RCBCWales Fellows' Research Profiles

Postdoctoral Fellow, Cardiff University

My research interest is in utilizing state-of-the-art genomic technologies and bioinformatics tools to improve the care of patients with genetic disorders. Particularly, I am interested in the use of rapid whole genome sequencing (rWGS) to enable faster and precise diagnoses for critically ill children. Rapid WGS is a powerful new genetic test that is used clinically to improve outcomes by reducing the need for multiple diagnostic tests and invasive procedures, facilitating earlier treatment decisions, and preventing repeated admissions. However, around half of children remain undiagnosed following rWGS. I plan to undertake detailed re-analysis of rWGS data from unsolved individuals in a research setting using advanced bioinformatics tools and different approaches. Key aims of my project are to increase the rate of diagnosis or children with rare diseases and to inform and improve NHS service provision (expanding the range of patients who can be tested and the range of disorders that can be tested for). Finding a genetic cause in a patient can drastically shorten their diagnostic journey, improve medical management, and, for some conditions, improve outcomes (e.g. better seizure control). Providing a family with a genetic diagnosis clarifies recurrence risks, facilitates genetic counselling and opens up access reproductive options such as preimplantation or prenatal testing. The findings of this project will also contribute to clinical service development, particularly how the NHS implements re-analysis of rWGS data as part of routine testing. The discovery of new disease genes will allow them to be included in routine NHS genetic tests.

Postdoctoral Fellow, Swansea University

Julia Terry is an Associate Professor at Swansea University. Her specialist area is mental health, particularly mental health promotion and early intervention. She is developing a research portfolio tackling health inequalities with Deaf people. Her Postdoctoral Fellowship with RCBC Wales is called SUPERSTAR – it’s about exploring systems that support hearing parents with deaf children.

Following two public engagement events, stakeholders said there is a lack of a deaf pathway for families with deaf children. Julia has engaged a project steering group to shape the project as it moves forward. First, she will be examining the current evidence and producing a scoping literature review. Second, she will be interviewing hearing parents of deaf children and people who work with deaf children to explore what are the challenges, barriers and what provides them all with help and support. After this, she will develop a preliminary framework of best practice, and engage with policy and decision-makers to progress positive change.

Outputs from this project will be journal articles and a British Sign Language (BSL) film of the project findings. During the Fellowship Julia will continue to engage with stakeholders on other project ideas, and progress further grant applications on her journey to research independence.

PhD Fellow, Cardiff University

My name is Cathryn Smith I am a lecturer in Primary Care and Public Health at Cardiff University. Prior to this I worked as a nurse within primary and community care for 10 years. I have a keen interest in academia and achieved a master’s degree in Community Health Studies which sparked my interest in research. My specialities include community nursing with my values focusing on the importance of this role and how research can benefit both nurses and patients within primary care. However, my passion is strongly linked to improving end of life care for people living with dementia. Therefore, the aim of my PhD study is to look at end of life clinical decision-making process of healthcare professionals’ within primary are. The irregular progression of patient deterioration warrants the need for specific decision making on end-of-life care (EoLC) strategies focused on dementia. The research study will focus on observing healthcare professionals’ recognition of deterioration in patients with dementia and establish the appropriateness of their clinical decision making in EoLC, including the reason behind the decision-making process of best place of care. It will also aim to establish if there are any facilitators and/or barriers associated with successfully recognising the deterioration of patients with dementia at end of life. This research study therefore has the potential to inform education and policy and make a difference to quality of care in the nature and timing of EoLC to patients with dementia in the remit of primary care.

PhD Fellow, Swansea University

My name is Ed and I qualified as a Paramedic in 2011, being a part of one of the first cohorts to complete Swansea University’s HEI Paramedic Science course and then went onto complete the MSc in Advanced Practice and now practice as an Advanced Paramedic Practitioner in Swansea. 

As part of the research pillar of advanced practice, I have participated in, led on and been a co-applicant on a number of research and service development projects within the Welsh Ambulance Service, including the trust evaluation of the analgesia Penthrox with EMTs, an investigation on the effects of home and agile working with WAST staff and ASSIST: which aims to analyse improving the chances of surviving an out-of-hospital cardiac arrest by using AI to support ambulance service clinical centre contact staff. 

My research will look at the health and wellbeing of ambulance staff in response to COVID-19 using a mixed methods approach. The quantitative approach will analyse sickness levels and expedite any themes and trends. The qualitative element will involve semi-structured interviews with ambulance staff to determine their experiences of the COVID-19 pandemic and how it has effected them on a personal and professional level. 

