The e-GFR Study. Accuracy of glomerular filtration rate (GFR) estimation using creatinine and cystatin C and albuminuria for monitoring disease progression in patients with stage 3 chronic kidney disease: an observational study in a multiethnic population. The aims of the research are to evaluate glomerular filtration rate (GFR)- estimating equations in assessing and monitoring measured GFR in people with stage 3 chronic kidney disease (CKD) over three years. A focus of the research is the impact of ethnic group, baseline diabetes and proteinuria in the estimation and evaluation of how accurately these equations reflect change in GFR over three years. A further aim of the research is to estimate and model disease progression and compare the effectiveness and costs of monitoring strategies for identifying people that have progressive loss of kidney function utilising different GFR-estimating equations and test schedules, accounting for differences in risk of progression. An accurate knowledge of GFR is required to identify and manage CKD. Measurement of GFR using reference procedures is impractical for large scale application, and GFR-estimating equations are widely used. There is little data addressing the ability of estimated GFR to detect change in true GFR, and no data addressing the accuracy of these equations in British ethnic minority populations. The evidence base on the frequency of monitoring is also very poor for some of the newer estimating equations, and whether the benefits of these new equations are outweighed by the increased costs. This study has been designed to address these questions. A prospective multi-centre longitudinal cohort study to estimate accuracy in eGFR and changes in eGFR. 1300 people will be followed for 3 years with reference (measured) GFR and test (estimated GFR – eGFR) measurements at baseline and 3 years. Test measurements are also undertaken every 6 months. The target population are adults with stage 3 CKD proportionally enriched to include people more likely to have progressive kidney disease (i.e. those with proteinuria and/or diabetes) and including Asians and African-Caribbeans. A sub-study of 300 people (100 each of Caucasian, Asian and African-Caribbean origin; in each case containing subjects at high and low risk of kidney disease progression) will also be undertaken. Reference GFR will be measured yearly in the sub-study population and patterns of disease progression assessed. Start date: 01/08/2013 End date: 31/01/2019 Funder: NIHR via EKHUFT Funding: £25,912 Publication: The eGFR-C study

This collaborative project between CHSS, Kent University’s School of Psychology, School of Biosciences and clinicians from East Kent’s hospitals pilots a new treatment for stroke sufferers diagnosed with hemi-spatial neglect. This is a disabling, visual-spatial neuropsychological impairment frequently associated with a lesion to the right hemisphere which causes sufferers to act as if one half of their visual world is missing - bumping into objects, leaving food on one side of a plate and failure to notice people at the affected side. Effects can be over-shadowed by more observable impairments of movement or communication, yet the disorder is far more strongly predictive of general functional recovery from stroke. So far it has proved very difficult to remediate, and many showing hemi-spatial neglect at hospital admission still struggle with daily routine years later. This new treatment seeks to restore lost function to damaged visual brain areas via trans-cranial electrical stimulation, a procedure which injects sub-sensory levels of electrical current though electrodes placed on the scalp just behind the ears to stimulate nerve pathways from the inner ear to the damaged parts of the brain. Current treatment requires specialist staff and space but this new stimulation method can be administered by a nurse at bedside. This is the first MRC-funded stroke study to directly involve East Kent Hospitals University NHS Foundation Trust personnel. Start date: 01/04/2011 End date: 31/03/2013 Funder: Medical Research Council Funding: £49,835 Publications: Does Repeated Vestibular Stimulation Induce Lasting Recovery From Hemi-Spatial Neglect? (web page) Galvanic vestibular stimulation in hemi-spatial neglect

This project aims to evaluate the characteristics of nursing homes and their residents in eight European countries, using standardised assessment instruments. It seeks to determine validity of the InterRAI Long Term Care Facilities assessment instrument by comparing assessments of residents within and between nursing homes over a 12 month period. The project also generates information on the characteristics of nursing homes by collection of data to support and contrast residents’ needs, and this will be entered into a specially created web-based project database. Start date: 01/01/2009 End dtae: 31/12/2011 Funder: European Commission FP7 Publication: Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (Shelter) study Services and Health for Elderly in Long TERm Care - Baseline report