisorders/research/currentprojects/adept/ . This trial had a small team, meaning I had a wealth of opportunities to turn my hand to lots of aspects of applied clinical research, lead secondary research streams and develop the skills to be an independent researcher.
In my fellowship, the overarching aim is to develop and evaluate new training initiatives for different clinicians in primary care settings: IAPT therapists and GPs. The aim of the training is to improve outcomes for individuals with complex emotional needs in the context of personality difficulties or disorder. We know that within IAPT, individuals with these difficulties in addition to a primary problem of depression or anxiety, can and do benefit from treatments, but do less well than others without these difficulties. In this setting, training will focus on developing therapist skills in subtly adapting practice to accommodate these additional personality difficulties, and evaluation will focus on whether this has an effect on therapist attitudes, perceived skills and also preliminary evaluate if this translates into improved outcomes. Within the GP workforce, a substantial amount of my work will focus on identifying the training needs and developing a suitable training intervention to address this. One of the things I’m most looking forward to is the early stages of this development work, where I will be consulting with practitioners, service users and other academics – having the opportunity to hear lots of different perspectives on the current issues and how to move forwards.
I don’t have to compromise between being part of exciting research groups making a meaningful difference and ‘farm life’ in North Devon, with an enviable blended working pattern between the Mood Disorder’s Centre and WFH on the farm (with a short 1 mile commute to the surf after work)!
“Intervention development in practice” snapshot of our PPI event to engage individuals with lived experience in our intervention development process for a GP workforce
Qualifying as physiotherapist nearly 20 years ago, most of my career has focused on working in the field of rehabilitation with older people – indeed that’s where my passion really lies. In 2016 I ventured into the wonderful world of “research” and wanted to take my clinical experience working with older people and apply it to developing the evidence base – particularly for those people with dementia. My training taught me little about how to treat people with dementia and my research has shown that many other physiotherapists experience similar challenges treating people with dementia. I completed my PhD in 2019 and then returned to work in clinical practice during the Covid-19 pandemic working with rehabilitation and urgent care teams – to try and keep people out of hospital and help support timely discharge of patients where able. Treating patients in primary care and community settings has been my role for the last ten years, so my research interests lie in these settings too.
During my fellowship I will build on work I undertook during my PhD and develop an intervention designed to improve the management of people with dementia following hip fracture. The project will involve working with patients, family members as well as clinicians who are experienced in treating people with dementia. As a researcher, the opportunity to develop your own research is a real privilege – although at times quite daunting – but the opportunity to continue the work that I’m passionate about is amazing! If I can make even a small difference to improve the management of people with dementia I will be delighted! I’m particularly excited to become a member of APEx and learn about the other great work that is being undertaken in primary care.
Outside of work, I’m probably known as being a little obsessed with my dogs – indeed the wonderful world of Zoom/Teams means that a lot of people have met the dogs in various conference calls! The dogs like to make their points known – or at least let everybody know that the postman has arrived! When not trying to “talk to” the postman, Max is happiest sleeping under my desk keeping my feet warm!
We’re delighted to welcome Professors Umesh Kadam (left) and Rupert Payne (right) to join our Primary Care team at the University of Exeter.
We’re looking forward to the new opportunities Rupert and Umesh’s added senior clinical academic support will bring to our team, as well as a range of new interests across the wider APEx team. Welcome!
Can you tell us a bit about yourself and research and/or career to this point?
I am a Research Associate with the PenARC patient and public involvement and engagement (PPIE) team and the Exeter Collaboration for Academic Primary Care (APEx). I joined PenARC’s PPIE team in October 2021, becoming a member of APEx as part of my role in establishing the infrastructure for a primary care-specific PPIE group in the School for Primary Care Research. I am a nurse by background, initially specialising in palliative care. Since then, I have worked in the field of learning and development in the NHS, social care and the third sector, as well as holding research posts, most recently working in the Peninsula Childhood Disability Research Unit, before joining PenARC last year.
What are you aiming to do through your fellowship/new post?
My role includes setting up a new APEx PPIE group with a focus on primary care research. I have established a PPIE Working Group, who have been working with me to develop the infrastructure for this new group, including drafting membership packs and role descriptions. We are currently planning our approach to recruiting and welcoming new PPIE members to the group from different communities. We have also developed a PPIE training plan to support involvement, which I am looking forward to implementing. I will be facilitating our suite of PPIE Ideas Cafés and Advice Clinics for APEx-affiliated researchers and clinicians to book on to, which are available throughout the year. Overall, I hope to be a useful resource for all researchers in APEx, to support patient and public involvement in their work.
3.What are you looking forward to most in starting your fellowship/new post?
