Current Studentships

Keele University studentships, when available, are funded internally or from external sponsors such as research councils or from industry. If you are interested in any of the studentships available you can apply online.

Research Topic Pain in Dementia: Consultation and treatment within Primary Care
Reference number: RPCH2016/02
Abstract

Institute overview: 

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014).

 

Project background: 

Dementia is a progressive disease with no known cure that impacts on the individual, and their family. Dementia is common in older people, about 1.5% of those at age 65 to 70 have some form of dementia, and this rises to over 30% in the oldest old. It is thought that there are currently about 750,000 people with dementia (PwD) in the UK, leading significant health and social care costs. The number of PwD is set to rise in the next 20 years because people are living longer, and so costs in healthcare will also rise and that is why research is looking to find better ways to manage this disease. It is thought that PwD do not receive appropriate treatment for painful conditions, resulting in distress, increases in ‘behavioural and psychological’ symptoms, and inappropriate prescribing (i.e. treating the symptoms, not the pain). Previous research has been almost exclusively on nursing home populations, and very little information is known on the experience of pain for PwD in the community. We aim to investigate the consultation and treatment patterns for pain for PwD within a primary care setting. This project will inform on the potential disparity of pain treatment for a sizable sub-population within primary care, and ultimately lead to the design of future projects aimed at intervention.

 

Aims:

To describe the prevalence and frequency of pain consultation and pain treatment (analgesia) for community dwelling persons with dementia (PwD) using primary care data, and assess GP process in pain management for those with dementia.

 Objectives & methods:

 

Specific objectives are: to assess pain consultation patterns for those with dementia, assess treatment patterns for those with dementia, examine treatment type (i.e. analgesia type/strength), and investigate process used by GPs and other health care practitioners in the management of dementia within primary care.

With the support of the supervisory team, you will have the opportunity to: 

1) Conduct a systematic review of the literature describing the current experience of pain assessment/treatment for those with dementia to inform on the overall project aim. 

2) Conduct process reviews and clinical consensus exercises to determine the appropriate clinical codes that will be used to identify patients and outcomes within a primary care database. 

3) Analyse existing data within large primary care database in accordance to project aims and objectives. 

4) Conduct semi-structured interviews to explore perspectives on the assessment and management of pain in patien

Details See Advert and details and Supplementary Information
Duration 3 years (Full-time) 6 years (Part-time)
Fees Fees provided at EU rates only, Non-EU students would be required to pay the additional overseas fees themselves.
Stipend Stipend paid at current Research Council rate, for three years full time or six years part time.
Closing date Friday 3rd June 2016

Apply online


Research Topic Understanding self-harm in older people: a qualitative study
Reference number: RPCH2016/03
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014)

 

Aims:

This qualitative study will increase understanding of the perspectives of older people (aged over 40years) who self-harm, barriers and facilitators of access to care, and the role of family, statutory service and third sector groups in support.

 

Objectives & methods:

 

Qualitative methods will be used:

  • Semi-structured interviews with people aged over 40years, and recruited using a number of methods:
  • Information circulated around people attending ECHO, the self-help support group (for people who self-harm) in Newcastle under Lyme
  • Posters displayed in public places eg libraries, GP practice waiting rooms, pharmacies, shops (this method has been used by CC-G in previous studies).
  • Use of social media (eg twiitter)
  • Purposive sampling will be used to ensure that participants with range of age groups (40years and above) gender, ethnicity and socio-economic status are interviewed. Up to 15 interviews are likely to be needed to achieve category saturation.

 

Semi-structured interviews with general practitioners in N West England and the West Midlands, recruited by:

  • Approaches to Local Medical Committees
  • Direct contact to practices (letter and e-mail)
  • Use of social media
  • ·          Purposive sampling will be used to ensure that GP participants are interviewed, with range of gender, years as a GP, demographics of practice. Up to 15 interviews are likely to be needed to achieve category saturation.

 

 Interviews will be digitally recorded and transcribed forming the data for analysis. Methods of constant comparison will be initially used with modification of the topic guide as data collection progresses. A framework analysis5 will be conducted on the final data sets, which will enable a multi-disciplinary approach, including PPIE participation in, analysis both within and across the data sets.

Details See Advert and details and Supplementary Information
Duration 3 years full time 6 years part time
Fees All fees paid at current UK/EU rates, for three years full time and six years part time
Stipend Stipend paid at current Research Council rate, for three years full time or six years part time.
Closing date Friday 3rd June 2016

Apply online


Research Topic The impact of musculoskeletal pain on health and disease outcomes in older people with multimorbidity
Reference number: RPCH2016/04
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014)

 

Aims: The overall aim of this project is to better understand the influence of new onset of musculoskeletal pain, or changes in the severity of existing pain, on health and disease outcomes in people with existing long-term conditions.

 

Objectives & methods: The PhD project will include 3 phases: (1) a systematic review will be conducted to summarize evidence from existing studies regarding the influence of pain on future general health outcomes in people with multimorbidity; (2) data from our existing our cohort studies will then be used to investigate the longitudinal associations between musculoskeletal pain and health outcomes in people with multimorbidity; and (3) electronic health records will be analysed to explore the role of new onset musculoskeletal pain in predicting future disease outcomes in a more specific subgroup, e.g. patients with COPD.

