Exeter

This internship project sits within a wider programme, Improving Support for Physical Activity in Type 1 Diabetes (T1D). The specific focus is analysis and write-up of qualitative data on stakeholder perspectives to inform the development and real-world implementation of physical activity support for adolescents with T1D.

Adolescence is a critical period for developing lifelong activity habits, yet many adolescents with T1D do not achieve the recommended 60 minutes of moderate-intensity physical activity per day. Despite clear physical and psychological benefits, including improved cardiovascular health, self-esteem and glycaemic control, participation is limited by barriers such as fear of hypoglycaemia, the complexity of managing diabetes around exercise, and limited confidence or knowledge among parents, healthcare professionals and coaches.

The project will draw on existing semi-structured interviews with adolescents with T1D, their parents, sports coaches and healthcare professionals. Data will be analysed using reflexive thematic analysis to identify key barriers, facilitators and stakeholder needs for effective physical activity support.

Findings will directly inform the design of an evidence-based, stakeholder-informed intervention to promote safe, sustainable physical activity in adolescents with T1D.
The intern will work within a multidisciplinary research team and will have opportunities to contribute to the wider programme, which may include: content analysis of school-based policies for T1D; pilot testing of educational resources for coaches; and contributing to data collection and analysis examining physical activity, glucose metrics and tools to reduce exercise-induced hypoglycaemia.

Building on a seminal 1998 US study (US study), which established that Adverse Childhood Experiences (ACEs) were common and there was a graded dose-response relationship between ACEs and poor adult health outcomes, a growing evidence base now highlights the lifelong impact of ACEs (including factors such as economic disadvantage and peer victimisation). Consequently, addressing ACEs has become a public health, economic, and moral imperative.

Whilst the societal changes required for primary prevention can appear insurmountable, a growing but fragmented body of evidence exists regarding possible community-level strategies that can protect and support young people and build resilience against harm.

The NHS 10 Year Health Plan envisages a neighbourhood health service where the broader determinants of health are co-located and more effectively integrated, and primary care can take a leading role in what it does best: holistic life-course care. This shift provides an opportunity to co-develop and embed community-level strategies designed to mitigate against ACEs and develop data infrastructure to measure what is working and how.

Our scoping review will map the evidence base around community-level approaches aimed at ACEs, identifying key concepts, design factors and knowledge gaps, which can act as a guide in the co-development of strategies to be tested alongside neighbourhood health services.

Using JBI methodology, the student intern is invited to be a team member and involved in all ongoing stages. Activities will include: defining inclusion/exclusion criteria, building the search strategy, organising and screening literature, extracting and charting data, then collating, summarising and reporting the findings.

The systematic review will assess the impact of ethnicity-specific reference ranges for prostate-specific antigen (PSA) testing on prostate cancer diagnosis. The project builds on our previous research demonstrating substantial ethnic variation in PSA levels, raising concerns that the use of a single universal PSA threshold, as currently applied in UK clinical practice, may increase the risk of overdiagnosis among men with higher baseline PSA values. The review will examine whether the adoption of ethnicity-adjusted PSA reference ranges could improve diagnostic accuracy and reduce potential harms associated with PSA testing. To support meaningful translation into practice, the review will focus on studies conducted in the UK and in countries with comparable healthcare systems (e.g., Canada, Sweden, and Denmark etc)

The review protocol is currently in development, and the literature search will be completed prior to the start of the intern’s placement. The successful intern will contribute to key stages of the review process, including study screening, data extraction, and risk-of-bias assessment. They will also contribute to report writing, present findings at departmental seminars, and co-author the resulting paper, subject to level of contribution. This project will provide hands-on experience in systematic review methodology, critical appraisal of evidence, and prostate cancer diagnostics research within an active research team.