Supervisors: Dr Lisa Ashmore, Dr Chris Gaffney

Lancaster Medical School are delighted to be offering a fully funded PhD to look at the role of prehabilitation in radiotherapy for cervical cancer. The successful candidate will work with experts in integrated physiology, social sciences and clinical radiotherapy service delivery to examine the physiological response to prehab, as well as psychosocial effects.

In recent years, prehabilitation has become an accepted component of many cancer pathways. However, to date, the vast majority of prehabilitation evaluations and evidence have focussed on cancer surgery. Any specific radiotherapy prehabilitation (prehab) services are regional with little, if any, understanding of the physiological benefits or the mechanisms that underpin any benefit. More broadly, the scientific evidence to support the use of prehabilitation is variable and the descriptions of prehabilitation interventions are often imprecise, making it difficult to translate research into practice and provide evidence for service development.

This study primarily seeks to assess the biopsychosocial impact of prehabilitation on patients undergoing radiotherapy for cervical cancer. Successful candidates will gain experience in researching physiological responses to interventions, including cardiopulmonary exercise testing to determine changes in cardiac and respiratory performance, as well as skills in using quality of life measures and qualitative research methods to explore patient experience.

You will join Lancaster University’s Faculty of Health and Medicine 5* Research Environment (as rated in the 2022 Research Excellence Framework). You will join the growing number of PhD students at Lancaster Medical School and connect with networks across Lancaster’s high-ranking research units. Working with the Radiotherapy Operational Delivery Network, the findings will have the potential to inform development of regional practice and national strategy.

Successful candidates will receive a stipend and fees included.

This project would suit a Health Care Professional with a strong interest in evidence based service development wishing to develop their academic career or anyone with an interest in physiology, sports and exercise science, or applied health research. We welcome applications from minority groups and do not discriminate against any applicant because of race, colour, sex, age, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other protected characteristics.

Anyone interested in this role is encouraged to contact the project supervisors: Dr Lisa Ashmore, Senior Lecturer in Social Sciences and Clinical Academic Therapeutic Radiographer l.ashmore@lancaster.ac.uk or Dr Chris Gaffney, Senior Lecturer in Integrated Physiology, c.gaffney@lancaster.ac.uk.

Application process: Applications should be made in writing to the lead supervisor. You must include the following:

1. CV (max 2 A4 sides), including details of two academic references
2. A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)

Supervisors: Rachel Isba, Jude Lunn

Health inequalities are systematic differences in health between people that are unfair and avoidable. In the UK, children and young people (CYP) living in socio-economically deprived areas are more likely to experience conditions such as tooth decay, asthma, diabetes, and obesity. CYP from more deprived areas are also less likely to be brought to their outpatient appointments and more likely to attend the Emergency Department than those in the least deprived areas.

The NHS has a legal duty to address health inequalities through the Health and Social Care Act 2012, and health inequalities were identified as a key priority in the Long Term Plan. Despite this there is very little central steer on the role of hospitals in regards to reduction of health inequalities, and initiatives are usually adult focussed.

This PhD will follow on from a nationally-commissioned project funded by the Children’s Hospital Alliance, which has looked at the role of children’s hospitals in addressing health inequalities. The PhD will aim to produce practical solutions and toolkits for hospitals to address health inequalities. The findings have potential to influence national and international policy and practice.

Mixed methods in design, it is anticipated that qualitative work will engage with children, young people, and their caregivers. Quantitative work could explore how data collection could be improved and used to identify health inequalities in this population of CYP accessing secondary and tertiary healthcare services in England.

The candidate will join a multidisciplinary and inclusive team working in the area of paediatric public health. A bespoke package of personal development will be designed around the candidate, in addition to the University’s traditional package of support.

Please contact: rachel.isba@lancaster.ac.uk

Application process: Applications should be made in writing to the lead supervisor. You must include the following:

1. CV (max 2 A4 sides), including details of two academic references
2. A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)

Supervisors: Dr Amy Gadoud

Based at Lancaster Medical School but potential for co-supervision within the International Observatory on End-of-Life Care.

An exciting opportunity has arisen to study for a PhD in an area related to palliative care with one of the leading centres of palliative care research in the UK. There is flexibility in the topic that you can propose for this PhD fellowship, as long as it is aligned with the research interests and expertise of potential supervisors at Lancaster University.

Amy Gadoud is a Senior Lecturer in Palliative Medicine at Lancaster Medical School.

She is NIHR Integrated Clinical Academic Training Lead, academic lead for the palliative medicine Specialist Advisory Committee (SAC) and works as an honorary consultant in palliative medicine at Trinity Hospice, Blackpool and is ideally placed to support academic clinicians in training.

