Research degrees

Clinical Guidance, approved by the National Institute for Health and Care Excellence provides recommendations for health and social care practitioners. Such guidance is not yet available within the domain of driver rehabilitation. Although driving is recognised as a key instrumental activity of daily living, with beneficial impacts on social inclusion and health care outcomes, return to driving is not routinely considered by practitioners as part of health and social care services.

Occupational therapists, who work within the NHS, Social Care and UK Forum of Mobility Centres are well placed to raise the profile of driver rehabilitation and to work with the College of Occupational Therapists to produce guidance for the national occupational therapy workforce.

This project would follow the NICE/ College of Occupational Therapists pathway to developing such guidance; this will include the establishment of a guideline development group including key stakeholders/service users, co-design of the scope and purpose of the guideline, a systematic review of the evidence base relating to driver rehabilitation and the publication of recommendations for occupational therapy practice. Implementation of the guidance would raise awareness of the importance of the need for driver rehabilitation and facilitate driving being routinely supported as part of health and social care rehabilitation services for older adults and people with health conditions/disabilities.

Supervisors:
Dr Priscilla Harries
Prof Carolyn Unsworth
Prof Joseph Giacomin
Dr Franaz Nickpour

Division: Occupational Therapy and Community Nursing

Little research to date has addressed the personal embodied experience of living with psoriasis, The skin as an organ is visible to others and psoriasis can be highly visible and can cause much distress to the sufferer. Little is known about how older people (50+) negotiate their everyday lives and the changes that occur with their condition as they age. Aim: To examine the experiencing of living with and negotiating daily life for older people who live with psoriasis.
Method: A qualitative approach with two main phases of data collection including recording visual diaries and in-depth life history interviews will be used.
Implications: Older people’s experiences of psoriasis are largely missing from previous research. The study will assist practitioners to be more aware of how changes associated with ageing (in the skin itself, and in social roles and everyday occupations) affect older people with psoriasis, and to offer better targeted information and advice to promote coping and well-being.

Supervisors:
Dr Elizabeth McKay
Dr Wendy Martin

Division:Occupational Therapy and Community Nursing

In various parts of the world, such as the USA and Australia, conditions can be applied to individuals’ driving licenses that allow drivers to compensate for the impact of age or a health condition/ disability. These conditions may be a requirement to undertake daytime driving only, driving without a passenger, driving of an automatic car only, etc. Although these imply restrictions on the driver or and/or their car they have the potential to facilitate individuals continuing to hold their licence for longer. Where such conditions are not available for use, the same driver may be required to cease driving. At present in the UK, the full range of conditions, available under EU law are not being utilised.This project would gather qualitative and quantitative evidence from driver assessors across a number of countries (USA, Australia, New Zealand and one EU country) to explore the impact of using the full range of conditions and to examine how this approach extends the driving life course for individual drivers. The impact on equality and inclusion for UK drivers will be considered in light of the findings.

Supervisors:
Dr Priscilla Harries
Prof Carolyn Unsworth
Prof Joseph Giacomin
Dr Franaz Nickpour

Division:Occupational Therapy and Community Nursing

Recovery is an international concept however cultural and societal differences influence individuals recovery journeys.This qualitative study will explore compare and contrast the recovery journey that occur in Brazil and UK illustrating what facilities and hinders recovery.

Supervisor: Dr Elizabeth McKay

Division: Occupational Therapy and Community Nursing

Brazil has the most extensive milk banking system in the world. However research into UK Milk Banking, from our team, has concluded there is a need to raise awareness and educate health care professionals about the benefits of using donated human milk, with pre-term or sick babies in neonatal intensive care units, and about the milk banking process.  This proposed action research study seeks to work with key stakeholders in UK Milk Banking in order to develop, implement and review an online training resource. Action research is a collaborative research framework which involves the researcher working with and for people to identify real life issues and, at the same time, seek to address them and generate new learning and knowledge.