Ultimately, I’m looking forward to working with, and supporting, researchers and public contributors to embed effective and meaningful involvement in all areas and stages of APEx’s research activity. This role also offers a fantastic opportunity to continue to learn so much from public contributors and other researchers about what works well (and what doesn’t!) in the field of PPIE and I will enjoy reflecting on this and further developing my practice.
4.Tell us something about yourself that may be less well known
I really enjoy open water swimming (cold!), growing broad beans (random!) and seeing which biscuits last longest when dunked in tea (nail-biting!).
Can you tell us a bit about yourself and research and career to this point?
I studied my BSc in Medical Sciences at Exeter, which involved looking at lots of different areas of health research and biomedical science. During this degree, I completed a Professional Training Year in Prof. Alison Curnow’s lab in Penryn, looking into the application of photodynamic therapy on human skin cancer and human glioma cells, which was a great experience. In my final year, I did my final research project with Dr Jane Smith in Primary Care, who’s now my PhD supervisor. My project looked into the process evaluation of a large ongoing study to improve asthma management in primary care, and I really enjoyed the project. I then moved back to Cornwall to complete an MSc in Environment and Human Health, which I loved.
I’m now fortunate enough to be conducting my PhD with Dr Jane Smith in Primary Care, and my fellowship is funded by the NIHR School for Primary Care Research. I’m looking into the mechanisms of action that take place during virtual shared medical appointments for the management of chronic physical conditions. This could include type 1 and type 2 diabetes, obesity, chronic pain, or asthma, to name a few. I’m also aiming to investigate any changes in health inequalities that may come about from using this type of consultation.
What are you aiming to do through your fellowship?
During my PhD, I’m aiming to start with a systematic review of the literature, to see what evidence is out there on this topic already. I’m then hoping to conduct some analysis to look into the mechanisms that take place during virtual shared medical appointments that lead to their success (or failure!). After this, I’m aiming to conduct interviews with patients and healthcare providers to find out about their points of view on the advantages, disadvantages, barriers, and facilitators to this type of consultation.
What are you looking forward to most in starting your fellowship?
I’m really looking forward to doing research on such a new and emerging topic, and especially talking to healthcare providers and patients to hear their thoughts on this new method of consultation. The health inequality side of this topic is one I that I think is vitally important, as this method of consultation will only be beneficial if it is accessible to everyone that it’s offered to.
Tell us something about yourself that may be less well known
I am a huge musical theatre fan, and if I have my headphones in, chances are I’m listening to an Original Cast Recording! My favourites are Hamilton, West Side Story and Legally Blonde – an eclectic mix!
On 22nd June, the Exeter Academic Collaboration for Primary Care (APEx), along with representation from the University of Exeter, key stakeholders from NIHR's School for Primary Care Research (SPCR), NHS Devon, and the public, were invited to an event at Sandy Park Conference Centre in Exeter, Devon.
The event formally launched APEx's membership of the SPCR, a prestigious membership awarded to nine higher education Primary Care departments across the UK, demonstrated research already undertaken as a result of joining the school, and future ambitions for primary care research in the South West.
Keynote speakers included a range of talks from members of the APEx community and beyond:
Prof Lisa Roberts, Vice Chancellor and Chief Executive, University of Exeter
Prof Richard Smith, Deputy Vice Chancellor (Strategy & Resources), Professor of Health Economics, University of Exeter
Prof Christian Mallen, Director, SPCR, Keele University, (pre-record)
Georgina Fletcher, Assistant Director, SPCR
Mr Nigel Acheson, Chief Medical Officer, Integrated Care System for Devon (ICSD)
Prof Willie Hamilton, Professor of Primary Care Diagnostics
Prof Stuart Logan, Director of the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenARC)
Prof G.J. Melendez Torres, Professor of Clinical and Social Epidemiology
Talks were also delivered on the 5 major themes of APEx's research:
Ageing, Frailty, Multimorbidity - introduced by Sallie Lamb
Primary Care focused HSR - Introduced by John Campbell
Mental Health - Introduced by Barney Dunn
Primary Care Diagnostics - Introduced by Willie Hamilton
Public and Patient Involvement - Introduced by Annette Gillett and Phil Ruthen(Primary Care PPIE Working Group members)
Dr Emma Pitchforth introduced Dr Sinead Mcdonagh and Dr Sarah Moore who have been awarded NIHR SPCR Fellowships.
We thank everyone who attended and made this an inspiring and unforgettable event.
We're looking forward to the inevitable expansion of Primary Care research in the South West as a result of SPCR membership.
Can you tell us a bit about yourself and research career to this point?
