D4D Renal Theme awarded NIHR Research Fellowship

D4D’s Renal Theme has been awarded a Doctoral Research Fellowship to develop work on Body Composition Monitor (BCM) in haemodialysis patients.

The award, presented by the National Institute for Health Research (NIHR), in partnership with the Chief Scientific Officer (CSO) for the Department of Health, will support a Clinical Scientist working in Leeds Teaching Hospitals Trust to build on the validation and adoption of the BCM and develop BCM guided fluid management strategies for dialysis patients.

D4D will be a collaborative partner in the work and one of the Renal Theme leads, Dr. Elizabeth Lindley, will act as one of the supervisors for the work.

The BCM will be used to characterise fluid distributions in healthy volunteers and in haemodialysis patients as well as exploring how these distributions are altered in these patients during fluid removal on dialysis.

Attempts at optimising fluid removal, such as promoting fluid shifts from body tissue into the vascular system, will be fully evaluated. The project aims to produce a number of fluid management strategies for different dialysis patient sub-groups, such as those with oedema or those who are prone to symptomatic episodes during dialysis. It is hoped this will help to reduce the rising number of cardiovascular risks in the population which has been linked to overhydration.

David Keane, Clinical Physicist at Leeds Teaching Hospitals, said: “This award is the culmination of years of work in the Renal Unit in Leeds, that started with a D4D funded project looking at BCM in paediatrics and has been supported by D4D throughout.

“It will allow me to work full-time on the project, which will use the BCM to try to make the process of fluid removal less traumatic for patients and better suited to their clinical needs.

“It also gives my team in Leeds the chance to extend their links with D4D and to forge new collaborations with clinicians and scientists in the UK and abroad.”

The NIHR, in partnership with the CSO for the Department of Health, annually runs the Healthcare Science Research Fellowship Competition to support the development of healthcare science research.

Major funding boost to help patients remain independent

Devices for Dignity (D4D), the organisation which works to improve the quality of life for patients with long term conditions has been awarded further funding.

After a successful first five years, D4D, hosted by Sheffield Teaching Hospitals, has been awarded £800,000 funding from the National Institute for Health Research (NIHR) to continue to help produce devices or aids which solve real areas of need for patients.

D4D brings together clinicians, patients, industry, charities and inventors to develop medical devices or technologies which assist people with their daily living. This can range from sophisticated communication aids to the development of new treatments for incontinence.

D4D focuses on three main clinical areas: Urinary Continence Management, Renal Technologies and Assistive and Rehabilitative Technologies.

The programme is hosted by Sheffield Teaching Hospitals and delivered through a co-operative of seven NHS Trust and Foundation Trust nodes around the country, and three academic partners (University of Sheffield, University of Cambridge and Coventry University). The new funding will allow D4D to extend its national network of nodes.

Wendy Tindale, Clinical Director for Devices for Dignity, said: “We are delighted to receive the funding for the next four years from the NIHR. We are proud of our real partnership approach which translates research and innovation to the person’s bedside – at home or in a hospital.

“We aim to build on our successes and become recognised as the national expert group in dignity-related unmet needs, by providing new medical technologies and inventions to help patients maintain dignity and improve their quality of life.”

New rehabilitation devices for patients recovering from stroke and an on-dialysis exercise programme which could help maintain muscle function and prevent patients becoming dependent on wheelchairs are just some of the innovations D4D is involved with.

Profile of D4D continues to rise

The profile of Devices for Dignity will receive a significant boost over the coming months with its role at a number of key healthcare related events around the UK.

Professor Wendy Tindale, D4D’s Clinical Director, will speak at an event in January 2013, having already played the role of compere at the Medilink Yorkshire & Humber Healthcare Business Awards in November (see picture).

The Medilink Healthcare Business Awards, held at the Cutlers’ Hall, Sheffield, celebrated the achievements of the leading healthcare businesses in Yorkshire and Humber.

Professor Tindale will take part in the Later Life: Engaged in Older Age Conference, at the Barbican, London, at the end of January as part of a Panel Debate.

The debate, “The impact of demographic change on public services: How do we make sure we don’t fail the Baby Boomers?”, will explore the most pressing demographic change facing the UK at the moment (and into the future) – that most of us will live for at least a decade longer than was expected when we were born.

Earlier in the month, Dr Nicola Heron, Programme Manager at D4D, will present at Assist UK’s National Conference, ‘Personal Independence Payments’, held at Heritage Motor Centre, Warwickshire.

Dr Heron’s presentation will look at assistive technologies delivering innovative solutions to support patients with long term conditions and preserving their dignity and independence.

