A collaboration between Camden People’s Theatre (CPT), King’s College London’s Lung Biology Group, and a group of Camden-based young people, Fog Everywhere is an inventive new professional theatre production looking at the impact of air pollution in the capital, explored through a playful folk history of the London fog. Developed through a programme of schools’ workshops, the production will headline a two-week festival exploring air pollution and practical ways to contribute to its reduction. It connects with Camden residents, in the top 13% of most deprived UK communities in terms of Living Environment, as well as key influencers.

With almost 10,000 people killed annually by air pollution in London, and the capital’s first ‘black warning’ issued in January 2017, the time is ripe for Fog Everywhere. The project draws on CPT’s extensive expertise presenting theatre festivals connected with urgent political issues, for instance Whose London Is It Anyway?, a festival exploring regeneration and the housing crisis that reached over 2,500 people in January 2016.

The project will make the science behind air pollution more widely understood by translating it into human stories, helping audiences reduce their environmental impact, protect their health and participate in change.

Camden People’s Theatre

CPT

King’s College London’s

Lung Biology Group

Camden

London

two-week

Camden

the top

UK

almost 10,000

annually

London

first

January 2017

Fog Everywhere

CPT

Whose London Is It Anyway

January 2016


Serum interleukin - 10 levels in asymptomatic HBsAg positive carriers and in patients with hepatitis B-related advanced liver disease in the Gambia, West Africa

the Gambia, West Africa


Our project will investigate and present the subjective experiences of tuberculosis (TB) through "swallowing the world" of TB patients and their families, medical science and its practitioners, the country’s history and political economy. In South Africa TB is still an urgent public health concern, exacerbated by HIV. The burgeoning tuberculosis epidemic South Africa faces highlights the necessity for researchers to commit to study the social and political tropes of the infection in order to contribute to, complement or challenge scientific expertise and medical practice. Integrating disciplines allows for a more dynamic understanding of infectious diseases that cannot be advanced by any discipline in isolation. The proposed interactive exposition aims to explore questions and challenge assumptions around tuberculosis from the standpoint of art and creativity. By interrupting public space, the installations will create a series of multi-sensory, visceral, interactive and inclusive exhibitions, performances, and public programs designed to generate experience and interpretation of living with and/or among tuberculosis. In order to push knowledge and experiences of TB to new understandings the project coordinators will bring their existing research findings to consult with and sketch collaborations between TB patients, their family, friends; visual artists, musicians, filmmakers, performers, engineers, medics and neighborhood organisations.

South Africa

South Africa


The aim of this project is to investigate the causes of morbidity and the response to antiretroviral therapy in HIV-infected adolescents aged 12-18 years in Harare, Zimbabwe.  The objectives are:  To investigate the spectrum of HIV-related disease in adolescents admitted to hospital, with a special focus on respiratory and febrile illnesses.  To investigate mortality, disease progression, development, sexual behaviour and psychosocial circumstances (quality of life, schooling, knowledge of HIV diagnosis) in HIV-infected adolescents before and after starting antiretroviral therapy (ART).  To investigate efficacy and toxicity of currently used ART regimes recommended by WHO in HIV-infected adolescents in Zimbabwe.  To investigate factors associated with poor clinical, developmental and psychosocial outcome one year after starting ART.  Three hundred and sixty sequential adolescents admitted to hospital medical wards will be recruited to a cross-sectional study of cause of admission.  Dedicated adolescent outpatient clinics will be set up and a cohort of HIV-infected adolescents (target number 200) will be established.  Patients will be followed up for one year after starting ART.  Follow-up data will be used to identify explanatory variables to investigate factors predictive of a poor outcome as defined at 1 year.

12-18 years

Harare

Zimbabwe

WHO

Zimbabwe

one year

Three hundred and sixty

one year

1 year


This study will be based on research of patients  notes in Bethlem Royal Hospital Archives and admission registers of London County Asylums, which are kept in the London Metropolitan Archives. The aim is to analyse the child population in Bethlem, as historians note that it admitted an unusually high number of youngsters, an earlier study found that 1069 patients under the age of twenty were taken in between 1815 and 1900. Since the hospital did not admit patients with chronic conditions, none o f its child inmates were idiot or epileptic, as was the case in most other hospitals. This makes the Bethlem cohort unique in its size and relative homogeneity.      The group studied will be under the age of fifteen, therefore the numbers will be significantly lower than 1069 of the under twenty category. This will make feasible a thorough examination of the patients  notes with the view of reconstructing the clinical picture that the admitted children presented. The findings from Bethlem will  be compared with figures from London county asylums in order to see if Bethlem was altogether unique or if its number of children inmates reflected the situation in London.

Bethlem Royal Hospital Archives

the London Metropolitan Archives

Bethlem

under the age of twenty

between 1815 and 1900

Bethlem

fifteen

under twenty

Bethlem

London

Bethlem

London


Estimating the returns to UK publicly funded musculo-skeletal-related research in terms of the net value of improved health outcomes.