Supervisors:
Dr Stephanie Tempest
Dr Cherry Kilbride

Division: Occupational Therapy and Community Nursing

Improving dexterity and mobility following incomplete spinal cord injury (SCI) remain high priorities for rehabilitation. SCI studies show improvements following intensive physical training with massed practice and additional sensory stimulation (Beekhuizen and Field-Fote, 2005; Hoffman and Field-Fote, 2007). In addition studies demonstrated the potential application of non-invasive brain stimulation to facilitate recovery of limb function using repetitive transcranial magnetic stimulation (rTMS) in incomplete spinal cord injuries (SCI) (Belci et al., 2004), as well as an improvement in limb functional mobility compared to physiotherapy alone (Kumru, et al., 2013). These suggest that effects of rTMS treatment promote cortical excitability changes and thus enhance CNS neuroplasticity of undamaged descending pathways which through continued physical rehabilitation leads to improved functional control. The use of rTMS for treatment in a clinical setting is more difficult, as it relies on cumbersome equipment, requires a pre-treatment to therapy, and an adequate sham treatment is more problematic. In contrast, a more feasible alternative to rTMS is transcranial electrical stimulation (tES) a variant of non-invasive brain stimulation. TES is administered using a portable, battery driven device and applies a small electrical current (1-2mA) through scalp electrodes. Several tES studies have demonstrated changes in cortical excitability which outlasts chronic treatment in both healthy (Reis et al., 2009) and neurological patients (i.e., stroke; Boggio et al., 2007) engaged in physical practice and motor learning tasks (Bastani and Jaberzadeh, 2012). TES is safe and painless, and provides a less restrictive method of application of non-invasive brain stimulation in rehabilitation settings. The potential therapeutic applications in neurological diseases where maladaptive plasticity may ensue from altered or diminished sensory input provides the impetus for further investigation as an adjuvant to rehabilitation in incomplete SCI.
This project will examine chronic tES (daily for 3 weeks) application to the motor cortex to target upper limb function and examine motor cortical circuitry changes using TMS in incomplete SCI patients who are undergoing conventional and novel therapeutic rehabilitation. Clinical and lab based assessments will be used to track changes in dexterity function and possible mechanisms of motor cortical neuroplasticity.
This project is a collaboration with Brunel University London and National Spinal Injuries Centre at Stoke Mandeville Hospital. This project would be suitable for qualified physiotherapists or occupational therapists, or a graduate in movement/rehabilitation sciences who has a post-graduate qualification (MSc) with an interest or experience in spinal cord injury rehabilitation.

Supervisors:
Dr Alex Nowicky
Dr Amir Mohagheghi
Mr Maurizio Belci (Stoke Mandeville Hospital)

Division: Physiotherapy

Multiple sclerosis (MS) is a progressive demyelinating disease of the central nervous system affecting around 100,000 people in the UK. A primary feature of MS is impaired mobility. Improving mobility is often a primary therapeutic goal of people with MS as reduced mobility may restrict participation in everyday activities and quality of life.
Mobility is therefore a key outcome to measure in a rehabilitation setting. According to the World Health Organisation’s International Classification of Functioning, Disability and Health human functioning occurs on three levels: body structures or functions, activity, and participation. Many commonly used outcome measures assess mobility at an activity level - the execution of a task or action by an individual. However the context in which a person executes an action can have a significant effect on the outcome. In view of the importance of context, activity has been further divided into three constructs: activity capacity (i.e. what a person can do in a standardised, controlled environment), activity capability (i.e. what a person can do in his/her daily environment), and activity performance (i.e. what a person actually does in his/her daily environment).
In practice, the efficacy of treatments is often assessed in a controlled environment (activity capacity) with the implicit assumption that this reflects the persons capability and performance, and that this in turn improves participation. However, the tenets of this assumption are questionable and it is of utmost importance for the efficacy of rehabilitation that the relationship between these constructs is understood.
The objectives of this study are:
1. Determine the association between activity capacity, capability and performance in adults with MS.
1. Compare activity performance between adults with and without MS.
2. Examine the contribution of activity performance to participation in adults with and without MS.

