Clinical Research Directory

Impact of AGEs on Metabolism & Cognition

A number of processed foods particularly those high in protein and based on whey protein are high in advanced glycation end products (AGEs). AGEs are the result of a chemical reaction between mainly sugar and protein when they are heated together (known as the Maillard reaction). Whey protein is routinely derived via high temperature processing methods which produce AGEs. AGEs are absorbed during digestion and high circulating concentrations of AGEs are associated with adverse health effects such as dementia and the metabolic syndrome. In this study we aim to firstly ascertain the habitual level of AGE intake in the diet via a dietary questionnaire and equate this to both metabolic health and cognition at baseline. Volunteers will then be given a milkshake with either a high or low AGE content on either a high or low fat background. AGEs are usually ingested as part of a processed food diet which can be high in fat and it is necessary to separate the effects of these two food types. We will test these effects in a young and older group of volunteers with low and higher levels of circulating AGEs respectively. Circulating levels of hormones, glucose and lipids in the blood will be measured as indicators of metabolic health. Cognitive tests will be carried out to assess the impact of AGEs on episodic memory.

Enhancing Child and Adolescent Mental Health Service Referrals 2

Background Increasing numbers of children and young people are being referred to Child and Adolescent Mental Health Services (CAMHS). However, a quarter are 'rejected' for treatment. This can happen for simple reasons like: 1. confusion about what support CAMHS can and cannot provide 2. lack of information about available non-CAMHS support 3. the paperwork submitted to CAMHS is incomplete Being rejected by CAMHS is distressing for children and young people and families. The current process also costs the NHS because of wasted clinical time reviewing children and young people who do not need CAMHS' help. For GPs and school staff making referrals, rejection is frustrating especially if no other help is offered. In the previous NIHR-funded ENCAMHS 1; project, the project team spoke to many children and young people and families with experience of trying to get help from CAMHS. The project team asked the stakeholders about the problems they had and what solutions might help. Aims This project aims to develop a simple, clear way for children and young people to get the right support for their mental health problems when they need it. This project aims to solve the problems people told us about and to improve the quality of referrals made to CAMHS. Design \& Methods The project team shall: * work with all relevant groups including children and young people and families to build a better referral process * make an easy-to-use digital referral process for CAMHS * make everything built useful and easy to use for as many people as possible * provide GPs, school staff and parents with information about non-CAMHS support * learn how to embed the new referral system across NHS systems (e.g. NHS app) * test the new process across 5-8 different CAMHS e.g. in and outside cities * ask people who tested the new process if they liked it and found it useful * analyse information collected to see how people used it * work with the charity MQ to make sure what is built is used widely The project team shall talk to children and young people, families, GPs, school staff, CAMHS staff and policymakers and build the new referral process with the project team. The project team shall hold several workshops which will shape the new digital tools, and ensure the project team considers how to include the right non-digital supports. The project team shall test the new process across 5-8 CAMHS and use a mix of statistical and interview data to understand if the new referral process is valued, useful and easy to use. The project team's partner, MQ, will develop a plan to roll out the tool nationally and to support its use in the long term. Patient \& Public Involvement The project team shall build on established collaborations with young people, their parents/carers/families. The project teamwon a national award for public involvement in the ENCAMHS 1 project. The project team shall be advised throughout by the Young People's Advisory Group (YPAG) and by the Parents and Professionals Advisory group (PPAG). The YPAG and PPAG from the ENCAMHS 1 project have told the project team they would like to work with the project team again on this project. The project team shall also recruit new members. Dissemination The project team want this project to transform how children and young people get access to appropriate mental health support and to reduce some of the pressures on CAMHS. The project team shall share learning with national NHS bodies. The project team shall make the digital tools the project team builds widely available through the networks. The project team shall publish the academic findings and share widely through social media and mental health partner networks.

Impact of an Intervention Education Program on the Knowledge, Attitudes, and Practices of Dietitians

This study aims to develop, implement, and evaluate an educational program-based intervention on the knowledge, attitude, and practice toward renal nutrition among dietitians working with chronic kidney disease (CKD) patients in public hospitals in Saudi Arabia. The study hypothesizes that there will be a significant improvement in the knowledge, attitude, and practice of renal nutrition among the dietitians in the intervention group compared to the control group after the implementation of the educational program. The findings will contribute to enhancing the ability of dietitians to provide effective nutritional care and support for CKD patients in Saudi Arabia.