Co-supervision is available from colleagues in the International Observatory on End-of-Life Care, Lancaster University. Academic staff have extensive experience of supervising PhDs in this area to successful and timely completion. Areas of expertise include patient and carer-focused research drawing from clinical and social science perspectives to contribute to end-of-life care knowledge, theory and practice. The candidate would join a lively, supportive postgraduate community within an internationally renowned palliative and end-of-life research centre.

Please contact Amy Gadoud with your area of interest/ project and identification of potential co-supervisors.

Application process: Applications should be made in writing to the lead supervisor. You must include the following:

1. CV (max 2 A4 sides), including details of two academic references
2. A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)

Supervisors: Dr James Shelley, Dr Matteo Crotti

Accelerometry is one of the most widely used device-based methods for assessing physical activity (PA). A key issue with using accelerometers is that individuals often do not wear accelerometers for prolonged windows of time during the designated PA assessment period. Wear time criteria such as “valid day” (i.e., number of hours individuals wear an accelerometer during a day) and “valid week” criteria (i.e., number of valid days in a week) and imputation methods therefore need to be considered when using accelerometers to measure habitual physical activity. Investigating the effect of different valid day and valid week criteria and imputation on PA is important as poor accuracy in PA assessment might lead to incorrect conclusions about PA intervention effectiveness, the relationship between PA and important health indicators or about the PA levels observed in the population. It is currently recommended that 10 hours (valid day criterion) and at least four valid days (valid week criterion) should be used for the measurement of habitual PA over a week. There is currently no solid evidence backing these guidelines and no established guidelines for proportion of valid week and weekend days to be included for PA analysis.

This research project aims to investigate how modifying valid day and valid week criteria can affect the accuracy of PA assessment over a week. Furthermore, the project aims to create evidence-based guidelines about valid day and valid week criteria to assess PA when using accelerometry. Specifically, the project will look to investigate the following research questions:

1. What can we define as adequate (leading to accurate PA estimates without excluding too many participants) valid day and valid week criteria when considering participants' sample size?
2. Could valid day and valid week criteria and imputation affect research findings by leading to detected differences in PA between 2 groups when significant differences should not exist?

Application process: Applications should be made in writing to the lead supervisor. You must include the following:

1. CV (max 2 A4 sides), including details of two academic references
2. A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)

Supervisors: Dr Brigit McWade, Dr Michael Lambert

We should like to develop a project with a prospective PhD candidate that aims to measure and explore the role that the extracellular matrix has in the development and progression of cancer using a multidisciplinary approach.

Raman spectroscopy is a non-invasive, laser-based method that can detect changes in the biochemistry of human tissue (1). This technique has potential to provide information about changes in cancer microenvironment, and is currently being developed for in vivo use for a variety of human conditions (2). In addition, if Raman spectroscopy could identify different aspects of the cell cycle in vivo, then this could be clinically useful in determining the rate at which a cancerous tumour is proliferating.

Overall, the main aim of this study is to develop a method for the analysis of tumour proliferation in vitro and demonstrate the potential of Raman spectroscopy to detect changes to the biochemistry of the tumour, providing reference spectra for common biochemical changes to assess the development of cancers.

Skills: the PhD student will have the opportunity to develop expertise in a range of skills that cross several science disciplines including vibrational spectroscopy, cell culture and histology, along with appropriate multivariate data analysis and classification tools.

References

1. Butler HJ, Ashton L, Bird B, Cinque G, Curtis K, Dorney J, et al. Using Raman spectroscopy to characterize biological materials. Nat Protoc 2016 114 [Internet]. 2016 Mar 10 [cited 2022 Jun 29];11(4):664–87. Available from: https://www.nature.com/articles/nprot.2016.036

2. Buckley K, Kerns JG, Gikas PD, Birch HL, Vinton J, Keen R, et al. Measurement of abnormal bone composition in vivo using noninvasive Raman spectroscopy. IBMS Bonekey. 2014 Nov 26;11:602.

Application process: Applications should be made in writing to the lead supervisor. You must include the following:

1. CV (max 2 A4 sides), including details of two academic references
2. A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)

Supervisors: Dr Brigit McWade, Dr Michael Lambert

Medicine is an elite profession, traditionally dominated by white, male, middle- or upper-class people, often from medical families. Some advances to diversify the profession have succeeded, but only 4% of medics come from a working-class background, and these doctors will experience an average class pay gap of £3,640. Medical student activism has highlighted how financial and structural barriers impact on academic achievement and career progression. Most widening participation activities focus on fair access, but the barriers to success, once candidates are admitted to medical school, are under-researched. This PhD will allow the candidate to explore barriers to success for medical students and influence national policy regarding the education of tomorrow's doctors. It is anticipated that this will be a qualitative or mixed-methods research project.

