
Emma CockcroftUniversity of Exeter | UoE · Medical School
Emma Cockcroft
PhD University of Exeter
About
67
Publications
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Introduction
Research fellow for the South West Peninsula Applied Research Centre (PenARC)
Education
October 2012 - October 2015
October 2011 - September 2012
October 2007 - June 2010
Publications
Publications (67)
Background
Patient and public involvement and engagement (PPIE) is integral to health research. Reporting of PPIE methods and impact is becoming increasingly common in health research. However, reporting on PPIE in studies using large, routinely collected electronic health record data sets is less common. Anecdotal evidence suggests that involvemen...
Background
General medical practitioners and other staff at primary care medical practices have an important role in facilitating patient access to online services in the National Health Service in England. These services range from online ordering of repeat prescriptions to conducting online consultations with health care professionals. We have de...
Aim: Type 1 diabetes (T1D) is one of the most common chronic conditions in children and adolescents. Approximately 1.5 million young people are currently living with T1D throughout the world. Despite recent improvement in overall indices of metabolic control in children and adolescents with T1D, control remains suboptimal and additional approaches...
Background
Current National Health Service policy in England encourages enhanced digital access in primary care service provision. In this study, we investigate ‘digital facilitation’ – that range of processes, procedures and personnel which seeks to support National Health Service primary care patients in their uptake and use of online services....
Background
Health service policy in many jurisdictions is driving greater investment into digital primary care services. While some patients and practices may benefit, there are concerns that not all are able or wish to access primary care services online. “Digital facilitation” is the “range of processes, procedures, and personnel seeking to suppo...
Objectives
Assess the effect of a modified muscle sparing posterior approach; SPAIRE (Save Piriformis and Internus, Repairing Externus), in hip hemiarthroplasty for displaced intracapsular fractures on postoperative mobility and function compared with a standard lateral approach.
Design
Pragmatic, superiority, multicenter, parallel-group, randomiz...
Introduction
Care home residents often have multiple long-term conditions and experience polypharmacy. Deprescribing is the reduction or stopping of prescription medicines that may no longer be providing benefit. Deprescribing is generally safe but it is unknown how to make it work well in practice, like care homes. Current tools and approaches oft...
Background
Regular physical activity (PA) results in extensive physical, psychological, and social benefits. Despite primary care being a key point of influence for PA behaviours in the UK, research indicates poor application of PA interventions in this context. To address this, the Royal College of General Practitioners’ (RCGP) developed and imple...
BACKGROUND
Health service policy in many jurisdictions is driving greater investment into digital primary care services. While some patients and practices may benefit, there are concerns that not all are able or wish to access primary care services online. “Digital facilitation” is the “range of processes, procedures, and personnel seeking to suppo...
Introduction
Care home residents often have multiple long-term conditions and experience polypharmacy. Deprescribing is the reduction or stopping of prescription medicines that may no longer be providing benefit. Previous research has found that deprescribing is generally safe but it is unknown how to make it work well in practice, like care homes....
Background
The National Health Service (NHS) and general practice are increasingly adopting digital services. These services can impact both positively and negatively upon patient experiences, and access to digital services is not equal amongst all groups. Within a wider project examining digital facilitation (the Di-Facto study) our team conducted...
Background: Care home residents often experience polypharmacy (defined as taking five or more regular medicines). Therefore, we need to ensure that residents only take the medications that are appropriate or provide value (also known as medicines optimisation). To achieve this, deprescribing, or the reduction or stopping of prescription medicines t...
Objectives
To explore the factors that may help or hinder deprescribing practice for older people within care homes.
Design
Qualitative semistructured interviews using framework analysis informed by the Consolidated Framework for Implementation Research (CFIR).
Setting
Participants were recruited from two care home provider organisations (a small...
Aim
To evaluate the impact of usual care plus a fundamental nursing care guideline compared to usual care only for patients in hospital with COVID‐19 on patient experience, care quality, functional ability, treatment outcomes, nurses' moral distress, patient health‐related quality of life and cost‐effectiveness.
