Staff Profile: Professor Margot Gosney

Name:

Professor Margot Gosney

Job title:

Director of Clinical Health Sciences

Responsibilities:

University of Reading, Research and Ethics Committee

University of Reading, Research and Ethics Committee - Professor Margot Gosney is currently the Chair of the Research and Ethics Committee, at the University of Reading.

Clinical Role - Royal Berkshire NHS Foundation Trust

Honorary Consultant in Elderly Care Medicine. Royal Berkshire NHS Foundation Trust: August 2003 - to date. 

British Geriatrics Society

Deputy Chair of the Academic & Research Committee of the British Geriatrics Society.

Research Interests:

Oncology

Whilst working as a registrar in chest medicine I developed an interest in bronchial carcinoma. This resulted in two presentations in the late 1980s to the British Geriatrics Society looking at the different presentation and pathology of bronchial carcinoma as well as the progress and survival of patients according to age. I wished to further my knowledge about the fundamental biology and behaviour of bronchial carcinoma with reference to age and I therefore approached the Northwest Cancer Research Fund to obtain sufficient funding to undertake my MD. My MD was awarded in 1993 and several publications and presentations arose which were accepted in a range of disciplines including respiratory medicine, pathology and geriatric medicine. In 1998 I was approached by Professor Ray Tallis to write the first chapter on geriatric oncology in the Textbook of Geriatric Medicine and Gerontology - one of the primary textbooks used by both undergraduates and postgraduates in geriatric medicine. I have subsequently written this chapter for the 6th and 7th editions of the textbook as well as other chapters on cancer drugs, cancer in old age for a training guide and two clinical pain management chapters pertinent to malignant disease. I have continued to be involved in a variety of oncology projects and I am on the Steering Group of ACTION, a trial studying adjuvant chemotherapy in older women with breast cancer. I am also an advisor to NICE and sit on a variety of groups representing the needs of older people with malignant disease.

Dental Science/Stroke

A project that started merely to look at nursing staff knowledge around oral care and the dental status of elderly inpatients developed into a close association with Dental Science. I became aware that dentition was particularly important in the day-to-day care of older people and that it was an area that had been poorly researched. I commenced work with an oral microbiologist within the School of Dental Science to look primarily at how various conditions affected the oral flora. Initial studies showed that the oral flora of patients following a stroke altered and they became colonised with aerobic Gram-negative bacilli (AGNB). The relevance of this is that many patients following a stroke have impaired swallowing and whilst clinicians caring for these patients may identify this problem, saliva production continues and if AGNB are present in the oral cavity they may be aspirated into the lungs when the patient attempts to swallow their own saliva. Oral selective decontamination (SDD) is widely used in the Intensive Care Unit and in patients during and after treatment of malignant disease. Its use had however, never been investigated in acute stroke patients.

This project linked with other areas of stroke research including the detection of microaspiration in patients following a stroke. One of my MPhil students (Jo Clayton), a speech and language therapist, looked at the detection of microaspiration into the respiratory tract using a tracheal pH probe.

To further study this area of research an ESRC project through the New Dynamics of Ageing was funded in 2008 and includes a work package looking at rheology to ensure that the physical properties of a variety of liquids and solids used in patients with dysphagia can be quantified.

Influenza

The Health Technology Assessment (HTA), a Government-funded research and development unit, put out a call in 1998 looking for interest in influenza vaccination of older subjects. I headed a group that were awarded almost £¼m. Our study was dogged by Government change of policy between years 1 and 2 that effectively removed the placebo arm of our study.

Whilst our findings suggested that the vaccination of fit, healthy 65-75 year olds is not cost effective we were struck by the data suggesting that frail elderly subjects who undergo vaccination against influenza may not respond with the production of adequate levels of antibodies. Further funding enabled us to study a role of micronutrients in optimising response to influenza vaccination.

This work was undertaking in parallel with a study of looking at the effect of antioxidants supplementations on the ability of cells from elderly people to respond to stress.

Clinical Research

A variety of researchers have done postgraduate higher degrees looking at pressure sore prevention, the role of micronutrients, in particular selenium in the prevention of depression and faecal incontinence in the older adult.

Nutrition

On initially arriving in Reading I set up strong links with the School of Food Biosciences. This has enabled us to successfully apply and successfully be funded by the ESRC and a variety of other agencies. Our work has focused particularly on the manipulation of sweet sip feeds and savoury hospital foods. It has brought together researchers from the Universities of Newcastle and Glasgow and diverse interests from the Dental School through to the School of Design. Researchers range from rheologists to sociologists with clinicians and speech and language therapists. The overall aim is to improve the nutritional status particularly of older people and those with swallowing difficulties in both the hospital and community setting.

This has enabled us to also work with businesses and recent funding has been secured from Nestle for a variety of innovative projects. To ensure application of research methodologies we are working closely with the world renowned chef Heston Blumenthal to ensure that all research is translational into a variety of health settings.