Details See Advert and details and Supplementary Information
Duration 3 years full time 6 years part time
Fees All fees paid at current UK/EU rates, for three years (full time) or 6 years (part time) only
Stipend Stipend paid at current Research Council rate, for three years full time or six years part time.
Closing date FRIDAY 3RD JUNE 2016

Apply online


Research Topic The effect of antidepressants on consultations for back pain
Reference number: RPCH2016/05
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014)

 

Research question:

In patients consulting with back pain in general practice, what is the effect of antidepressant prescribing on primary care consultation for (reporting of) back pain?

 

Objectives & methods:

The objectives of the PhD are to:

  1. establish whether patients treated with antidepressants consult their general practitioner less frequently for back pain and have fewer prescriptions for analgesics, than those who are not treated with antidepressants
  2. investigate the extent to which differences in type and duration of antidepressant prescribing are responsible for any variation in the outcomes of antidepressants in patients consulting with a general practitioner for back pain
  3. investigate the effects of potential predictors, identified from the systematic review and measurable in the consultation data, on outcome

The methods will include a systematic review of the published literature to assess current evidence about the outcome of antidepressant use on people with back pain.

 

The student will use electronic consultation data from general practice to answer the research question and will need to consider 1) defining the appropriate “baseline” period from the dataset, 2) definitions of exposed and non-exposed (to antidepressants) groups, 3) potential relevant outcome measures that can be identified from electronic healthcare data, 4) length of “follow-up” period, 5) potential for dose response effect of antidepressants, 6) potential for investigation of predictors of outcome based on findings from the systematic review.

Details See Advert and details and Supplementary Information
Duration 3 YEARS FULL TIME 6 YEARS PART TIME
Fees All fees paid at current UK/EU rates, for three years (full time) and six year (part time)
Stipend Stipend paid at current Research Council rate, for three years full time or six years part time.
Closing date FRIDAY 3RD JUNE 2016

Apply online


Research Topic Population impact of arthritis; estimating the extent of the impact and identifying potential targets for healthcare, public health and policy makers to reduce the burden
Reference number: RPCH2016/06
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014)

 

Aims:

There are two key aims for this work:

(i)            To provide an estimate of the disability free life expectancy and healthy life work expectancy for adults with musculoskeletal health conditions (e.g. low back pain and osteoarthritis).

(ii)          To explore the factors influencing transitions from normal function to disability and work loss.

 

 

Objectives & methods:

With people living longer, a greater proportion of the population have musculoskeletal conditions and experience disability and work loss as a consequence. On the basis of this, doctors, health professionals, policy makers and people with the conditions aim to reduce the burden of musculoskeletal conditions on the activities of daily life and quality of life. This study will estimate the number of years that people with musculoskeletal conditions can stay free of disability and be healthy and in work. The research draws on (i) a unique study which has been taken place in North Staffordshire in which people aged over 50 years, sampled from the general population, have completed questionnaires about their health, disability, work and social life at 3 year intervals, and (ii) a large (n>10,000) well-established national study (English Longitudinal Study of Ageing) that has collected information, at 2 year intervals, to understand the health, social and psychological elements of the ageing process in adults aged 50 and over. The proposed research is divided into two main parts. In the first part, the aim is to provide an estimate of the disability free life expectancy and healthy life work expectancy for adults with musculoskeletal health conditions (e.g. low back pain and osteoarthritis, identified through medical records). This will involve developing the healthy work life expectancy indicator. Estimates will be calculated separately for men and women as well as for groups of people from different socio-economic groups (identified by the occupation or the area they live in).

The second part of the study aims to explore the factors influencing transitions into normal function to disability and work loss. The issue examined in this part of the research concerns how health (having additional health problems), behavioural and occupational (e.g. flexible working hours) and social (e.g. living in poverty) elements combine to influence levels of disability free life expectancy and healthy work life expectancy. Better understanding of the influence of these factors will assist in the development of health practice and policies for preventing the impact of musculoskeletal conditions on individuals.

In identifying factors that promote disability free life expectancy and healthy working life, the study's outcomes will be of considerable interest to public policy and health and social care professionals. The findings will be publicised to relevant groups through the most appropriate means as follows:

you will work closely with user groups to inform policy-making and practitioner groups to encourage the design of policies and practices that can improve musculoskeletal health; To research participants, you will publicise the results locally (e.g. posters in general practice surgeries) and copies of report summaries and project newsletters will be made available to participants;

To other academic researchers through articles to be submitted to national and international peer-reviewed journals and conference/workshop presentations in the UK and abroad so that your findings will contribute to the wider body of knowledge and improve future studies

Details See Advert and details and Supplementary Information
Duration FULL TIME: 3 YEARS PART TIME: 6 YEARS
Fees All fees paid at current UK/EU rates, for three years (full time) and six years (part time) only
Stipend Stipend paid at current Research Council rate, for three years full time or six years part time.
Closing date FRIDAY 3RD JUNE 2016

Apply online


Research Topic Treatment fidelity in randomised controlled trials for musculoskeletal pain
Reference number: RPCH2016/07
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014)

 

Aims:

There are two key aims for this work:

(i)            To provide an estimate of the disability free life expectancy and healthy life work expectancy for adults with musculoskeletal health conditions (e.g. low back pain and osteoarthritis).

(ii)          To explore the factors influencing transitions from normal function to disability and work loss.