Earlier this year, D4D announced that it had entered a partnership with the charity Assist UK as part of its commitment to Patient and Public Involvement.

Professor Wendy Tindale said: “To be involved in so many high level events around the UK is a fantastic platform for us to communicate the important work we are doing at D4D.

“Knowledge of D4D and our role is growing rapidly and we’re looking forward to taking part in a number of events throughout 2013.”

These events follow on from D4D’s Assistive Technology Lead, Professor Mark Hawley, presenting as the key-note speaker at November’s RAatE conference in Warwick. RAatE 2012 is the only UK conference focused on the latest innovations in Assistive Technology.

D4D expands its expert panel

Devices For Dignity has strengthened its panel of experts with the additions of two vastly experienced clinicians.

Dr Sandip Mitra has joined D4D’s panel of experts to co-lead the Renal Technologies theme. He will provide further knowledge as this theme expands to cover not only improved patient care in home and hospital dialysis but also looks to address early diagnosis of kidney disease.

Dr Mitra is a Consultant Nephrologist at the Central Manchester Hospitals NHS Foundation Trust where he leads the largest Haemodialysis at Home programme in Europe. He leads transformational change and Innovation in dialysis delivery systems aimed at improving patient experience and outcomes.

Professor Bipin Bhakta has joined D4D to co-lead the Assistive and Rehabilitative Technology theme to further boost knowledge in the area of rehabilitative medicine.

Mr Bhakta is Charterhouse Professor in Rehabilitation Medicine and Head of Academic Department of Rehabilitation Medicine, Division of Musculoskeletal and Rheumatics Diseases, University of Leeds.

He is an NHS Consultant Physician and clinical lead for Specialist Rehabilitation Medicine Services at Leeds Teaching Hospitals NHS Trust. He is also a lead for the regional specialist rehabilitation centre for people with disability arising from neurological conditions.

His research focuses on how disabled adults and children with neurological injury (e.g. stroke, multiple sclerosis, cerebral palsy) and other causes of disability such as musculoskeletal diseases reacquire functional skills.

Dr Nicola Heron, Programme Manager for D4D, said: “We’re delighted to welcome Sandip and Bipin to our expert panel.

“They have exceptional knowledge across two of our key themes and strengthen what is already a highly knowledgeable and proactive group of experts. Having such as vastly experienced panel of experts allows us to provide informed support for companies which are developing new technologies for areas of clinical need.

“We’re looking forward to working with them both on a number of projects in 2013 and beyond.”

Virtual clinic to benefit LUTS sufferers

The world’s first virtual assessment clinic in the field of Lower Urinary Tract Symptoms (LUTS) has been launched.

ELAROS 24/7 is an innovative new way of carrying out initial assessment as well as the long term management and monitoring of patients with LUTS.

LUTS refers to a range of urinary problems that can significantly impair the quality of life for sufferers. Effective treatment requires clinical evidence on frequency of urine volumes passed and urgency, which is typically recorded using paper diaries.

Use of such diaries is infrequent outside specialist services due to limited experience in primary care and the difficulty of interpreting the raw, variable data.

A potential solution to these problems has been developed by ELAROS 24/7 Ltd (Electronic LUTS And Remote Observation Service). The system, ELAROS 24/7, was launched at a special event at the University of Sheffield’s conferencing facility, The Edge, which was attended by more than 100 clinicians, business people and key stakeholders.

ELAROS 24/7 Ltd is a partnership between Devices for Dignity (D4D)/Sheffield Teaching Hospital Foundation Trust, MDTi Healthcare Ltd, Medipex (NHS Innovation Hub for Yorkshire and Humber) and RTC North, with funding awarded through the Engineering and Physical Science Research Council (EPSRC).

The ELAROS system consists of three parts – the UroDiary (to collect data), the UFlow meter (to measure flow rates) and the UroConnect (to manage and analyse data).

Informed by NICE guidelines on the identification and management of LUTS, ELAROS 24/7 is used by the patient to record times, volumes passed, and the desire to urinate. Once recoded, data is downloaded to the GP’s computer system for data visualisation, interpretation and patient management.

The UroDiary®, a portable electronic diary, is more discrete than writing in a diary, and makes data easily traceable and transferable between healthcare providers. Simple data capture, analysis and quicker diagnosis will potentially save the NHS £66M per year* through reduction in referrals to secondary care and diagnostic costs.