Design
Parallel two‐arm, cluster‐le...
Background
Rural primary care practices struggle to employ and retain staff, and existing literature regarding recruitment and retention is focussed on doctors. Shortages of qualified staff affect practice functioning, quality of care and patient experience. Dispensing of medications is a rural service valued by patients. However, little is known a...
Background
Despite the known benefits of physical activity (PA), one third of adults in the UK fail to meet recommended levels of PA. PA promotion in primary care has been shown to be effective at improving PA in patients but implementation of PA promotion by GPs remains poor. Research has shown a need to improve PA education in undergraduate medic...
Published by The Lancet Child & Adolescent Health
Background:
Older people are often explicitly or implicitly excluded from research, in particular clinical trials. This means that study findings may not be applicable to them, or that older people may not be offered treatments due to an absence of evidence.
Aims:
The aim of this work was to develop recommendations to guide all research relevant...
Background:
Self-harm and eating disorders share multiple risk factors, with onset typically during adolescence or early adulthood. We aimed to examine the incidence rates of these psychopathologies among young people in the UK in the 2 years following onset of the COVID-19 pandemic.
Methods:
We conducted a population-based study using the prima...
Background
The National Health Service (NHS) and general practice are increasingly adopting digital services. These services can impact both positively and negatively upon patient experiences, but access to digital services is not equal amongst all groups. Within a wider project (the Di-Facto study) our team conducted a patient survey amongst Engli...
Children and young people have much to contribute to the design and delivery of health research and care. Nevertheless, there are multiple barriers to meaningful and impactful involvement of children and young people. This narrative review synthesised existing literature on the involvement of children and young people as partners in health research...
Background
Many children and adolescents with Type 1 Diabetes Mellitus (T1DM) don’t meet the recommended levels of physical activity. Healthcare professionals (HCPs) have a key role in supporting and encouraging children and adolescents with T1DM to be physically active. This study aims to understand the perspectives of HCPs in relation to supporti...
Background
Care home residents often have multiple long-term conditions and experience polypharmacy. However, some medicines may be unnecessary or may cause more harm than good, especially as residents develop increasing frailty. Previous research has found that deprescribing (the reduction or stopping of prescription medicines that may no longer b...
Introduction:
Rural General Practice (GP) surgeries often struggle to employ and retain multidisciplinary team members. Existing research into rural recruitment and retention issues is limited, and usually focussed on doctors. Rural practices often rely on income from dispensing medications; little is known about how maintaining dispensing service...
Background
The HemiSPAIRE trial is being conducted to determine whether a modified muscle sparing technique (SPAIRE-“Save Piriformis and Internus, Repairing Externus”) in hip hemiarthroplasty brings clinical benefits compared to the standard lateral technique in adults aged 60 years or older, with a displaced intracapsular hip fracture. This articl...
Background: The HemiSPAIRE trial is being conducted to determine whether a modified muscle sparing technique (SPAIRE - “Save Piriformis and Internus, Repairing Externus”) in hip hemiarthroplasty brings clinical benefits compared to the standard lateral technique in adults aged 60 years or older, with a displaced intracapsular hip fracture. This art...
Background
The use of web-based services within primary care (PC) in the National Health Service in England is increasing, with medically underserved populations being less likely to engage with web-based services than other patient groups. Digital facilitation—referring to a range of processes, procedures, and personnel that seek to support patien...
Introduction
Patient and public involvement in research is anchored in moral and epistemological rationales. Moral rationales relate to the public having a right to influence how knowledge about them is generated. Epistemological rationales relate to how research design and implementation can improve when informed by experiential, as well as techni...
Aims
To identify strategies used by registered nurses and non‐registered nursing care staff in overcoming barriers when providing fundamental nursing care for non‐invasively ventilated inpatients with COVID‐19.
Design
Online survey with open‐ended questions to collect qualitative data.
Methods
In August 2020, we asked UK‐based nursing staff to de...