Supervisors:
Dr Jennifer Ryan
Dr Meriel Norris

Division: Physiotherapy

Falls in older adults represents a significant social and economic problem, presenting an urgent need for researchers and health providers to develop ways of identifying older adults at risk, and preventing falls through rehabilitation programmes. Older adults who have fallen will often develop a debilitating fear of falling which, paradoxically, is a predictor of future falls. Based on recent evidence we know that the relationship between fear of falling and future falls is only partly explained by physical deconditioning resulting from activity avoidance, meaning that other psychological factors must play a significant role in causing falls. The purpose of the proposed PhD is to identify what these factors are and develop tailored interventions that could be utilised by health services. There are established techniques used by sports psychologists to help athletes overcome performance anxiety. However, very little work has been done to apply these modern techniques to clinical settings (e.g. to help older adults overcome mobility problems associated with fear of falling). This project will use these principles to design rehabilitation tools for training attentional control during balance/walking tasks. Possible measures include eye tracking, motion analysis and electrophysiological methods such as electroencephalography (EEG). An example of one possible project is to work with expert game designers to develop videogames that have the capacity to: 1) learn about a player’s balance difficulties; and 2) automatically adapt to meet the specific training needs of each specific older adult. Once the prototype games are designed there are opportunities to: 1) pursue further technological development with collaborators at Stanford University (USA); and 2) evaluate their effectiveness within NHS falls services.

Supervisor: Dr Will Young

Division: Physiotherapy

Dr. Stanley O. Gaines, Jr. and colleagues (in press a, b) recently developed the Brunel Ethnic Behavior Inventory (BEBI) to measure what individuals say and what individuals do to affirm their ethnicity.  Currently, Dr. Gaines is interested in expanding the BEBI to measure what individuals say and do specifically to affirm the racial, religious, and national aspects of their ethnicity. At a minimum, the PhD student would collaborate with Dr. Gaines in designing and implementing a study, involving approximately 200 participants, to measure racial, religious, and national aspects of ethnic speech and ethnic action within the UK.  The study is likely to include additional measures, such as an expanded version of Phinney and Ong’s Revised Multigroup Ethnic Identity Measure (MEIM) and various measures of individuals’ well-being.

Supervisor: Dr. Stanley O. Gaines, Jr. 

Division: Psychology

Music, dance and other forms of coordinated movement are fundamental forms of human behaviour, involved in the creation of social bonds and close communities in all societies. Although there is now much evidence to suggest that simple synchronised movements can make people feel socially closer, there has been less investigation into the more complex forms of movement that typically characterise socially bonding activities. Similarly, there is still relatively little known about the mechanisms by which these effects work (in terms of cognitive processes or biological substrates).The project could take a number of different forms, depending on the interests of the candidate: (1) Exploring ecologically valid forms of coordinated movement (e.g. dance, singing) and using both carefully controlled laboratory experiments and field studies to investigate the conditions that lead to optimal social bonding between group members. (2) Investigating the mechanisms by which social bonding might occur through coordinated movements using physiological measures. (3) Working with existing community choir, music or sports groups to assess the efficacy of their organisation for wellbeing, health, and sense of local community.

Supervisor: Jacques Launay

Division: Psychology

Psychoanalysis is a theory of mental functioning, a clinical practice and a research methodology. Students wishing to examine any aspect of these three interlocking dimensions of psychoanalysis, including the relationship between psychoanalysis and other disciplines, are encouraged to submit a research proposal that has the potential to lead to a significant, original contribution to the discipline. Any project drawing on psychoanalytic concepts will be considered. This may include historical projects based on archival source materials, theoretical projects investigating the epistemic foundations of the psychoanalytic paradigm, clinical studies of specific conditions in the broad field of mental health care, and the psychoanalytic investigation of topical socio-cultural issues.

