Our vision
Chronic illnesses are non-communicable conditions, generally of long duration and slow progression. With many chronic illnesses associated with ageing, such as cardiovascular disease, osteoarthritis, dementia and Type 2 diabetes, the focus has tended to be on managing these in the older population. However, some long-term conditions, such as scoliosis, inflammatory bowel disease (IBD)and rheumatoid arthritis, Type 1 diabetes and Parkinson’s can also affect people from a much earlier age; others, including learning disabilities, impact individual’s ability to manage their health as they age. Recognising this, the Centre for Chronic Illness and Ageing (CCIA) takes a more holistic approach, with research and practice that addresses the lived experiences and impacts of chronic illnesses across the lifespan, from childhood and adolescence through to older age.
We aim to:
- Build an understanding of chronic illness as often a lifelong experience, thus challenging and expanding the current social and health policy focus on chronic illness in older adults only.
- Encourage Centre members to progress in their careers, building a sustainable pipeline of researchers to deliver world-class research across our areas of interest.
- Establish and maintain effective partnerships with the Third Sector, other higher education institution and community providers.
Our impact on the world
With people generally living longer and thus more likely to be affected by chronic illnesses, pressure on resource-limited health systems is growing. As a result, a new ‘Healthy Ageing’ agenda is emerging globally, which asks us to take greater personal responsibility for our own health and wellbeing, encouraging and enabling individuals to stay as healthy as possible, for as long as possible. The research undertaken at the Centre for Chronic Illness and Ageing (CCIA) has a beneficial impact by seeking to address the big challenges to this agenda, like diabetes and dementia. We also work to improve the experiences of those affected by chronic illnesses, such as scoliosis and IBD, which can arise at an earlier stage, leading to sustained health challenges throughout the lifecourse.
CCIA’s work therefore directly contributes to UN Sustainable Development Goal Good Health and Well-being (SDG3). Examples of our impact include:
- Informing recommendations for best care practices used by NICE, the UK’s National Institute for Health and Care Excellence.
- Developing new patient-reported outcome measures (PROMS) for people living with IBD, and with scoliosis.
- Delivering research to improve care and treatment for people with diabetic foot ulcers, and with dementia.
- Developing interventions to address dysphagia (swallowing difficulties) in a range of conditions.
- Working with people with learning disabilities to understand their needs and challenges in respect of managing their health as they age
Who we are
An interdisciplinary approach
Solving big challenges requires a wide skill set and multiple perspectives – something that is increasingly valued by those funding our research. Our interdisciplinary approach enables teams of researchers who between them have the specific knowledge and training required to competently address complex questions. Among CCIA members are experts in public health, epidemiology, psychology and medical sociology, working alongside nurses with interests in multiple forms of chronic illness, as well as in the natural processes of ageing. All share a deep commitment to addressing the challenges of chronic illness and ageing.
Partners
In order to meet its challenges, the Centre for Chronic Illness and Ageing takes an open and inclusive approach, collaborating with those most impacted by chronic illness across the lifespan, and with the agencies that support them. We have many internal and external partners, and our wide-reaching networks encompass the health, social care and higher education sectors. For instance, we work closely with many local and national NHS Trusts, as well as with disease-specific charities, such as Diabetes UK, Crohn’s & Colitis UK, the British Heart Foundation, Age Concern, Bowel Research UK and the Alzheimer’s Society. Our academic partners range from The University of East London (Rix Centre for Inclusive Research), King’s College London, Imperial College London and the Royal College of Art to South Africa’s Stellenbosch University and Soochow University in China. We also collaborate with the other research centres within the University of Greenwich, such as the Centre for Inequalities.
Funding
The work of the Centre for Chronic Illness and Ageing is supported by competitive funding for research projects from Diabetes UK, Age Concern and Bowel Research UK and other charities, as well as by the National Institute for Health and Care Research, the Economic and Social Research Council, the Leverhulme Foundation and the Wellcome Trust, among others.
Our research
Patients are our partners
Our research and practice cover issues as diverse as the care and management of the self and others with chronic illness regardless of age, the management of life-long chronic illness and ageing well, right through to end of life care. Crucially, our research often involves close collaboration with patients themselves in the form of Patient and Public Involvement (PPI) groups. These ensure that our research outputs are co-designed with patients, increasing the likelihood that any new healthcare interventions are successful in real world settings.