Background
Patient experience of nursing care is associated with safety, care quality, treatment outcomes, costs and service use. Effective nursing care includes meeting patients’ fundamental physical, relational and psychosocial needs, which may be compromised by the challenges of SARS-CoV-2. No evidence-based nursing guidelines exist for patients...
Background
Drug-related problems and potentially inappropriate prescribing impose a huge burden on patients and the health-care system. The most widely used tools for appropriate prescription in older adults in England and in other European countries are the Screening Tool of Older People’s Prescriptions (STOPP)/Screening Tool to Alert to the Right...
BACKGROUND
The use of web-based services within primary care (PC) in the National Health Service in England is increasing, with medically underserved populations being less likely to engage with web-based services than other patient groups. Digital facilitation —referring to a range of processes, procedures, and personnel that seek to support patie...
Aim
This systematic review identifies, appraises and synthesizes the evidence on the provision of fundamental nursing care to hospitalized patients with a highly infectious virus and the effectiveness of adaptations to overcome barriers to care.
Design
Systematic review.
Data Sources
In July 2020, we searched Medline, PsycINFO (OvidSP), CINAHL (E...
Introduction
Currently National Institute for Health and Care Excellence clinical guidelines in the UK suggest that surgeons performing partial hip replacements (hemiarthroplasty) should consider using the lateral approach. Alternatively, a newer, modified posterior approach using a muscle sparing technique named ‘Save Piriformis and Internus, Repa...
Background: The risk of some of the co-morbidities associated with type 1 diabetes (T1D) can be mitigated through physical activity. Despite benefits, research shows that children and adolescents with T1D are not meeting recommended levels of physical activity. Health Care Professionals (HCPs) have an important role in supporting and encouraging ch...
Introduction
Patient experience of nursing care is correlated with safety, clinical effectiveness, care quality, treatment outcomes and service use. Effective nursing care includes actions to develop nurse–patient relationships and deliver physical and psychosocial care to patients. The high risk of transmission of the SARS-CoV-2 virus compromises...
Information received by women regarding physical activity during and after pregnancy often lacks clarity and may be conflicting and confusing. Without clear, engaging, accessible guidance centred on the experiences of pregnancy and parenting, the benefits of physical activity can be lost. We describe a collaborative process to inform the design of...
Background
Older people with multimorbidity often experience polypharmacy. Taking multiple medicines can be beneficial; however, some older adults are prescribed multiple medicines when they are unlikely to improve clinical outcomes and may lead to harm. Deprescribing means reducing or stopping prescription medicines which may no longer be providin...
Background: Older people with multimorbidity often experience polypharmacy. Taking multiple medicines can be beneficial; however, some older adults are prescribed multiple medicines when they are unlikely to improve clinical outcomes and may lead to harm. Deprescribing means reducing or stopping prescription medicines which may no longer be providi...
Background:
Current evidence of metabolic health benefits of high-intensity interval training (HIIT) are limited to longer training periods or conducted in overweight youth. This study assessed 1) fasting and postprandial insulin and glucose before and after 2 weeks of HIIT in healthy adolescent boys, and 2) the relationship between pre interventi...
For patients and the public to work collaboratively with researchers, they need support and opportunities to engage in learning that builds on their skills and grows their confidence. In this article, we argue for a different approach to this learning, which starts with the expertise patients/ the public arrive with, and helps them identify and dev...
New findings:
What is the topic of this review? Hypoglycaemia is a commonly cited barrier to exercise in type 1 diabetes mellitus (T1D). Knowledge of approaches to prevent or manage exercise-induced hypoglycaemia can support patients to exercise and help clinicians to give advice. This review presents evidence-based strategies to prevent exercise-...
Background
Public involvement in research is seen as a quality marker by funders. To understand the process and impact of involvement, more in‐depth studies are needed on how members of the public contribute in meetings with researchers.
Objectives
This study aimed to observe and reflect on what is said by public advisers in involvement. We wanted...
Background : Current evidence of metabolic health benefits of high-intensity interval training (HIIT) are limited to longer training periods or conducted in overweight youth. This study assessed 1) fasting and postprandial insulin and glucose before and after two weeks of HIIT in healthy adolescent boys, and 2) the relationship between pre interven...