Supervisor: Prof Dany Nobus

Division: Psychology

Autoimmune disease is one of the five human diseases remaining as a challenging task in current medical research. To avoid autoimmune diseases it is important to maintain the tolerance of T cells. However the mechanism of how the immune system is broken down of tolerance to self-molecules and why excessive activation of auto reactive T cells is induced in such situations remain unclear. Recently it has been discovered that early growth response (Egr)-2 molecule is expressed in some subsets of T cells important for the control of autoimmunity and inflammation. To understand the gene expression for the tolerance cells a microarray analysis technology and different animal models will be used to identify the transcriptional program regulated by Egr-2. Experimental Work. 1) Analyse the phenotype of GFP-Egr2 knockin mice and the role of Egr2 positive T cells in adaptive immune response by genotyping, histology and immunochemistry technologies. 2) Identify the transcriptional program regulated by Egr-2 by microarray analysis technology with Egr2/3 knockout and Egr2 transgenic mice.

Reference:  Zhu B., Symonds A.L.J, Martin JE., Kioussis D., Wraith D., Li SL and Wang P. Early growth response gene 2 (Egr-2) controls the self-tolerance of T cells and development of lupus like autoimmune disease. Vol. 205, 2295-2307, J Exp. Medicine, 2008. Suling Li, Tizong Miao, Meera Sebastian,Punamdip Bhullar,Emma Ghaffari,Mengya Liu,Alistair L.J. Symonds,and Ping Wang. The Transcription Factors Egr2 and Egr3 Are Essential for the Control of Inflammation and Antigen-Induced Proliferation of B and T Cells. Immunity 37, 1–12, October 19, 2012.

Supervisor: Dr. Suling Li

Division: Biosciences

Tumour infiltrated lymphocytes (TILs) contain tumour reactive T cells and have been used as adoptive cell transfer therapy in patients which can mediate cancer regression. However, without in vitro manipulation, TIL T cells are tolerant to tumour. Although it has been reported that PD1, a negative co-stimulatory molecule, could be induced highly in TIL T cells than T cells from peripheral, the intrinsic mechanisms for TIL T cells to resistant to tumour are largely unknown. The aim of the project is
to understand the mechanisms of Egr2 and 3 mediated T cell tolerance in tumour immunology. We will analyse the phenotype and function of Egr2 positive T cells in TILs using EG7 tumor model with GFP-Egr2 knockin mice; investigate what effects of Egr2/3 influence anti-tumour responses of T cells using Egr2/3 knockout and Egr2 overexpression transgenic mice; and understand how Egr2 and 3 expressions are regulated under tumour microenvironment, which may provide the potential bio-marks for tumour immune responses, and new strategy for individual immunotherapy of cancer patients.
Experimental Work.
1. Establish Eg7 tumor model in GFP-Egr2 knockin mice   
2. Characterization of Egr2 positive TIL cells using EG7 tumor model with GFP-Egr2 knockin mice.
3. Examine the function of Egr2/3 positive or negative TIL T cells with proliferation assay, cytokine production and cytotoxic function to see the differences of sub-populations of TILs, providing the evidence why the novel immunotherapeutic strategy can be considered.
4. Define what are the role of Egr2 and 3 in regulation of tumour immune responses using Egr2/3 KO (Egr2/3 genes deleted in lymphocytes) and Egr2 Tg mice (Egr2 gene overexpressed in lymphocytes)
References:
 Zhu B., Symonds A.L.J, Martin JE., Kioussis D., Wraith D., Li SL and Wang P. Early growth response gene 2 (Egr-2) controls the self-tolerance of T cells and development of lupus like autoimmune disease. Vol. 205, 2295-2307, J Exp. Medicine, 2008.
Suling Li, Tizong Miao, Meera Sebastian,Punamdip Bhullar,Emma Ghaffari,Mengya Liu,Alistair L.J. Symonds,and Ping Wang. The Transcription Factors Egr2 and Egr3 Are Essential for the Control of Inflammation and Antigen-Induced Proliferation of B and T Cells. Immunity 37, 1–12, October 19, 2012.
Gajewski TF, Schreiber H, Fu YX. Innate and adaptive immune cells in the tumor microenvironment. Nat Immunol. 2013;14:1014-22.
Harris, J.E., K. D. Bishop, N. E. Phillips, J. P. Mordes, D. L. Greiner, A. A. Rossini, M. P. Czech. 2004. Early growth response gene-2, a zinc-fi nger transcription factor, is required for full induction of clonal anergy in CD4+ T cells. J. Immunol. 173: 7331 – 7338.

