Working with people affected by cancer – Phase 1 of a mixed methods exploration of practitioner perspectives in nutritional therapy

Introduction - Nutritional therapy (NT) is a bioscience-based branch of complementary and alternative medicine (CAM) with National Occupational Standards (NOS) and accredited training courses which include compulsory clinical training. Approximately 900 practitioners are registered with the voluntary regulator, the Complementary and Natural Healthcare Council (CNHC), but the number of unregulated practitioners is unknown. Cancer is a leading cause of death worldwide; nutrition and lifestyle factors may affect recurrence and survival rates. Many cancer patients and survivors seek individualised advice on diet and use of supplements and appropriately skilled nutritional therapy practitioners (NTP) may be well-placed to safely provide this advice. Little is known of NTPs’ perspectives on working with people affected by cancer; this study seeks to explore their views on training, use of evidence and other resources, to support the development of safe evidence-based practice in this important clinical area. Methods – An on-line anonymised questionnaire collected data from participants recruited from all UK registered NTPs. Recruitment was facilitated by the British Association for Applied Nutrition and Nutritional Therapy (BANT). Quantitative data on practitioner characteristics, years in practice, other therapies practiced and work with cancer clients were collected. Qualitative data on types of evidence used, barriers to practice and perceived training and support needs when working with clients with cancer, were collected and analysed. SPSS was used to produce descriptive statistics. Preliminary Results – 274/888 (31%) of registered NTPs participated. 61% respondents had accredited NT qualifications of which 46% were at degree or post-graduate level. 73% (202) participants indicated they also had other higher education qualifications, including 153 (56%) at degree or above. When asked to describe their position on cancer work, 17% respondents (40/238) indicated no interest, and 35% (84/238) respondents already work with cancer clients (cancer practitioners - CP). A further 48% (114/238) respondents expressed interest in starting cancer work, and typically requested specialist training and practice guidelines to support this area of clinical practice. Cancer practitioners (CP) rated searches of peer-reviewed literature as most useful for information to support practice, whereas commercial product information was rated least useful. CPs requested engagement with mainstream medicine, more access to research evidence and professional recognition to facilitate and support work with cancer clients. A need for professional networking, mentorship and/or supervision was noted by CP and non-CP respondents, which is of interest since 81% all participants worked as sole practitioners exclusively or as part of their practice, <1% worked within the NHS. Discussion & Conclusions – This is the first detailed documentation of NTP perspectives on cancer work. A number of areas have been identified for further detailed evidence to be collected using focus groups and interviews, including detailed training needs, communication with mainstream cancer professionals, access to research evidence, and professional recognition. This work will inform and support the development of professional practice guidelines for NT and inform the development of specialist training and other resources.

Clinical potential of oligonucleotide-based therapeutics in the respiratory system

The discovery of an ever-expanding plethora of coding and non-coding RNAs with nodal and causal roles in the regulation of lung physiology and disease is reinvigorating interest in the clinical utility of the oligonucleotide therapeutic class. This is strongly supported through recent advances in nucleic acids chemistry, synthetic oligonucleotide delivery and viral gene therapy that have succeeded in bringing to market at least three nucleic acid-based drugs. As a consequence, multiple new candidates such as RNA interference modulators, antisense, and splice switching compounds are now progressing through clinical evaluation. Here, manipulation of RNA for the treatment of lung disease is explored, with emphasis on robust pharmacological evidence aligned to the five pillars of drug development: exposure to the appropriate tissue, binding to the desired molecular target, evidence of the expected mode of action, activity in the relevant patient population and commercially viable value proposition.

From science gateways to commercial solutions

The European CloudSME project that incorporated 24 European SMEs, besides five academic partners, has finished its funded phase in March 2016. This presentation will provide a summary of the results of the project, and will analyze the challenges and differences when developing “SME Gateways”, when compared to “Science Gateways”. CloudSME started in 2013 with the aim to develop a cloud-based simulation platform for manufacturing and engineering SMEs. The project was based around industry use-cases, five of which were incorporated in the project from the start, and seven additional ones that were added as an outcome of an open call in January 2015. CloudSME utilized science gateway related technologies, such as the commercial CloudBroker Platform and the WS-PGRADE/gUSE Gateway Framework that were developed in the preceding SCI-BUS project. As most important outcome, the project successfully implemented 12 industry quality demonstrators that showcase how SMEs in the manufacturing and engineering sector can utilize cloud-based simulation services. Some of these solutions are already market-ready and currently being rolled out by the software vendor companies. Some others require further fine-tuning and the implementation of commercial interfaces before being put into the market. The CloudSME use-cases came from a very wide application spectrum. The project implemented, for example, an open marketplace for micro-breweries to optimize their production and distribution processes, an insole design validation service to be used by podiatrists and shoe manufacturers, a generic stock management solution for manufacturing SMEs, and also several “classical” high-performance computing case-studies, such as fluid dynamics simulations for model helicopter design, and dual-fuel internal combustion engine simulation. As the project generated significant impact and interest in the manufacturing sector, 10 CloudSME stakeholders established a follow-up company called CloudSME UG for the future commercialization of the results. Besides the success stories, this talk would also like to highlight the difficulties when transferring the outcomes of an academic research project to real commercial applications. The different mindset and approach of academic and industry partners presented a real challenge for the CloudSME project, with some interesting and valuable lessons learnt. The academic way of supporting SMEs did not always work well with the rather different working practices and culture of many participants. Also, the quality of support regarding operational solutions required by the SMEs is well beyond the typical support services academic institutions are prepared for. Finally, a clear lack of trust in academic solutions when compared to commercial solutions was also imminent. The talk will highlight some of these challenges underpinned by the implementation of the CloudSME use-cases.