 

 

Objectives & methods:

With people living longer, a greater proportion of the population have musculoskeletal conditions and experience disability and work loss as a consequence. On the basis of this, doctors, health professionals, policy makers and people with the conditions aim to reduce the burden of musculoskeletal conditions on the activities of daily life and quality of life. This study will estimate the number of years that people with musculoskeletal conditions can stay free of disability and be healthy and in work. The research draws on (i) a unique study which has been taken place in North Staffordshire in which people aged over 50 years, sampled from the general population, have completed questionnaires about their health, disability, work and social life at 3 year intervals, and (ii) a large (n>10,000) well-established national study (English Longitudinal Study of Ageing) that has collected information, at 2 year intervals, to understand the health, social and psychological elements of the ageing process in adults aged 50 and over. The proposed research is divided into two main parts. In the first part, the aim is to provide an estimate of the disability free life expectancy and healthy life work expectancy for adults with musculoskeletal health conditions (e.g. low back pain and osteoarthritis, identified through medical records). This will involve developing the healthy work life expectancy indicator. Estimates will be calculated separately for men and women as well as for groups of people from different socio-economic groups (identified by the occupation or the area they live in).

The second part of the study aims to explore the factors influencing transitions into normal function to disability and work loss. The issue examined in this part of the research concerns how health (having additional health problems), behavioural and occupational (e.g. flexible working hours) and social (e.g. living in poverty) elements combine to influence levels of disability free life expectancy and healthy work life expectancy. Better understanding of the influence of these factors will assist in the development of health practice and policies for preventing the impact of musculoskeletal conditions on individuals.

In identifying factors that promote disability free life expectancy and healthy working life, the study's outcomes will be of considerable interest to public policy and health and social care professionals. The findings will be publicised to relevant groups through the most appropriate means as follows:

you will work closely with user groups to inform policy-making and practitioner groups to encourage the design of policies and practices that can improve musculoskeletal health; To research participants, you will publicise the results locally (e.g. posters in general practice surgeries) and copies of report summaries and project newsletters will be made available to participants;

To other academic researchers through articles to be submitted to national and international peer-reviewed journals and conference/workshop presentations in the UK and abroad so that your findings will contribute to the wider body of knowledge and improve future studies

 

Details See Advert and details and Supplementary Information
Duration 3 YEARS FULL TIME 6 YEARS PART TIME
Fees ALL FEES PAID AT CURRENT UK/EU RATES, FOR THREE YEARS FULL TIME, AND SIX YEARS PART TIME ONLY
Stipend STIPEND PAID AT CURRENT RESEARCH COUNCIL RATE, FOR THREE YEARS FULL TIME OR SIX YEARS PART TIME ONLY
Closing date FRIDAY 3RD JUNE 2016

Apply online


Research Topic Mapping primary care doctors’ interests with population disease burden: is musculoskeletal pain neglected?
Reference number: RPCH2016/08
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014)

 

Aims: To explore GPs clinical interests and priorities against the burden of common conditions in the national population.

Research questions:

How does the focus of primary care doctors’ professional training portfolios match with the populations’ burden of disease?

  1. 1.    What are the clinical interests of GPs and how do these differ?
  2. 2.    What are GPs’ perceived clinical priorities and how do these differ?
  3. 3.    How have education, training and post-qualification experiences influenced interests and priorities, in particular views around MSK pain?
  4. 4.    What are the key policy and service factors influencing interests and priorities?

 

 

 

  • Objectives: To map the areas of primary care doctors’ interest with the prevalence and/or burden of disease and thus to identify areas in which there is a significant interest-burden mis-match
  • To identify the triggers for primary care doctors to consider particular topics within their continuing professional development and professional portfolios
  • To use the information obtained from the study to direct behavioural change interventions and educational (training and continuing professional development) approaches among primary care doctors
  • To identify implications for education, training, CPD, service provision and policy.

Methods:

This PhD would be a four stage study:

1)    A systematic review of the topic – investigating the reported clinical interests and priorities of primary care doctors and the stimuli for these

2)    A document study of primary care doctors portfolios – participants will be asked to submit a copy of their electronic portfolio (PDF versions are downloadable from the trainee (provided by the Royal college of General Practitioners) and GP portfolios (e.g. Clarity)) and the data will be coded and themes derived regarding disease area, the trigger for inclusion in the portfolio and mention of relevant skills such as lifestyle interventions. The data can be analysed using discourse analysis (10) and the frequency of common, high population burden conditions and diseases such as MSK pain will be determined and compared with other conditions that the primary care doctors focus on.  It is anticipated that 25-30 portfolios will be sufficient for data saturation.

3)    1:1 interviews with a sample of participants to explore in more detail the ways in which their portfolios reflect their views and interests. Participants will be sampled to reflect the emerging themes in the discourse analysis, and to allow for an in-depth exploration of similarities and differences. It is anticipated that 10-15 interviews will be sufficient. An applied thematic analysis will be applied (11) and findings compared and integrated with those from the discourse analysis.