Professor Chris Chapple, D4D’s Urinary Continence Management Theme Lead, said at the launch event: “A bladder diary is an essential tool for clinicians assessing lower urinary tract symptoms – but a paper diary is not practical and often not reliable.

“ELAROS 24/7 gives the clinician a huge amount of information and allows us to effectively and accurately evaluate and treat people.”

It is also predicted that the ELAROS service will make significant savings on pharmacology budgets of at least 10% on the drugs being used in this area of health, with a pilot being run in February 2013 to test these assumptions.

Professor Paul O’Brien, Chief Executive of ELAROS 24/7 Ltd, said: “ELAROS 24/7 reduces the need for patients to make unnecessary journeys to their GP and also cuts down on inappropriate referrals – therefore benefiting both GP and patient, as well as reducing costs for the NHS.”

D4D awards funding to develop ideas

THREE innovative projects in the field of continence management have been awarded a total of £35,000 to help accelerate the development of their devices.

Devices for Dignity (D4D), the organisation which delivers technology solutions to support people with long-term conditions preserving their dignity and independence, identified continence management as the theme of this year’s Proof of Concept Competition.

The three challenge themes set were:

Tackling continence for people with dementia
Helping children and/or young adults with continence problems
Self-help tools for prevention or management of urinary incontinence

Professor Paul Abrams of Bristol Urological Institute (BUI) announced the winners and presented the awards at BUI’s 19th Annual Scientific Meeting (ASM) at the Watershed Conference Centre. This year’s BUI ASM was held in honour of Prof Abram’s life-long contribution to urinary continence management.

The first prize went to Andrew Gammie from North Bristol NHS Trust for a Fluid Management System. This is an ‘app’ that will inform and empower patients to manage lower urinary tract symptoms that are troublesome but do not require medical intervention.

Joint second award was presented to Pippa Bowkett from Great Bear Healthcare Ltd for Baby Bear Leg Bag. Her idea is to develop a child-friendly paediatric leg bag for very young children who need catheterisation.

Prof Chris Chapple (right), Prof Paul Abrams (middle) and
North Bristol NHS Trust prize winner Andrew Gammie (left)

Joint second award was won by Eleanor van den Heuvel from Brunel University for Don’t Wee. This project takes the notion of biofeedback for pelvic floor exercise to a new dimension.

Great Bear’s Pippa Bowkett (middle left) and
Lindsey Carruthers (left) with Prof Paul Abrams
(middle-right) and Prof Chris Chapple (right)

North Bristol NHS Trust’s Andrew Gammie said: “This is great news – I have been thinking about this idea for several years and it can finally be brought to the testing stage. If successful, we will be able to save many patients unnecessary visits to diagnostic clinics and assist their management of fluids.”

Pippa Bowkett from Great Bear said: “We are delighted to have won the D4D PoC competition. As a UK manufacturer of urology products this award will help not only the end user, young children, but also ensures the design, development and manufacturing stays in Cardiff.”

Brunel University’s Eleanor van den Heuvel said: “The Don’t Wee is going to be an exciting project to be involved in. It has huge potential benefits for improving women’s continence status.”

The winners will now be given the opportunity to work with D4D’s national experts’ network, resources and specialist clinicians, bridging the gap between initial concepts, securing grant funding and attracting early stage investment.

Professor Chris Chapple, D4D’s Urinary Continence Management Theme Lead, said: “This has been a wonderful opportunity for D4D to help drive and support innovations in this area of clinical need. The excellent applications which we received emphasised the innovative ideas that are awaiting development and which D4D is keen to identify and nurture for the benefit of patients.”

Tackling ageing continence through theory, tools and technology

The Bristol Urological Institute (BUI) BioMed has been part of a consortium working together on a £1.2 million project to find ways of reducing the impact of continence difficulties for older people.

This interdisciplinary project, entitled ‘Tackling Ageing Continence through Theory, Tools and Technology’ (TACT3), was led by the Brunel Institute for Bioengineering (BIBS) and funded by a Research Council New Dynamics of Ageing programme grant. The project started in November 2008 and has recently been completed.

The research was being carried out by teams at Brunel University, the Helen Hamlyn Centre for Design, the University of Manchester, the University of Sheffield, the University of the West of England and the BioMed at the BUI.