I am excited about undertaking this project and am looking forward to working with RCBC and COS. 

First into Research Fellow, Cardiff University

Claire is currently a senior pharmacist working with the All Wales Therapeutics and Toxicology Centre (AWTTC). As part of the Patient Access to Medicines Service within AWTTC, Claire's work is focused primarily on Health Technology Assessment and horizon scanning. Claire graduated from Cardiff University in 1994 and worked in secondary care until moving to AWTTC in 2016. Much of her time in secondary care was spent in Medicines Information, where she led the Medicines Information service for Cwm Taf University Health Board for over 10 years.

The research to be undertaken with RCBCWales will be looking at aspects of the medicines horizon scanning process in NHS Wales. This process identifies new medicines in development and helps to assess their likely impact on budgets and services to aid planning. In line with current guidance from Welsh Government, new medicines recommended by the National Institute for Health and Care Excellence and the All Wales Medicines Strategy Group have to be made routinely available for prescribing to patients in Wales as soon as possible and certainly within 60 days, unless there are exceptional circumstances. This can be challenging for Welsh Health Boards/Trusts. Without effective horizon scanning this will become more difficult as the number of complex and high cost medicines reaching the UK market increases.

This study plans to survey key stakeholders to identify what improvements can be made with the horizon scanning process, particularly in terms of clinical expert engagement, to help support planning and patient access to medicines in NHS Wales.

First into Research Fellow, Swansea University

I am a Research and Development lead and Senior Biomedical Scientist within Cellular Pathology in Swansea Bay University Health Board. The research may be tests developed in house or a collaboration with Swansea University. I act as Person Designated (PD), assisting the designated individual (DI) and governance officer ensuring compliance with human tissue authority (HTA) standards for research. I also volunteer on a research ethics committee.

Endometrial cancer (EC) is the most common gynaecological cancer, with over 9,000 new cases diagnosed annually in the UK. Currently divided into two subtypes - Type I (~80% of cases) and Type II [DOI:10.1177/107327480901600102]. This simplistic model has recently been challenged with the development of molecular profiling; however, this too is of limited benefit [DOI:10.1186/s40661-016-0035-4]. There remains a significant need for better profiling of EC to determine and deliver the best patient care pathway.

Genomics can provide a breakthrough solution, leading to a revolutionary understanding into how an individual patient’s cancer has developed, prove instrumental in diagnosing, managing and treating their disease. The focus of my project is to use ‘Spatial transcriptomics’, a ground-breaking technology that enables the measurement of all the gene activity in a tissue sample, mapping this to exactly where the activity is occurring in the tumour.

Applying this to EC samples has the potential to deliver an urgently needed step to change in the care of these patients by enabling personalised therapies to be selected based on gene profiling. This is essential in light of the British Gynaecological Cancer Society COVID-19 guidelines that has put EC as the lowest priority for surgery.

First into Research Fellow, University of South Wales

Research Allied Health Professional (Podiatrist), Cardiff & Vale University Health Board.

Project: Early access to virtual resources for the self-management of Plantar Fasciitis: A proof of concept and feasibility study.

Kerry Nyland qualified as a Podiatrist in 2014 and has gained experience in a variety of clinical settings across two health boards. Her substantive post since 2018 has been with the Research Delivery team helping to support researchers set up and deliver their studies. Kerry also continues to work closely with Cardiff & Vale Podiatry and is committed to help increase research within this area.

The aim of the First into Research project is to investigate how podiatry patients who are symptomatic of Plantar Fasciitis respond to virtual resources for self-management, by introducing them to the materials as they join the podiatry waiting list. The primary objective will be to assess patients’ acceptance and usability of virtual resources and the feasibility of conducting a future randomised controlled trial.

Covid-19 has accelerated the use of virtual communication in an attempt to find ways of working as part of a ‘new normal’. This research therefore presents a timely opportunity to provide insight into the benefit of a treatment approach that has the potential to result in improved early outcomes for a common condition.

First into Research Fellow, University of South Wales

Malisa is Lead Clinical Nurse Specialist and Manager at the Welsh Epilepsy Centre at Cardiff and Vale University Health Board. She has worked in the field of neurosciences for over 20 years and specialised in the field of epilepsy for the last 18. She is a recipient of a Betsi Cadwaladr and Florence Nightingale Scholarship, Epilepsy Action UK Health Practitioner of the year award and was a finalist in the Royal College of Nursing, Wales, Nurse of the year.   