A stakeholder process to gain deeper understanding of results from stage 2, to refine further the findings from stages 2 and 3, and to develop recommendations for behaviour change and educational interventions

Details See Advert and details and Supplementary Information
Duration 3 YEARS FULL TIME 6 YEARS PART TIME
Fees ALL FEES PAID AT CURRENT UK/EU RATES FOR THREE YEARS FULL TIME OR SIX YEARS PART TIME ONLY
Stipend STIPEND PAID AT CURRENT RESEARCH COUNCIL RATE, FOR THREE YEARS FULL TIME OR SIX YEARS PART TIME ONLY
Closing date FRIDAY 3RD JUNE 2016

Apply online


Research Topic The impact of co-morbidity on exercise and clinical outcomes in those with OA in primary care.
Reference number: RPCH2016/09
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014)

PhD Background:

Osteoarthritis (OA) is the most common musculoskeletal condition in older adults and is one of the diseases with the highest prevalence of co-morbidity with other long-term conditions (such as hypertension, cardiovascular diseases, obesity, respiratory diseases, and diabetes). This co-existence may have significant implications upon the successful management of OA.

Recent NICE guidelines have recommended exercise as a core treatment for OA, however how to implement this successfully within primary care is still yet to be determined. Increasingly, individuals with OA are living with co-morbidity, however its impact on the benefits, prescription and uptake of exercise in this population has not been clearly investigated. The clinical care of patients with co-morbidity is often complex and the evidence base for managing long-term conditions is based largely on trials of interventions for single conditions, which do not take co-morbidity into account or specifically exclude patients with co-morbidity.

It is hoped that this piece of work with help to develop recommendations for new exercise interventions for patients with OA that also have other co-morbidities which could then be tested within subsequent randomised controlled trials.

Aims:

This PhD will explore the effectiveness of exercise interventions for those with OA and co-morbidity, examine and compare the uptake of exercise in individuals with OA that do and do not have other co-morbidities and examine the attitudes and beliefs of both patients and health care professionals regarding exercise prescription for those with OA and co-morbidity.

Objectives:

1. To determine the effectiveness of exercise based interventions for individuals with co-morbidity.

2. To examine the exercise levels of those with OA with and without co-morbidity and the impact upon physical and mental health status.

3. To examine the attitudes and beliefs regarding exercise for those with OA and co-morbidity from both patient and health care professional perspectives.

4. Develop recommendations for a new exercise intervention for patients with OA co-morbidity that could be tested within a subsequent randomised controlled trial.

Methods:

Objective one will be addressed by a systematic review of previous research focused on the effect of exercise interventions for individuals with co-morbidity. Objective two will involve secondary analysis of the BEEP and MOSAICS trial baseline datasets to determine the impact of co-morbidity on the exercise levels of those with OA and to investigate associations with physical and mental health status and quality of life. Objective three will involve up to 20 semi-structured telephone or face-to-face interviews with primary care based health care professionals involved in the management of OA and up to 20 semi-structured telephone or face-to-face interviews with individuals with OA and co-morbidity to gain an in-depth insight into the their attitudes and beliefs regarding exercise for those with OA and co-morbidity. Objective four will be addressed by synthesising findings from objectives 1-3, working with Patient and public Involvement and Engagement (PPIE) team and generating recommendations for exercise interventions for patients with OA and comorbidity.

Details See Advert and details and Supplementary Information
Duration 3 YEARS FULL TIME 6 YEARS PART TIME
Fees All fees paid at current UK/EU rates, for three years (full time) or six years (part time) only
Stipend Stipend paid at current Research Council rate, for three years full time or six years part time.
Closing date FRIDAY 3RD JUNE 2016

Apply online


Research Topic Physiotherapists’ role as a weight loss facilitator for adults with osteoarthritis
Reference number: RPCH2016/10
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014)

 

Aim: to develop recommendations for a new physiotherapy-led weight loss intervention for patients with OA who are overweight or obese.

 

Objectives:

 

1.         Identify effective ‘lifestyle’ interventions used to promote weight loss in older adults (aged 45 years and over) with chronic long-term diseases. 

2.         Describe and understand Physiotherapists’ attitudes and current approach towards weight loss in patients with OA. 

3.         Investigate the role of General Practitioners in delivering weight loss interventions for patients with OA.

 

Methods:

Objective one will be addressed by a systematic review of previous reviews exploring ‘lifestyle’ interventions to promote weight loss in older adults with chronic long-term diseases. 

Objective two will involve secondary analysis of a mixed methods study (ABC-Hip study). A survey was sent to 3000 physiotherapists nationally and interviews were undertaken with 30 respondents to explore in more detail their attitudes and beliefs about primary care management. This project would use the existing quantitative and qualitative datasets to analyse physiotherapist's perspectives on weight loss as part of their role in the management of hip OA. The student will have a key role in developing the analysis plan.

Objective three will be addressed by completing telephone interviews with up to 30 General Practitioners across the UK who responded to a previous survey conducted within the centre, and provided consent to further contact. This will give the student experience in empirical research and forms part of the research training programme. 

Based on the findings from the above, recommendations will be made for a new physiotherapy-led weight loss intervention for patients with OA who are overweight or obese.

Details See Advert and details and Supplementary Information
Duration FULL TIME: 3 YEARS PART TIME: 6 YEARS
Fees ALL FEES PAID AT CURRENT UK/EU RATER FOR THREE YEARS (FULL TIME) OR SIX YEARS (PART TIME)
Stipend STIPEND PAID AT CURRENT RESEARCH COUNCIL RATE, FOR THREE YEARS FULL TIME OR SIX YEARS PART TIME
Closing date FRIDAY 3RD JUNE 2016

Apply online


Research Topic Views and experiences of patients with musculoskeletal conditions aged 65+ on stratified care: implications for primary care
Reference number: RPCH2016/11
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (REF 2014)

 

Aims:

This PhD studentship will explore the views and experiences of participants in a large randomised controlled trial on the use of stratified care for musculoskeletal conditions.  Participants in the PhD study will be aged 65 and be receiving stratified care (the intervention). The overall aim is to contribute to improving access to appropriate and effective health care for older people.