I started my academic journey in West London, where I completed a BSc in Sport Sciences at Brunel University in 2011. I then moved to the University of Exeter to study for a MSc in Sport and Exercise Medicine, which I thoroughly enjoyed.
During my time as a Masters student, I became interested in the effects of dietary nitrate supplementation (e.g. beetroot and green leafy vegetables) and lifestyle choices on cardiovascular health and exercise tolerance and went on to pursue a PhD in this area.
In 2017, I joined the Exeter Collaboration for Academic Primary Care (APEx) as a Postdoctoral Research Fellow. My research to date has focussed on the prevalence of postural hypotension (the fall in blood pressure when rising from sitting or lying to standing), the detection and management of hypertension (high blood pressure) in primary care, rural workforce issues, and the implementation and digitisation of a home-based cardiac rehabilitation programme for heart failure (REACH-HF) in the NHS.
What are you aiming to do through your Fellowship?
The aim of my recently awarded NIHR School for Primary Care Research (SPCR) Postdoctoral Fellowship is to undertake, and seek funding for, a programme of work focussing on postural hypotension assessment in primary care settings in England, and to participate in training to enhance my skills in research methods, patient and public involvement and leadership.
What are you looking forward to most in your Fellowship?
I feel extremely privileged to have been awarded a NIHR SPCR Fellowship. It has provided me with an opportunity to pursue my own research interests as well as undertake training that is specifically targeted toward my personal and professional development. I’m looking forward to attending a range of courses, meeting new people with similar interests, as well as finding out more about how primary care teams detect and manage postural hypotension so that we can develop new ways to support those affected by the condition and clinical teams in detecting it.
Tell us something about yourself that may be less well known
My academic training was predominantly in cardio-respiratory exercise physiology – which might make some people wonder how I ended up in Primary Care research! However, the dietary nitrate interventions that I employed and studied during my MSc and PhD not only improved exercise tolerance in healthy individuals and clinical populations, but were also effective in reducing blood pressure. I had always been interested in the study of chronic disease, particularly those with cardiovascular disease, such as hypertension, so jumped at the chance to join Dr Chris Clark and Professor John Campbell as a Postdoctoral Research Fellow in APEx, to learn more about blood pressure measurement and management in primary care settings. I’m so glad I made this move as I now get to enjoy another 2 years working in this area and in such a supportive department.
Between 2012 and 2016 I studied for a PhD in the Sport and Health Sciences at the University of Exeter. This involved lab-based research, looking at how children processed sugar after different intensities of physical activity. I was interested in the physiology, taking blood samples, and looking at metabolic and vascular function. If you’re interested in the specifics, you can check out my PhD here. In my final year, I got a taste for Health Service Research, getting to work with children with type one diabetes and clinical staff.
Combining my interest in physical activity and health and knowledge of health service research I was able to apply for a Post-Doctoral Fellowship with the NIHR School of Primary Care Research to pursue my own research interest and take the next step towards an independent research career.
Fellowship focus
During this two-year fellowship I will be working with adolescents with type one diabetes, parents and carers, health care professionals, and sports coaches/PE teachers to develop an intervention that helps adolescents with Type One Diabetes to be more physically active.
Type One Diabetes is one of the most common chronic diseases in adolescents with around 29,000 people under the age of 17 living with Type One Diabetes in the UK. Adolescents with Type One Diabetes have twice the risk of developing heart or blood vessel disease, compared to those without diabetes. Along with diet and insulin, regular exercise is an important aspect of the treatment of Type One Diabetes. Because of these benefits, adolescents with Type One Diabetes are recommended to do 60 minutes of physical activity per day. However, most are not meeting this target. Adolescents with Type One Diabetes find that it is hard to exercise because they are worried about low blood sugar levels and are unsure how to best manage this. Currently, there are no specific programmes for adolescents with Type One Diabetes that provide help and support for diet and insulin management while exercising.
I will be conducting a systematic review to understand what to include in the intervention and how to deliver it; doing some qualitative work with key stakeholders to understand their needs and preferences for a programme to support physical activity; and using findings from these two project I will work with key stakeholders to develop an initial programme to promote and maintain safe physical activity. Identifying intervention objectives, components, and delivery method.
Enjoying the sunshine in Weymouth at the end of a half ironman in September
What I’m looking forward to
I’ve had this project in my head for a while now, so I’m really excited that it is becoming a reality and I can spend my time and effort building a research career in this area. It’s also great that I have the capacity to attend a number of training courses, gaining skills and understanding to become a better researcher.
What I do outside of work
When not at my desk you will most likely find me burning off some excess energy, either exploring on my bike, out for a run, or in the pool. Until last year I competed at a national level in cycling, but I’m now giving long distance triathlon a go.