Recent Grants:

  • Moynihan P, Macdonald A, Methven L, Gosney M et al. 'Multidisciplinary approach to develop a prototype for the prevention of malnutrition in older people: products, people, places and procedures' (MAPPMAL). ESRC, 2008: £1,081,411.85
  • Vulevic J, Gibson G, Gosney M. 'A double blind, placebo controlled, randomised, single centred, parallel group study to determine the potential of a prebiotic to beneficially influence the colonic microflora and immune status of hospitalised elderly patients'. Clasado, 2008: £100,000
  • Gosney M, Methven L. 'Yummy Project' Optimising elderly people's nutrition. Nestle, 2009: £440,000
  • Yaqoob P, Rowland I, Tuohy K, Gosney M, Todd S. 'Immunomodulatory effects of pre- and probiotics'. DRINC (BBSRC), 2009: £723,886

Recently submitted papers: 

Gosney MA. Update on clinical geriatrics. Aging Health 2008; 4(1) 29-31

Gosney MA. Enterobacter sakazakii bacteraemia. Age and Ageing 2008; 37:236-7

Gosney MA, Hammond MF, Sherkin A, Allsup S. Effect of micronutrient supplementation on mood in nursing home residents. Gerontology 2008; 54(5):292-9

Gosney MA. General Care of the Older Cancer Patient. Clinical Oncology 2008; 21(2):86-91

Papamichael D, Audisio R, Horiot JC, Glimelius B, Gosney M et al. Treatment of the elderly colorectal cancer patient: SIOG expert recommendations. Annals of Oncology 2009; 20(1):5-16

Gosney M. Optimising cancer care for older patients. GM Midlife and Beyond; Vol 39(4); 2009:202-07

Quarini C, Gosney M. Review of the evidence for a colorectal cancer screening programme in elderly people. Age and Ageing 2009; 38(5):503-8

Gosney MA. Geriatric Oncology. Age and Ageing 2009; 38:644-645

Nyman SR, Gosney MA, Victor CR. Psychosocial Impact of Visual impairment in Working Age Adults. Br J Ophthalmol published online October 22, 2009 doi:10.1136/bjo.2009.164814

Nyman SR, Victor CR, Gosney MA. Counselling for people with sight loss in the UK: The need for provision and the need for evidence. Br J Opthalmol 2010; 94:385-386

Gosney J, Chester J, Gosney M. Current approaches to the diagnosis and management of pneumonia in older people. Prescriber 2010 March; 47:52

Nyman SR, Gosney MA, Victor CR. Emotional well-being in people with sight loss: Lessons from the grey literature. British Journal of Visual Impairment In press 2010

Kennedy OB, Law CKW, Methven L, Gosney MA. Investigating age related changes in taste and affects on sensory perceptions of oral nutritional supplements. Age and Ageing In press 2010

Methven L, Rahelu K, Economou N, Kinneavy L, Ladbrooke-Davis L, Kennedy OB, Mottram DS, Gosney MA. The Effect of Consumption Volume on Profile and Liking of Oral Nutritional Supplements of Caried Sweetness: Sequential Profiling and Boredom Tests. Food Quality & Preference In press 2010

Gange N, Gosney M. Oral Care in Stroke. Submitted to Age and Ageing 2009

Ito E, Cheun WK, Opsypiw J, Methven L, Kennedy OB, Gosney M. The Assessment of Pre-albumin as an Effective Screening Tool in Malnutrition. Submitted to Journal of Human Nutrition and Dietetics 2009

Leonard R, Barrett-Lee P, Gosney M, Willett A, Reed M, Hammond P. Effect of patient age on management decisions in breast cancer: consensus from a national consultation. Submitted to The Oncologist 2009

Nyman SR, Gosney MA, Victor C. Psychosocial Impact of Vision Loss: An Update of the Evidence. Submitted to Ageing & Society 2009

Robinson L, Johnson, Ellis, Mansi, Ring, Thomas, Gosney et al. Failure of a Randomised Trial of Chemotherapy versus observation in older women with breast cancer. Submitted to Lancet 2009

Nyman SR, Gosney MA, Victor CR. Qualitative exploration of emotional well-being and views toward support services amongst adults with visual impairment. Submitted to Disability and Rehabilitation 2009

Nyman SR, Gosney MA, Victor CR. Literature review of qualitative studies. To be submitted to British Journal of Health Psychology 2009

Mansour S, Gosney M. Attitudes Towards Elderly People: The Effect of Medical Education. Submitted to Age and Ageing 2010

Nyman SR, Dibb B, Victor CR, Gosney MA. Emotional well-being and adjustment to vision loss: A meta-synthesis of qualitative studies. Submitted to British Journal of Health Psychology 2010

Burbridge PM, Gosney MA. A Painful Hip. Submitted to CME Journal Geriatric Medicine 2010

Behrman S, Gosney MA. Lunchtime on the Elderly Care Wards. Submitted to Age and Ageing 2010

 

Contact Details

m.a.gosney@reading.ac.uk+44 (0) 118 378 6850

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