 

Objectives & methods:

The objectives are to explore the following research questions:

 

  1. What are the views and experiences of older people with musculoskeletal pain regarding a stratified approach to treatment?
  2. How do these views and experiences differ across age cohorts i.e. those aged 66-75; 76-85; 85+?
  3. Are there differences in views amongst those with known moderators for poor outcome such as low socioeconomic status, low education, strong opioid medication use, and low treatment outcome expectations, etc.?
  4. What are the implications for service provision and treatment targeting for older age groups in primary care?

 

Data will be collected using two methods:

 

1. Trial data: descriptive data from the trial will used to spectrum sample participants, ensuring a wide range of characteristics including gender, age, self-efficacy, psychological distress and risk of persistent pain, and to provide individual participant profiles including change in key clinical outcomes (pain intensity). Key treatment moderators will also be sampled for, e.g. socioeconomic status, education, use of medication, and treatment outcome expectations. The quantitative trial data of these key variables will be presented for the sample of patients interviewed in order to fully understand the sample and potential generalisability of data given participants’ characteristics.

 

2.  Qualitative 2-stage interviews:

Stage 1: individual face-to-face interviews of 60-90 minutes will use a topic guide and will take a life-course perspective in exploring issues such as current pain problem, expectations around healthy ageing, current health status, experience of their recent health care for their pain problem - in particular their views on their treatment according to stratified care – and future needs and expectations around how these might be met. Information relating to individuals’ biographies will also be collected, providing data on the impact of life course factors on experiences and expectations, as well as offering insights into changes in over time.

Stage 2:The follow up interview of up to 30 minutes, which may be by telephone, will provide an opportunity to check details from the preliminary analysis of the first interview and possibly a deeper exploration of emerging themes.

 

Qualitative data analysis will be on-going from first data collection time-point, i.e. applied in an iterative cycle of meaning, checking against and within cases for similarities and differences, and the possible reasons. Given the need to understand the relationship between attitudes and beliefs in later life and those earlier life-course experiences which profoundly structure them a narrative biographical, life-course theoretical framework will be applied. To ensure reliability, members of the team (student and supervisors) will independently code a sample of transcripts. 

 

In addition, emergent findings and developing themes will be checked for validity with the randomised control trial research team to enable comparison with other data emerging from the broader programme of research. 

Details See Advert and details and Supplementary Information
Duration THREE YEARS FULL TIME SIX YEARS PART TIME
Fees All fees paid at current UK/EU rates, for three years (full time) or six years (part time) only
Stipend Stipend paid at current Research Council rate, for three years full time or six years part time.
Closing date FRIDAY 3RD JUNE 2016

https://scims.keele.ac.uk/urd/sits.urd/run/siw_ipp_lgn.login?process=siw_ipp_app&code1=DPCSRD&code2=0001


Research Topic Psychosocial interaction, and influence on outcomes for those with musculoskeletal pain
Reference number: RPCH2016/12
Abstract

Institute overview:

 

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014)

 

Project background:

 

Lots of research has been carried out to see what factors are likely to play a role on why someone gets pain, and why some people don’t get better once they have pain (outcomes). Evidence has shown that many psychological factors (e.g. how the person’s feels, thinks and acts) are related to poor outcomes for those with pain, but there is no agreement on what one or combination of factors are the most important. We also know that there are other factors that the person has before they have pain that also seem to relate to why they might have a poor outcome once they have pain; things like the person’s level of education, their health literacy and their level of social support are important. Recent research has shown that many of these factors group together, and are more likely to work together to influence a person’s outcome. We now need to understand what factors work together and how they work together, as this will help us better inform interventions that can alter or halt the progression toward a poor outcome for someone with musculoskeletal pain.

 

One theoretical model that may inform understanding is the “diathesis stress model”. Diathesis refers to underlying biopsychosocial susceptibility factors that predispose an individual towards poor health outcomes. Using a diathesis approach has the potential to uncover underlying stable characteristics that may moderate the relationship between pain, psychological reactions to pain, and subsequent disability, and provide a much needed theoretical framework that can help explain why broader social effects (e.g. education level, social support, health literacy) have an impact on an individual’s perception and management of pain.

 

We propose to test the moderation influence of diathesis characteristics that have been shown to relate to pain outcomes. Literature shows that aspects such as social support, health literacy, physical activity, comorbidity, education level, are associated with pain outcomes, and using the diathesis approach may explain how they have influence, by exploring their effect on the “pain, psychology, disability pathway”.

 

 

Aims: 

Test the moderation influence of key stable patient characteristics (social support, health literacy, physical activity, comorbidity, education) on the pain, psychology, disability pathway.

Methods:

 

With the support of the supervisory team, and any identified training needs, you will have the opportunity to:

1) Conduct a systematic review of the literature describing diathesis stress models, as well as other theoretical models on the influence of psychological factors on musculoskeletal pain. 

2) Apply the findings of the review to the creation of testable theoretical models using a structural equation modelling format. 