CCIA’s research currently covers the following chronic illnesses/conditions:
- Adolescent Idiopathic Scoliosis
- Cardiovascular Disease
- Dementia
- Diabetes
- Dysphagia
- Inflammatory Bowel Disease
- Enduring mental illness
- Chronic pain
Adolescent Idiopathic Scoliosis
Scoliosis is the abnormal twisting and curvature of the spine. Adolescent idiopathic scoliosis (AIS) is so called because onset is typically at puberty, and the cause is unknown, though believed to be due to irregularities in muscles and connective tissues around the spine. The vertebrae themselves are not damaged. We are currently co-producing a new PROM for people living with this condition. An emerging finding from the research is that while surgery can be a very effective treatment, insufficient information is provided to patients about the longer-term implications when a decision is being made about whether to proceed with a surgical intervention.
Cardiovascular Disease
Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions. Examples of our research in this area includes a comparative epidemiological study in the UK and South Africa, measuring CVD risk in different communities.
Dementia
Dementia is a group of related symptoms, associated with an ongoing decline of brain functioning, which affects memory, thinking and the ability to perform daily activities. At CCIA we are developing psychological-based, i.e., non-pharmaceutical, interventions for people with Alzheimer’s disease.
Diabetes
Diabetes is a chronic, metabolic disease characterized by failure in insulin production and/or effectiveness causing elevated levels of blood glucose (or blood sugar), which can lead, over time, to serious damage to the heart, blood vessels, eyes, kidneys and nerves. Examples of recent and ongoing work on diabetes at the CCIA includes research on improved care and treatment for people with diabetic foot ulcers.
Dysphagia
Dysphagia is the medical term for swallowing difficulties. Some people have problems swallowing certain foods or liquids, while others cannot swallow at all. The condition can have several different causes, such as strokes. We are developing interventions to address or manage dysphagia, supporting carers, partners and healthcare professionals.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a term to describe long-term conditions which cause severe tummy pain and diarrhoea. The main types of IBD are Crohn’s disease and ulcerative colitis, which can occur from childhood. CCIA members are developing new patient-reported outcome measures, known as ‘PROMS’, for people living with IBD. This is involves developing a questionnaire based on the experience of people with the condition, as well as clinician input. Our work includes assessing how well a patient might adjust to having the condition and the psychosocial factors which determine whether additional support is required.
Publications/Output
Researchers at the Centre for Chronic Illness and Ageing maintain a sustained high level of publication in high quality academic journals. A representative selection of recent publications is given below (CCIA-affiliated authors in bold):
- Adjaye-Gbewonyo, Kafui and Cois, Annibale (2024) Explaining population trends in cardiovascular risk in South Africa and England 1998-2017. [Dataset] (doi:https://doi.org/10.25828/DKY5-R183)
- Hsu, Tien-Wei, Tsai, Chia-Kuang, Kao, Yu-Chen, Thompson, Trevor , Carvalho, Andre F, Yang, Fu-Chi, Tseng, Ping-Tao, Hsu, Chih-Wei, Yu, Chia-Ling, Tu, Yu-Kang and Liang, Chih-Sung (2024) Comparative oral monotherapy of psilocybin, lysergic acid diethylamide, 3,4-methylenedioxymethamphetamine, ayahuasca, and escitalopram for depressive symptoms: systematic review and Bayesian network meta-analysis. BMJ, 2024 (386):e078607. ISSN 1756-1833 (doi:https://doi.org/10.1136/bmj-2023-078607)