Application process: Applications should be made in writing to the lead supervisor. You must include the following:

1. CV (max 2 A4 sides), including details of two academic references
2. A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)

Supervisors: Professor Hedley Emsley, Professor Jo Knight

This clinical PhD studentship at Lancaster University has been created for aspiring medical academics and will suit those seeking a nationally competitive PhD studentship, including those completing an NIHR Academic Clinical Fellowship. Supervised by Professor Hedley Emsley (Consultant Neurologist & Professor of Clinical Neuroscience at Lancaster University) & Professor Jo Knight (Professor of Applied Data Science), this represents a ground breaking opportunity at the intersection between neurology and data science.

The project, on the theme of late-onset and vascular epilepsy, will involve identification of the study population using data mining approaches with application of natural language processing and/or other relevant approaches to routine neurology records within the Lancashire Neurosciences Centre Trusted Research Environment/NHS England Secure Data Environment. The PhD is expected to involve linkage of primary and secondary care data sets, analyses of the influence of deprivation and comorbidities, as well as image analysis using routinely acquired brain imaging data for which we have an automated images analysis pipeline in development within the TRE. The project is likely to deliver diverse training in research methodologies, significant impact, and numerous academic outputs including development of relevant phenotypes. There will be the option to incorporate academic epilepsy experience at the emergent Centre for Late-Onset and Vascular Epilepsy Research (CLOVER) – a new partnership between Lancaster University, the Chalfont Centre and University College London. There is also overarching support for the work from Health Data Research-UK North.

Crucially, this project will address highly topical issues. The northwest of England has a particularly high burden of cerebrovascular disease owing to underlying health inequalities; patients with late-onset or vascular epilepsy are at risk of stroke and dementia, but little or no attention is currently paid to opportunities to prevent these complications. The optimal use of routinely collected data is also a key NHS priority.

Application process: Applications should be made in writing to the lead supervisor. You must include the following:

1. CV (max 2 A4 sides), including details of two academic references
2. A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)

Supervisors: Dr Nicola Rennie, Professor Joanne Knight

Machine learning models are becoming increasingly common in healthcare settings, from aiding in diagnosis to analysing patterns of hospital usage. Though these models have the potential to greatly improve health outcomes, there is also a risk that they could increase health inequalities due to decisions about how data is collected and used. Structural inequalities and biases are embedded in datasets and, when machine learning models are applied to such datasets, these biases can become amplified.

This project will examine how often biases and inequalities are considered in the development of models in healthcare settings, and whether some types of biases are addressed more frequently than others. The PhD student will develop methodology for evaluating the performance of machine learning models in relation to bias and fairness, with the aim of proposing a framework to prevent the amplification of inequalities through machine learning. There will be opportunities to develop and publish open-source software packages built with R, Python, or Julia to encourage evaluation of model fairness in health data science research. Further, this project will analyse routinely collected NHS data to identify potential sources of bias and evaluate the potential impact of failing to account for bias when modelling.

Application process: Applications should be made in writing to the lead supervisor. You must include the following:

1. CV (max 2 A4 sides), including details of two academic references
2. A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)

Supervisors: Dr Kate Slade, Dr Helen Nuttall (Psychology Department: the Neuroscience of Speech and Action Laboratory)

Around 70% of people aged 70+ have hearing loss, and there is evidence that age-related hearing loss may be related to increased mental health issues or cognitive declines. In fact, hearing loss is recognised as the largest potentially modifiable risk factor for dementia, and whilst the relationship is unclear it is important that we understand more about hearing loss and brain health.

There is emerging evidence that lifestyle and socioeconomic factors may impact the risk of someone developing hearing loss; an exciting area of interest is the idea that maintaining physical health and activity could reduce risk of hearing loss. Physical activity benefits our brains through promoting neuroplasticity, which could help us with hearing and communication. This research project would aim to understand the links between physical activity and incidence of hearing loss as we age. This could be in exploring the mechanisms (i.e., neural, physiological, or psychological) by which increased physical activity could mitigate risk of hearing loss, and whether physical activity is a potential moderator of the potential relationship between hearing loss and cognitive declines in ageing. The objective would be to provide new research understanding of how hearing and brain health can be impacted by physical activity, and what the potential underlying mechanisms might be in order to inform potential future interventions to help people hear better for longer.