3) Analyse an existing prospective cohort study dataset using structural equation modelling to test the moderation influence of stable characteristics on the pain/psychology/outcome pathways. 

4) Assess feasibility of finer grade analysis on specific subgroups, such as patients with different sites of pain (e.g. back, neck, shoulder, knee, multisite pain), and different populations by utilising other available datasets within the Research Institute (e.g. patients with long term persistent pain).

 

Details See Advert and details and Supplementary Information
Duration THREE YEARS FULL TIME SIX YEARS PART TIME
Fees All fees paid at current UK/EU rates, for three years (full time) or six years (part time) only
Stipend Stipend paid at current Research Council rate, for three years or six years only
Closing date Friday 3rd June 2016

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Research Topic The epidemiology of imaging use for the diagnosis and management of osteoarthritis in primary care: evidence synthesis and secondary analysis
Reference number: RPCH2016/13
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014).

 

Aim:

To review and synthesize current national and internal guidance on imaging for OA diagnosis, determine rates of referrals for imaging in primary care, the characteristics of who is being referred and whether this has any impact on the subsequent treatments and referrals.

 

Objectives:

  1. 1.    To systematically review i) OA guidelines and determine the recommendations for diagnosing OA and the role imaging plays in this and ii) previously reported rates of primary care referrals for x-rays for musculoskeletal conditions and osteoarthritis
  2. 2.    To examine the rates of referrals for musculoskeletal imaging in primary care.
  3. 3.    To determine the characteristics associated with individuals who are referred for x-rays for joint pain and OA compared to those that are not referred.
  4. 4.    To investigate whether referral for x-ray affects the subsequent diagnoses, treatments and further referrals an individual receives in comparison to those that are not referred.

 

Methods:

 

Objective 1. The student will conduct a systematic review to identify i) OA guidelines and ii) primary care referrals rates for x-rays for musculoskeletal conditions and osteoarthritis. To identify potentially relevant articles the student will devise a search strategy and select appropriate sources to search including national and international bodies, guideline search engines as well as electronic databases. Selection criteria will be devised and used to screen the articles. Articles meeting the criteria will be included in the review and critically appraised using appropriate instruments for guidelines and observational studies. A synthesis will be completed of i) the guidance for diagnosing OA, whether this is specified by a joint site, if any imaging is required and the circumstances and setting in which the criteria have been devised for use, and ii) the reported rate of referrals for x-rays, whether the data is specified by joint site and source of the data and whether the x-rays were need for diagnoses and subsequent referrals.

 

Objective 2. The student will access national (Diagnostic Imaging Dataset (DID) held by NHS England) and local (CiPCA) datasets to investigate rates of referral in musculoskeletal imaging. The proportions of referrals from primary care will be identified at a national level for different imaging modalities and also specifically for musculoskeletal procedures. Local data will provide more detailed estimates, specifically rates of primary care referrals for x-rays in North Staffordshire.

 

Objective 3. Analysis will be undertaken on data from the Management of OSteoArthritis In ConsultationS (MOSAICS) study(Dziedzic 2014) and/or Primary Care Osteoarthritis Screening Trial (POST). In these studies, individuals who completed a baseline general health survey, gave permission for access to medical record review and consulted with joint pain will be identified. Individuals who were referred for x-ray, as determined from the medical records, will be compared to those individuals who were not referred using a number of baseline characteristics. These characteristics will include those self-reported in the baseline surveys by the patient (e.g. age, gender, pain severity, number of sites affected, anxiety status, employment status), those identified from the medical records (e.g. joint identified in the consultation Read Code, number of previous musculoskeletal consultations) and also GP characteristics (e.g. number of musculoskeletal consultations). Multilevel logistic regression analysis will be required to compare the characteristics of those referred for x-ray compared to those not referred so that analysis can take account of GP level differences.

 

Objective 4. Further analysis will be undertaken on data from the MOSAICS and/or POST studies to examine whether there are different outcomes for patients that were referred for x-ray in comparison to those that were not referred. The outcomes of interest could include: subsequent diagnoses that patients receive in their medical records that could identify OA as well alternative diagnoses; medications that a patients has been prescribed, including analgesics by group(Green 2013), NSAIDS, as well as medications indicating alternative non-OA diagnoses (such as methotrexate, allopurinol, sulfasalazine etc.); subsequent referrals by the GP to physiotherapy, occupational therapy, rheumatology and orthopaedics; and self-reported over the counter treatments and private referrals. The exact outcomes to be included will be identified by the student with the assistance of the supervisory team. Multilevel logistic regression analysis will be required to compare the outcomes following referral for x-ray compared to those not referred so that analysis can take account of GP level differences.

Details See Advert and details and Supplementary Information
Duration THREE YEARS FULL TIME SIX YEARS PART TIME
Fees ALL FEES PAID AT CURRENT UK/EU RATES FOR THREE YEARS FULL TIME OR SIX YEARS PART TIME ONLY
Stipend STIPEND PAID AT CURRENT RESEARCH COUNCIL RATE FOR THREE YEARS FULL TIME OR SIX YEARS PART TIME ONLY
Closing date FRIDAY 3RD JUNE 2016

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Research Topic Exploring the perspectives of young adults living with a stoma, and healthcare professionals about access to care for mental health needs: a qualitative study
Reference number: RPCH2016/14
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014)

 

Aims:

 

This PhD studentship will investigate the perspectives of young adults (aged 18-29) who have a colostomy or ileostomy as a result of Inflammatory Bowel Disease (IBD), and of relevant primary and secondary care providers (GPs, community nurses, stoma nurses and gastroenterologists), with a focus on identification and management of co-morbid anxiety and depression. The study will aim to generate an in-depth, theoretically-informed understanding of perceptions.