- Chen, Mu-Hong, Cheng, Shu-Li, Kao, Yu-Chen, Tseng, Ping-Tao, Hsu, Chih-Wei, Yu, Chia-Ling, Yang, Fu-Chi, Thompson, Trevor , Hsu, Tien-Wei and Liang, Chih-Sung (2024) The association between diverse psychological protocols and the efficacy of psilocybin-assisted therapy for clinical depressive symptoms: a Bayesian meta-analysis. Frontiers in Psychiatry, 15:1439347. ISSN 1664-0640 (Online) (doi:https://doi.org/10.3389/fpsyt.2024.1439347)
- Jiang, Harmony , Eaglestone, Gill, McCrone, Paul, Carr, Catherine and Stoner, Charlotte (2024) How are nature-based interventions defined in mild cognitive impairment and dementia studies? A conceptual systematic review and novel taxonomy. Dementia. ISSN 1471-3012 (Print), 1741-2684 (Online) (doi:https://doi.org/10.1177/14713012241261788)
- Essex, Ryan , Govintharajah, Poonkulali, Issa, Rita, Kalocsanyiova, Erika , Lakika, Dostin, Markowski, Marianne , Smith, James and Thompson, Trevor (2024) Health related quality of life amongst refugees: a meta analysis of studies using the SF-36. Journal of Immigrant and Minority Health. ISSN 1557-1912 (Print), 1557-1920 (Online) (doi:https://doi.org/10.1007/s10903-024-01615-4)
- Monks, Sarah and Clark, Andrew (2024) The role of pets in the lives of people with dementia: a scoping review. Aging and Mental Health. pp. 1-8. ISSN 1360-7863 (Print), 1364-6915 (Online) (doi:https://doi.org/10.1080/13607863.2024.2372709)
- Salanti, Georgia , Peter, Natalie Luise , Tonia, Thomy , Holloway, Alexander , Darwish, Leila, Kessler, Ronald C, White, Ian, Vigod, Simone N., Egger, Matthias, Haas, Andreas D, Fazel, Seena , Herrman, Helen, Kieling, Christian , Patel, Vikram, Li, Tianjing, Cuijpers, Pim , Cipriani, Andrea , Furukawa, Toshi A , Leucht, Stefan and Thompson, Trevor (2024) Changes in the prevalence of mental health problems during the first year of the pandemic: a systematic review and dose-response meta-analysis. BMJ Mental Health, 27 (1):e301018. ISSN 2755-9734 (Online) (doi:https://doi.org/10.1136/bmjment-2024-301018)
- Fisher, Emily , Venkatesan, Shreenila , Benevides, Pedro , Bertrand, Elodie , Brum, Paula Schimidt , El Baou, Céline , Ferri, Cleusa P , Fossey, Jane , Jelen, Maria , Laks, Jerson , Liu, Lisa , Mograbi, Daniel C , Natarajan, Nirupama , Naylor, Renata , Pantouli, Despina , Ramanujam, Vaishnavi , Rangaswamy, Thara , Santos de Carvalho, Raquel L , Stoner, Charlotte R. , Vaitheswaran, Sridhar and Spector, Aimee (2024) Online cognitive stimulation therapy for dementia in Brazil and India: acceptability, feasibility, and lessons for implementation. JMIR Aging, 7:e55557. pp. 1-16. ISSN 2561-7605 (doi:https://doi.org/10.2196/55557)
- Ojo, Omorogieva and Elliott, Helen (2024) The role of prebiotics in gastrointestinal health: a systematic review. Gastrointestinal Nursing, 22 (5). pp. 242-249. ISSN 1479-5248 (Print), 2052-2835 (Online) (doi:https://doi.org/10.12968/gasn.2023.0040) Item availability restricted.
- Hsu, Tien-Wei , Yeh, Ta-Chuan, Kao, Yu-Chen, Thompson, Trevor , Brunoni, Andre R., Carvalho, Andre F., Tu, Yu-Kang, Tseng, Ping-Tao, Yu, Chia-Ling, Cheng, Shu-Li and Liang, Chih-Sung (2024) Response trajectory to left dorsolateral prefrontal rTMS in major depressive disorder: a systematic review and meta-analysis. Psychiatry Research, 338:115979. ISSN 0165-1781 (doi:https://doi.org/10.1016/j.psychres.2024.115979) Item availability restricted.