Supervisor: Dr. Suling Li

Division: Biosciences

Enveloped viruses, including influenza A, are intracellular parasites. They hijack the host cellular machinery to replicate. Deciphering cellular pathways viruses interact with along their journey inside infected cells enables better understanding of the biology of viruses and cells. New discoveries could lead to novel antiviral strategies. Novel interactions between influenza A virus and human cellular proteins have been identified in the lab. I am looking for motivated candidates to analyse the relevance of these interactions. Molecular biology, cellular biology, biochemistry and virology approaches will be used to determine the stage of infection the interaction occurs at and its implication in pathogenesis. The cellular pathway involved will be studied and druggable targets identified. 

Supervisor: Dr Beatrice Nal-Rogier

Division: Biosciences

Envelope glycoprotein-pseudotyped viral particles (GP-pp) are powerful tools in research and diagnosis. They are safe, non-replicative alternatives to real viruses. GP-pp have been developed to study the viral envelope glycoprotein-dependent entry stage of viruses into susceptible host cells. Because they can enclose a reporter gene, they are extremely useful in screening for entry inhibitors. We are looking for a motivated candidate to develop GP-pp for a selection of respiratory viruses we are currently working on in the lab. Techniques used will include virology, cellular biology, molecular biology, biochemistry. GP-pp will be validated on susceptible cells and screening strategies for inhibitors (neutralising antibodies, purified innate immune molecules, peptides) will be established.

Supervisors:
Dr Beatrice Nal-Rogier,
Dr Uday Kishore

Division: Biosciences

The first line of defence against viral infection is mediated by innate immune mechanisms. Of interest, soluble innate immune molecules are able to sense pathogens at very early stages of infection and mediate their opsonisation for destruction by phagocytic cells and activation of adaptive immunity. We have identified soluble innate molecules that can bind influenza A viruses of different strains. It is important to understand the mechanism of interaction and consequences for infection in vitro and in vivo. We are looking for a motivated candidate to analyse the molecular patterns involved in these interactions. The candidate will determine whether infection is blocked by pre-incubation of the virus with these innate factors. The minimal inhibitory domains will be determined and produced at large scale to test inhibition of infection in animal models. Our objective is to develop novel inhibitors of infection.

Supervisors:
Dr Beatrice Nal-Rogier,
Dr Uday Kishore 

Division: Biosciences

The study of parenting cultures is a growing field. It explores how parenting is socially constructed in different social contexts. So far, this literature paid relatively little attention to religious contexts. It is argued that this absence is partly due the continuous influence of the Secularisation Thesis which dominated academic thinking, especially in Western Europe and the USA in the latter part of the twentieth century. Researchers who followed this tradition assumed that society is gradually secularising and religion will eventually disappear (Sherkat and Ellison, 1999). The proposed study will seek to fill in this gap by studying the parenting culture of such strictly religious
community, in two different geographical locations, the Jewish Haredi (Ultra Orthodox) community in Brazil and the UK.
There are about 110,000 Jews living in Brazil today, mainly in Sao Paulo and Rio de Janeiro. About a third of them are Haredi. In the UK, the Haredi society is estimated at about 55,000 people and is concentrated in London and the Greater Manchester.
Methodology: the study will be based on the analysis of qualitative interviews with Jewish Haredi parents in both locations from the main Haredi sub-groups. Additional interviews might be conducted with other members of the Haredi community, such as educators, social workers or psychologists who are working with parents.
Analysing these materials will help exploring the following research questions:
1. How are the relations between children and their parents being perceived & presented?
2. Is this parenting culture affected by external contemporary discourses such as Western psychology, the democratic discourse or the risk discourse, despite the segregated nature of this society?
3. If it is being affected by such external discourses - How are these new discourses presented? Which parts of these discourses are adopted and incorporated, and which parts are rejected, and why?

Supervisors:
Dr Yohai Hakak
Dr Emma Wainwright

Division: Social work