 

It is intended that findings will have significant implications for improving access to and integration of care for stoma-associated mental health problems. Specifically, findings can have implications for establishing better co-ordination between primary and secondary care in addressing mental health problems experienced by young adults with a stoma, with greater emphasis on identifying and managing mental health problems and clearer guidance for patients about accessing appropriate forms of support from the different healthcare providers. Findings will also have implications for enhancing sources of support outside of the clinical setting, including supporting individuals in their use of social media with regard to concerns about their stoma (e.g. issues of online disclosure; stigma; dealing with views portrayed through social media, etc.).

 

Objectives & methods:

 

The objectives are to address the following research questions:

 

  1. What are young adults’ perspectives on care and support received, and how have any anxieties and distress been addressed?
  2. What do these patients view as being the key barriers and facilitators to care, and what are their care preferences?
  3. How do primary and secondary care providers view their role in the care of these patients in relation to mental health needs?
  4. How can collaboration across primary and secondary care services regarding associated mental health problems be improved to better support this patient group?
  5. In what ways, and to what extent, do young adults engage with online resources and social media in relation to their stoma, e.g. online disclosure/ support resources etc., and how can support be further improved?

 

Qualitative, semi-structured interviews will be conducted. This will enable in-depth exploration of the perspectives of young adults living with a stoma resulting from IBD, and related healthcare providers. It is estimated that 15-20 patient interviews and 15-20 healthcare professional interviews will be required for data-saturation. Interview participants will be recruited through various avenues, following appropriate NHS and university ethics approvals. These will include:

 

  • Hospital clinics, via specialists and clinical nurse specialists.
  • National and local associations; e.g. The Ileostomy and Internal Pouch Support Group (IA); Crohn’s and Colitis UK; Ostomy Lifestyle; Stomawise UK.
  • Advertising via universities/colleges, libraries, shops within the local geographical area.
  • Online/ social media platforms; e.g. stoma support groups/ forums etc.

 

Interview data will be transcribed and coded for recurrent concepts and themes using an inductive, exploratory approach, influenced by grounded theory (Glaser and Strauss, 1967). An appropriate analytic framework will be used in analysing the data, informed by the preliminary findings; for instance, narrative analysis, discourse analysis or interpretative phenomenology. Analysis will be informed by relevant theories of long-term condition management (e.g. from the fields of medical sociology and health psychology), as well as the literature on managing co-morbid mental health problems in patients with long-term conditions. Analysis will aim both to identify common themes across the dataset, as well as gain in-depth understanding of the perspectives of young adults with a stoma and relevant healthcare providers.

Details See Advert and details and Supplementary Information
Duration FULL TIME, THREE YEARS PART TIME, SIX YEARS
Fees ALL FEES PAID AT UK/EU RATES FOR THREE YEARS FULL TIME OR SIX YEARS PART TIME ONLY
Stipend STIPEND PAID AT CURRENT RESEARCH COUNCIL RATE FOR THREE YEARS FULL TIME OR SIX YEARS PART TIME ONLY
Closing date FRIDAY 3RD JUNE 2016

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Research Topic Understanding impact of psychological distress in general practitioners and practice nurses: a mixed methods study
Reference number: RPCH2016/15
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014)

Primary care doctors (GPs) and nurses (PNs) are under unprecedented levels of stress due to longstanding workforce shortages, an ageing and evermore medically complex population, and the policy imperative to deliver care closer to home. There is concern about the impact of this workload on patient safety (Royal College of General Practitioners, 2015), with high rates of psychological distress, burnout and suicide reported in GPs. (Brooks et al, 2011) Little is understood about the comparative effect of working in primary care on the mental health of nurses, who play an increasingly demanding role delivering a number of initiatives within practices.  At a time where resilience of the entire general practice workforce is being challenged, this study will acknowledge the important role of nursing staff in primary care, estimate levels of psychological distress experienced and seek to identify personal and role-specific characteristics that can improve resilience in PNs and NPs to reduce the impact of distress on patient safety.   This research will add to the understanding of practice factors which impact on psychological health of GPs and PNs and add to the growing literature in this area, to inform the development of an effective practice-level intervention to support and protect primary care colleagues during the current challenges.

Aims:

1.         Estimate the impact of anxiety, depression, psychological distress and burnout in GPs and practice nursing staff.  (Assessed by online questionnaire).

2.         What are the role-specific and personal characteristics that contribute to, or could protect from, psychological distress? (Investigated using in-depth qualitative interviews)

3.         Can these job and personal characteristics be used to inform a practice intervention to protect against/prevent adverse outcomes? (Analysis of data from interviews, and comparison with existing literature)

Objectives & methods:

All GPs, PNs and NPs working within Stoke-on-Trent and North Staffordshire will be sent an online questionnaire to complete anonymously.  This questionnaire will be based upon the 16-item Oldenburg Burnout Inventory (OLBI) which is a brief measure validated for use in assessing psychological distress in healthcare workers. (Demerouti et al, 1999) In addition demographic data about participants will be collected, including age, sex, job-role, current number of working hours and number of years in practice.  The online format and brevity of the questionnaire have been chosen to maximise practitioner response.  Potential participants will also be sent an e-mail to ask if they would be prepared to take part in a qualitative interview, in order that respondents can express their interest whilst their questionnaire responses remain completely separate and anonymous.  From those who are willing to participate purposive sampling will be used to sample 10 GPs and 15 practice nurses with whom face-to-face semi-structured interviews will be conducted. 