- Essex, Ryan , Booth, Lesley, Sirois, Fuschia, Burch, Jennifer and Dibley, Lesley (2024) A scoping review of the qualitative literature reporting experiences of living with a stoma for inflammatory bowel disease. Journal of Advanced Nursing. ISSN 0309-2402 (Print), 1365-2648 (Online) (doi:https://doi.org/10.1111/jan.16254)
- Yoshimatsu, Yuki, Hansjee, Dharinee, Smithard, David and Enderby, Pamela (2024) Referral patterns to speech and language therapy in the UK before, during and after the Covid-19 pandemic: dysphagia compared with communication disorders. Folia Phoniatrica et Logopaedica. pp. 1-9. ISSN 1021-7762 (Print), 1421-9972 (Online) (doi:https://doi.org/10.1159/000539436)
- Hsu, Tien-Wei , Yeh, Ta-Chuan, Kao, Yu-Chen, Thompson, Trevor , Brunoni, Andre R., Carvalho, Andre F., Hsu, Chih-Wei, Tu, Yu-Kang and Liang, Chih-Sung (2024) The dose-effect relationship of six stimulation parameters with rTMS over left DLPFC on treatment-resistant depression: a systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews:105704. ISSN 0149-7634 (doi:https://doi.org/10.1016/j.neubiorev.2024.105704)
- Essex, Ryan and Kalocsanyiova, Erika (2024) Australian immigration detention and its impact on healthcare professionals and the Australian healthcare community. In: Peterie, Michelle, (ed.) Immigration Detention and Social Harm: The Collateral Impacts of Migrant Incarceration. Routledge - Taylor & Francis, New York. ISBN 978-1003370727 (In Press) (doi:https://doi.org/10.4324/9781003370727)
- Clark, Andrew, Ahmed, Anya, Blezard, Eve, Elder, Bernadette, Groves, Vanda and Haynes, Dave (2024) Developing age-friendly communities in an emergent post-pandemic world. Report. University
- Ojo, Omorogieva , Kalocsanyiova, Erika , McCrone, Paul , Elliott, Helen, Milligan, Wendy and Gkaintatzi, Evdoxia (2024) Non-pharmacological interventions for Type 2 diabetes in people living with severe mental illness: results of a systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 21 (4):423. pp. 1-25. ISSN 1661-7827 (Print), 1660-4601 (Online) (doi:https://doi.org/10.3390/ijerph21040423)
- Liu, Ting, Liu, Bin, Jiang, Yi-qing, Ojo, Omorogieva , Jiang, Xiao-song, Wang, Yu-yu, Wang, Can and Wang, Xiao-hua (2024) Effects of different dietary fiber supplement strategies on incidence of acute gastrointestinal injury in ICU patients: a prospective observational study. Intensive and Critical Care Nursing:103673. ISSN 0964-3397 (doi:https://doi.org/10.1016/j.iccn.2024.103673)Essex, R., 2023. The delivery of health services as resistance. Bioethics.
- Essex, R., Thompson, T., Evans, T.R., Fortune, V., Kalocsányiová, E., Miller, D., Markowski, M. and Elliott, H., 2023. Ethical climate in healthcare: A systematic review and meta-analysis. Nursing Ethics, p.09697330231177419.
- Dibley, L., Hart, A., Knowles, C.H., Kerry, S., Wade, T., Terry, H., Verjee, A., Fader, M. and Norton, C., 2023. Supported Intervention Versus Intervention Alone for Management of Fecal Incontinence in Patients With Inflammatory Bowel Disease: A Multicenter Mixed-Methods Randomized Controlled Trial. Journal of Wound, Ostomy and Continence Nursing, 50(3), pp.235-244.
- Ojo, O. and Adegboye, A.R.A., 2023. The effects of nutrition on chronic conditions. Nutrients, 15(5), p.1066.
Teaching and training
CCIA members teach into faculty programmes according to their subject or methodological expertise. We are also beginning, together with other Centres in the Institute for Lifecourse Development, to develop methodology short courses for aspiring researchers.
News and events
The Centre for Chronic Illness and Ageing is represented at a broad range of local, national, and international conferences, and public-facing knowledge exchange events. Most chronic illnesses have a charity which works on behalf of patients, and these often fund our work; therefore, many of CCIA findings are disseminated via the relevant Third Sector organisation.
In addition, we have recently held the following events, some of which are annual:
- The Hermeneutic Phenomenology Summer School – an annual three-day event exploring the philosophy and methodology of hermeneutic phenomenological research
- The Hermeneutic Phenomenology conference – an annual one-day event providing a platform for presentation and demonstration of the applicability of HP research in practice
- CCIA Knowledge Exchange Events – up to three one-day events per year presenting Centre research and supporting knowledge transfer in lay accessible formats. Produces videos and podcasts.
- Explaining Population Trends in Cardiovascular Risk: A one-off research dissemination and knowledge exchange event in London.
We also hold internal, bi-monthly Centre meetings to which external experts are invited to discuss their work. Finally, CCIA publishes a digital newsletter, disseminating a wide range of opportunities and relevant events.
Contact Us
Ryan Essex, Marianne Markowski or Lesley Dibley – or via the ILD
R.W.Essex@Greenwich.ac.uk
A.M.Markowski@Greenwich.ac.uk
L.B.Dibley@Greenwich.ac.uk
ILD@Greenwich.ac.uk