Background This study examined whether improvements in fasting and postprandial [insulin], [glucose] and aerobic fitness are possible after two weeks of high-intensity interval training (HIIT) in adolescent boys. Methods Seven boys (14.3 ± 0.3 y) completed 6 sessions of HIIT over two weeks. Homeostatic model assessment of insulin resistance (HOMA-I...
Patient and public involvement (PPI) refers to patients and/or members of the public being involved in research, not as subjects or participants, but as active partners and decision makers alongside researchers. In Health Service research, PPI is common place, and is often an essential requirement for grant funding. Sports Medicine has a lot in com...
Purpose: This study had two objectives: 1) to examine whether the validity of the supramaximal verification test for maximal oxygen uptake (V ̇O2max) differs in children and adolescents when stratified for sex, body mass and cardiorespiratory fitness (CRF); and 2) to assess sensitivity and specificity of primary and secondary objective criteria fro...
‘In this method note, we question if the primary search strategy in a systematic review should be accompanied by a search narrative. A search narrative could offer a conceptual and contextual report on the search strategy, which we suggest might benefit the peer review of literature searches and increase engagement with, and discussion of, the lite...
Background:
Oxidative stress and inflammation may contribute to anabolic resistance in response to protein and exercise in older adults. We investigated whether consumption of montmorency cherry concentrate (MCC) increased anabolic sensitivity to protein ingestion and resistance exercise in healthy older men.
Methods:
Sixteen healthy older men w...
This study examined the time course of adaptions in insulin sensitivity (IS) in adolescent boys after acute high intensity interval exercise (HIIE) and moderate intensity exercise (MIE). Eight boys (15.1±0.4 y) completed three 3-day experimental trials in a randomised order: 1) 8 x 1 minute cycling at 90 % peak power with 75 s recovery (HIIE); 2) c...
Current physical activity guidelines for youth with type 1 diabetes (T1D) are poorly supported by empirical evidence and the optimal dose of physical activity to improve glycemic control is unknown. This case report documents the effect of acute high-intensity interval exercise (HIIE) and moderate-intensity
exercise (MIE) on 24-h glycemic control i...
Assessment of plasma insulin and glucose outcomes is important in paediatric studies aimed at reducing future risk of type 2 diabetes and cardiovascular disease. The aims of this study are to determine the between-method agreement and the day-to-day reliability of fasting and oral glucose tolerance test (OGTT)-derived estimates of insulin sensitivi...
The purpose of this study was to assess the acute effect of high-intensity interval exercise (HIIE) and moderate-intensity exercise (MIE) on glucose tolerance, insulin sensitivity and fat oxidation in young boys. Eleven boys (8.8 ± 0.8 y) completed three conditions: 1) HIIE; 2) work-matched MIE; and 3) rest (CON) followed by an oral glucose toleran...
INTRODUCTION
Involving members of the public in the development of Health Technology Assessments (HTAs) has scientific and public value (1) but the most common form of involvement in HTA remains collection of people's views in the form of data (2). Involving members of the public in shaping the research is rare due to perceived time or resource con...
High-intensity interval training (HIIT) improves traditional cardiovascular disease (CVD) risk factors in adolescents, but no study has identified the influence of HIIT on endothelial and autonomic function in this group.
Thirteen 13-14 y old adolescents (6 girls) completed six HIIT sessions over two weeks. Each training session consisted of 8-10 x...
Objectives:
High-intensity interval exercise (HIIE) may offer a time efficient means to improve health outcomes compared to moderate-intensity exercise (MIE). This study examined the acute effect of HIIE compared to a work-matched bout of MIE on glucose tolerance, insulin sensitivity (IS), resting fat oxidation and exercise enjoyment in adolescent...
Questions
Question (1)
I wondered if anyone had any references for a protocol for conducting a mixed meal tolerance test. Particularly in terms of make up of the meal. Is there a typical glucose load (e.g 60g) or is part of the method that the make up of the meal can vary.