Descriptive statistics will be used to analyse the responses to the online survey.  Grounded theory and framework analysis will be used to identify themes, patterns and associations within the qualitative data and build on concepts from existing literature. 

Details See Advert and details and Supplementary Information
Duration THREE YEARS FULL TIME SIX YEARS PART TIME
Fees ALL FEES PAID AT UK/EU RATES FOR THREE YEARS FULL TIME OR SIX YEARS PART TIME
Stipend STIPEND PAID AT CURRENT RESEARCH COUNCIL RATEs FOR THREE YEARS FULL TIME OR SIX YEARS PART TIME
Closing date FRIDAY 3RD JUNE 2016

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Research Topic Examining the influence of examiners’ episodic memory on recollection accuracy and score variability in medical education performance assessments
Reference number: RPCH2016/16
Abstract

The Institute for Primary Care and Health Sciences (iPCHS) is the largest and most successful Research Institute at Keele (http://www.keele.ac.uk/pchs/). It is dedicated to undertake research that will improve the quality and content of primary care for arthritis, chronic musculoskeletal pain and associated comorbidities.  It hosts the Arthritis Research UK Primary Care Centre-of-Excellence, is a current member of the NIHR School for Primary Care Research and holds the Queen’s Anniversary Prize for Pioneering the early prevention and treatment of chronic pain.  91% of Keele’s research in Primary Care has been judged world leading or internationally excellent (Ref 2014).The Medical Education Research Group (MERG) has a growing international reputation and an ambition to become world leading over the next 5-10 years.


 


Brief background to the research:


Accurate assessment of the clinical skills of trainee healthcare professionals is vital for both patient safety and educational fairness. Current assessment approaches rely on observation and judgement by professionals but are beset by problems: observation is resource intensive; unwanted variations between examiners produce problematic variability in scores; examiners are reluctant to fail poor candidates; and examiner training has limited benefits.


 


This PhD will contribute to the growing field of “Assessor Cognition” which seeks to understand influences and biases on examiners’ judgements, with a view to producing theoretically-orientated solutions. A number of important findings have emerged over recent years. Amongst these it appears that examiners vary in their attentional focus whilst observing performances, and struggle to manage the mental workload of the judgement task. Despite this, no studies to date have examined how examiners’ ability to retain and recall their observations may influence the judgements they produce. Pilot research by the supervisor (PY) suggests that examiners recognition accuracy for observed performances (a measure of memory) is poor.


 


The ability to recollect a performance depends on “episodic memory” which in turn is understood to rely on four sequential processes: attention, encoding, storage and retrieval (AESR). Based on the recent findings around variable attention and high mental workload, we could hypothesise that the predominant influence on the AESR process arises due to the influence of processing load on the proximal parts of this sequence. Conversely, a variety of influences (transience, retroactive interference, misattribution, recency or primacy effects) could influence the distal parts of the process: storage and retrieval. Choosing appropriate practical interventions will depend on understanding the relative contributions of each of these processes.


 


Aims:


To determine the relative influence of different mediators of episodic memory function on examiners’ recollection accuracy and score variability within medical education.


 


Methods:


The study will use cognitive experimental methods. The PhD student will be supported to develop their own hypotheses as they review the literature. Consequently this study should be seen as illustrative.


 


Example Study 1: This study will test whether transience effects arise within the duration of a standard length (6-10 minutes) exam performance.


Hypothesis: Increasing performance duration will reduce recognition accuracy for the initial component of a performance, and increase score variability. 


The study will use a 3 independent group crossover design. Group 1 will see the first minute of a performance and then immediately provide responses. Group 2 will see the same 1st minute of the performance, followed by a neutral distractor task for 7 minutes. This will control for the effect of elapsed time. Group 3 will see the full 8 minute videoed performance. Following the performance, participants will be asked to score the performance and perform a memory recognition task.  For this, participants will be presented with 10 real excerpts from the 1st minute of the performance, and 10 plausible but spurious invented excerpts. They will be asked to indicate for each whether it is true or false. Participants will then view 2 further performances, with all groups experiencing all conditions across the 3 performances in a balanced rotational order. Score variability and recognition accuracy will be compared across conditions. Participants: medical undergraduate examiners, expected n=45.


 Outcomes: The PhD is expected to consist of 3 studies. One study, could (as an alternative) use qualitative methods to provide a broader view based on examiners perceptions. The initial literature review is expected to be publishable as a narrative review, with the PhD producing 4 academic papers.

Details See Advert and details and Supplementary Information
Duration THREE YEARS FULL TIME SIX YEARS FULL TIME
Fees FEES PAID AT UK/EU RATES FOR THREE YEARS FULL TIME OR SIX YEARS PART TIME ONLY
Stipend STIPEND PAID AT CURRENT RESEARCH COUNCIL RATE FOR THREE YEARS FULL TIME OR SIX YEARS PART TIME
Closing date FRIDAY 3RD JUNE 2016

Apply online here