Application process: Applications should be made in writing to the lead supervisor. You must include the following:

1. CV (max 2 A4 sides), including details of two academic references
2. A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)

Supervisors: Sam Moore Jon Read

Vaccine deployment strategies are critical in maximising the impact of available vaccines whilst respecting supply, deployment and cost related constraints. During the COVID-19 pandemic, the use of complex vaccine models proved effective in helping to shape a world leading vaccination campaign within the UK, though the focus here was on mass deployment and the potential benefits of spatial targeting was not explored in detail.

Spatial heterogeneities are frequently found to have a significant impact on the spread of disease within a country. Even in the case of widespread endemic infection, regional variation in population demographics, deprivation measures and access to healthcare resources often lead to large disparities in both infection prevalence and the subsequent impact of disease. While there is an existing precedent for spatial modelling in epidemiology, such dynamics have been largely neglected in the context of national vaccination strategies.

The aim of this project will be to investigate the benefits of using spatial models to inform vaccine deployment strategies. This may involve considering the effects of reactively targeted vaccination, to reduce the burden of disease within a localized outbreak, as well as how proactive vaccination in neighbouring regions may be used to minimise further disease elsewhere. The project is expected to be a combination of theoretical model development and practical application, to be valuable in the direction of future national vaccination campaigns against both newly emerging and currently endemic diseases.

Application process: Applications should be made in writing to the lead supervisor. You must include the following:

1. CV (max 2 A4 sides), including details of two academic references
2. A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)

Supervisors: Chris Gaffney, Karen Wright (BLS)

Cannabidiol (CBD) may have anti-inflammatory, analgesic, anxiolytic and neuroprotective effects, which have attracted the attention of athletes. The regulations around CBD are complex, and in the UK, consumption is limited to 70mg/day where any impact on physiology and metabolism is unknown. This PhD will undertake a series of physiology-focused studies in the Lancaster Human Performance Lab to determine the impact of CBD on metabolism, performance, and recovery.

Application process: Applications should be made in writing to the lead supervisor. You must include the following:

1. CV (max 2 A4 sides), including details of two academic references
2. A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)

Supervisory Team

Dr Dawn Goodwin and Dr Susannah Brockbank

Project Title

PhD Fellowship: When healthcare harms: Exploring investigative practices in the regulation of healthcare professionals

Project Description

Lancaster Medical School invites applications from clinically qualified graduates for a PhD scholarship in medical research.

Background

It is thought that 1 in 10 patients are harmed while receiving healthcare (Health Foundation, 2011). Much patient safety research has been dedicated to understanding how to prevent this. Far less is known about what happens to patients, their families, and the practitioners concerned, once harm has occurred. The GMC report about the deaths of doctors while under investigation (2022) indicates concerns about the stress of GMC investigations and the suicide rate of doctors undergoing investigation. Yet, little is known about the investigative procedures professional bodies undertake, the decision-making processes that underpin them and the human consequences of these procedures. Moreover, little research exists on the perspectives of those raising concerns, be they patients, families or colleagues. It has been suggested that investigative procedures can be cathartic, but this has been contested by others arguing that they compound and prolong grief.

Aim

This study will explore the lived experience of professional bodies’ regulatory practices to deepen understanding of their knowledge-making practices, uncover the costs and benefits of the processes, and examine how such investigations function as tools for justice and accountability.

Methods

The study will utilise a range of qualitative methods and data sources. It will include discourse analysis of professional bodies’ policies and procedures, narrative interviews with practitioners as well as patients/families who have raised concerns, and ethnographic observation of MPTS hearings. These data will be analysed narratively and thematically to elucidate the complexity of value and harm enacted by regulatory investigations.

Outputs

The study will produce a number of academic and clinically focused articles on accountability in healthcare as well as seeking to inform regulators about the experience of those involved to influence policy and practice.

Application process

Applications should be made in writing to the lead supervisor, Dr Dawn Goodwin (d.s.goodwin@lancaster.ac.uk). You must include the following:

1. CV (max 2 A4 sides), including details of two academic references
2. A cover letter outlining your qualifications and interest in the studentship (max 2 A4 sides)

Funding Notes

This position is for fully GMC registered doctors in a recognised training programme in the UK, with an NTN (ST1 to 5). Funding is available for PhD at 80% of FTE; whilst continuing clinical work at 20% of FTE and we welcome candidates who wish to work flexibly and less than full-time. The candidate would need to have at least a year left in their training programme. This post would be especially suitable for academic clinical fellows, although other trainees are welcome to apply.