The project covered three key areas of continence research, with the role of the BUI-BioMed focussed on the development of two assistive technologies to make continence problems easier and less stressful to manage:

  • A colour change odour detector to reassure pad users by alerting them to the smell of stale urine before it can be detected by the human nose. The odour detector had a 90% response rate when tested in vitro and responded within 2 minutes of exposure to stale urine. Continence pad users were asked for their opinion on the design of the device, with 90% believing it was a good idea and 80% that it would be easy to use.
  • Smart underwear designed to detect a leak from a continence pad before the urine can spread to outer clothes or furniture. A clinical prototype was successfully developed and evaluated by continence pad users. Over 90% of participants who tested it thought the underwear would or might make them feel more confident and have a positive impact. Discussions with industry are in progress over the commercialisation of this product.

D4D project presented at international nephrology conference

D4D team members from St. James’ Hospital, Leeds, have implemented a novel approach to body composition monitoring which allows many more patients to benefit from this objective assessment of haemodialysis patients’ fluid status. This helps ensure that the right amount of fluid is removed from the patient’s body during their treatment.

D4D’s Renal Technology Theme works to facilitate the development and adoption of systems, devices and services to assist renal patients’ independence and help achieve better outcomes. One of the Theme’s key projects is the validation and implementation of body composition monitoring (BCM) which provides an objective assessment of haemodialysis patients’ fluid status.

The models used for BCM were developed and validated for measurements between hand and foot, meaning that patients with lower limb amputations or heavily bandaged feet can be excluded from measurements. The team in Leeds performed a study which compared hydration measurements made from hand to hand to standard hand to foot measurements in 101 patients.

Sufficient agreement was found between the readings to encourage the use of this approach in patients unsuitable for a standard measurement. Consequently, a number of patients in the care of the Renal Unit in Leeds, such as bilateral amputee Terry seen right, are benefitting from having their fluid removal routinely guided by hand to hand measurements.

This work was recently presented at the annual conference of the European Dialysis and Transplant Nurses Association and European Renal Care Association in Strasbourg to great interest.

For the conference abstract, see abstract O52 in:

Partnerships with national charities announced

Devices for Dignity (D4D) is pleased to announce that it has entered partnerships with two national charities as part of its commitment to Patient and Public Involvement.

The fundamental aim of D4D is to deliver technology solutions to support people with long term conditions – and crucial to this aim is the ability to communicate and engage with the end users of the technology.

As part of our commitment to patient and public involvement, D4D has formed strategic partnerships with key charities operating in the same areas of healthcare in order to explore unmet clinical needs direct from the people who are best placed to identify them – patients and carers.

These partnerships, with the Bladder and Bowel Foundation and Assist UK, have been formed to ensure user needs and views remain at the centre of D4D’s ongoing strategy.

Robert Dixon, Chief Executive of Bladder & Bowel Foundation: “We look forward to the opportunity to work collaboratively with D4D in the future. We believe our ability to represent the views of bladder sufferers within the urinary continence work stream will add real value to both current and future projects.

“We would expect the collaboration to make a real difference in establishing an informed and definitive database of patient needs in this often neglected area of opportunity.”

Alan Norton, Chief Executive of Assist UK, said: “As a member of the D4D Independent Steering Committee, I have advised D4D from both the perspective of CEO of Assist UK and as a disabled person myself.

“D4D has demonstrated a clear commitment to understanding unmet need from a holistic point of view by involving users in all aspects of product design.”

Paralympic business summit success

Two companies collaborating with D4D have taken part in a major global business summit on Advances in Assistive Medical Technologies as part of the Paralympic programme.

The global summit, which was organised by United Kingdom Trade and Investment (UKTI) and took place at British Business Embassy Lancaster House in early September, was attended by Tomorrow Options and Kingkraft.

The summit, which took place during the Paralympic Games, focused on the impact of innovative approaches to rehabilitation and assistive technologies on the activities of people living with injuries, disabilities or illnesses.

Paulo Ferreira dos Santos, from Tomorrow Options, a company that develops electronic devices for markets including health, sport and industry, delivered a presentation called ‘Advances in human biomechanics assessment’.

Kingkraft displayed its Shower Chair project, which aims to develop an ultra-lightweight, mobile and compact collapsible shower chair (transportable by disabled people themselves) for the independent disabled person showering markets.

The Summit was part of an 18-day programme taking place over the Olympic and Paralympic Games, with the Prime Minister, Deputy Prime Minister, Chancellor, Business Secretary, Foreign Secretary and over 30 other British ministers welcoming over 3,000 business leaders and global figures.

The series of global business summits was the largest and most ambitious set of trade and investment events ever held in this country.

Speakers included Professor Sir Bruce Keogh (KBE FRCS, Medical Director of the NHS), Mike Spindle (Trekinetic), Professor Guang-Zhong Yang (Imperial College) and Geoff McGrath (McLaren Applied Technologies).