The aim of the research is to analyse the experiences of patients receiving virtual care in epilepsy during the Covid-19 pandemic. Covid 19 has changed service delivery beyond recognition. Normally it would be imperative to involve patients, but at the onset of the pandemic there was no time. The only way to offer any service was by switching to virtual clinics. The future of care delivery is uncertain and with Covid 19 still a predominant feature it has become apparent it is the only way to offer a service to many.  With virtual appointments seen as an opportunity to make significant improvements in access to care delivery within the NHS (Welsh Government 2019), it is unlikely we will return automatically to how care was provided before Covid-19. Now therefore it seems the right time to explore patients’ views on the ability of virtual appointments to provide adequate care.

With this in mind, this research hopes to interview individuals with epilepsy and ask their views of using the virtual service within a chronic health condition, epilepsy. 

First into Research Fellow, Cardiff Metropolitan University

I am a Speech and Language Therapist working for Aneurin Bevan Health Board, a member of the Royal College of Speech and Language Therapists (RCSLT) and the Health and Care Professionals Council (HCPC). My previous research in phonological acquisition in bilingual development has been published in the International Journal of Bilingualism and I have guest lectured at Cardiff Metropolitan University as part of the BSC Speech and Language Therapy Course.

I work in the specialist multidisciplinary Neurodevelopmental Team which assesses children aged 5-18 for Autism Spectrum Disorder. As part of the assessment process, pragmatic language skills are assessed in a face-to-face clinical setting. However, this process has been disrupted during the COVID-19 pandemic. My current project is: “Are video-based consultations with children investigated for Autism Spectrum Disorder appropriate and reliable? A mixed methods approach”. I will be exploring the effectiveness of telehealth on this particular aspect of autism assessment in two phases – (1) gathering quantitative data to assess the extent to which members of the multidisciplinary team are consistent in their observations of impairment of pragmatic language skills achieved via video consultation and (2) gathering qualitative data through interviews with Neurodevelopmental Team staff to identify the perceived benefits and barriers of using video consultation as a substitute for face-to-face appointments.

First into Research Fellow, Cardiff University

I have worked as a Physiotherapist since 2003, moving to focus on Musculoskeletal Outpatient physiotherapy in 2006. I completed my MSc in Advanced Practice at Birmingham University and went on to publish my dissertation in the BMJOpen in 2015. I have peer reviewed articles for PlosOne and the BMC Medical Research Methodology in 2018. Currently I am working in the First Contact Physiotherapy service within Cardiff and Vale UHB and am looking forward to gaining further experience in undertaking research.

My research project is to re-design a pre-existing physical activity tool and assess whether it is acceptable for use in patients with osteoarthritis. The aim is to improve self-management of physical activity in people with osteoarthritis, promoting independence and self-efficacy of disease management. The tool will be co-produced during a virtual focus group of volunteers with osteoarthritis. Once the tool has been developed accordingly semi-structured interviews with volunteers with osteoarthritis, and physiotherapists working with people with osteoarthritis will be conducted to evaluate the tool. Thematic analysis will be used to develop the tool further as needed.

First into Research Fellow, Swansea University

As a Diagnostic Radiographer, I specialised in Plain Film Reporting, Health & Safety and Clinical Leadership. I am now the operational and strategic Manager at the National Imaging Academy Wales (NIAW).

Driven by my belief in the NHS Values and the workforce that bring them to life, my professional goals include the development of a programme of high quality training and continued professional development (CPD) opportunities for Diagnostic Imaging Professionals across NHS Wales.

In addition to my primary professional role, I am committed to promoting and undertaking research within diagnostic imaging and have personal and professional ambitions to encourage and assist other professionals to do the same.

I am proud to be awarded this prestigious RCBC Wales First into Research fellowship for my study, Identifying and Prioritising Diagnostic Imaging Training: a national training needs assessment in Emergency Medicine (EM).

The project will use a Delphi Survey to establish consensus on the training needs of workers that use diagnostic imaging in EM. The Delphi Process will identify and prioritise the training needs for this workforce to do their role effectively and safely. The data will enable NIAW to identify and prioritise the design & delivery of its training programme for EM discipline. NIAW will use the results of the study to develop the most useful and worthwhile diagnostic imaging training packages for the EM workforce. This will promote prudent approach to delivery of care in A&E settings and provide an evidence based approach for the use of NIAW resources.