UK


The research aims to study the history of the guide dogs for the blind in Britain and to reflect on their contemporary status in society. It considers the medical value of guide dogs, particularly their status as prostheses which replace the blind person's eyes, their contribution to their masters' health and their psychological benefits as companions. Britain has been the 'leading' country' in the world in the training of guide dogs and in innovation in the field. The research assesses this uni que British trajectory. It involves a 16-week research stay in Britain in the course of which the following archives and libraries will be consulted: Wellcome Trust Library, British Library, the Library of the Royal National Institute of Blind People, the BBC archives (all in London); the historical archives of the Guide Dogs for the Blind Association and International Guide Dog Federation (held in Reading). Oral history interviews will also be conducted with employees of the Guide Dogs for th e Blind Association and with guide dog owners. Following the research in Britain, the collected data will be analyzed and two scholarly articles, a number of shorter articles for popular magazines and a blog will be produced.

Britain

Britain

British

Britain

Wellcome Trust Library

British Library

BBC

London

International Guide Dog Federation

Reading

Britain

two


There is growing commitment by developing countries to achieve Universal Health Coverage (UHC). The goal of UHC is to ensure that everyone can use the health services they need without risk of financial ruin. There is however evidence that, if not well designed, these efforts tend to benefit the well-off while excluding the poor in society, resulting in highly inequitable health systems. Using multiple methods (cross-sectional survey, in-depth interviews, focused group discussions, document revi ew), the this research will explore how best UHC efforts in Kenya can be designed to offer financial risk protection for all while ensuring equity in access to needed services and the inclusion of the poor.  Key questions that will be answered by the study include; what are the determinants of inequity in use of health services? How can the poor be identified and how can healthcare services be extended to reach them? How can the institutional design and organizational capacities of health fi nancing systems ensure equity and pro-poorness? What are the perceptions and experiences of the poor and the barriers they face in benefiting from HF mechanisms? Results will inform national and international UHC policy debates and the design of health policy reform.

UHC

Kenya

UHC


Dermatology is an under-resourced area of research, however, the University of Dundee has established a critical mass of internationally competitive researchers in genetic skin disease and cutaneous therapy development.  This award will strengthen this multidisciplinary research centre and catalyze further clinically applicable research at the interface of genetics, dermatology and drug discovery.  Specifically, a large collection of diverse monogenic disorders accumulated through a UK genoderma tology network will be analysed using whole exome sequencing approaches, informed by transcriptome analysis.  Targeted sequence capture and next-generation sequencing of loci identified by genomewide association studies will discover new causative variants in eczema, in addition to streamlining analysis of the large, repetitive filaggrin gene.  Our previous genetics work has identified a number of new therapy targets tractable by small molecule approaches, which will extended here.  A profession ally-managed biotech-style cutaneous drug discovery portfolio will be developed (3 projects already initiated) and extended to run 15 high-throughput screens, supported by hit validation and early hit-to-lead chemistry, with the aim of taking at least 2 dermatology targets through to pharmaceutical partnering.  Animal and cell-culture platforms for assessing cutaneous drug/siRNA delivery/efficacy will be established.  This award will also strengthen our capacity for patient outreach and training  of new investigators.

the University of Dundee

UK

at least 2


The project will explore the history of the Scottish State Inebriate Reformatories, a short-lived initiative in the management of alcohol abuse, 1901-1925.  The existing records of the State Inebriate Reformatory in Perth will be read and surviving records from the local Inebriate Reformatories will also be looked at to address specific questions:- 1) What were the characteristics of the inmate population of these institutions?  What was the nature of the therapeutic regime they experienced?  2) What were the backgrounds of the medical men involved in the running of these institutions and how were they connected to the prior campaign for Inebriate Reformatories?  What roles did doctors play within these institutions? 3) What were the views of the Scottish psychiatric establishment toward these institutions?  What was the nature of the day-to-day relations between the Inebriate Reformatories and the Royal and District asylums.  In part this is an exploration of how easy or diffi cult it proved in practice to separate the Inebriate  from the Insane , and hence to what extent the problems associated with alcohol use were medicalised. It is hoped that this study will contribute to our understanding of alcohol abuse issues in Scotland today.

the Scottish

the State Inebriate Reformatory

Perth

Inebriate Reformatories

Inebriate Reformatories

Scottish

day

the Inebriate Reformatories

the Royal and District asylums

Scotland

today


The Sainsbury Wellcome Centre aims to understand how computation in neural circuits generates flexible behaviour—a complex, scientific challenge that cannot be tackled by any one laboratory. The Centre is in a unique position to reveal general principles that link behaviour to neural processes across scales, by relating algorithms to neural circuits, cells and synapses. We will determine how these neural elements give rise to computations contributing to innate and learned behaviours, and develop a theoretical framework that explains how flexible, adaptive behaviour arises from neural activity. We have assembled outstanding scientific talent in an exceptional environment, with access to shared resources and state-of-the-art facilities that deliver new technologies, empowering bold research. We will exploit new models of scientific collaboration by integrating experiment, theory, data science and engineering, in close partnership with colleagues at the Gatsby Computational Neuroscience Unit. Our multi-disciplinary collaborative approach extends to the training and support of early career researchers, enhancing their success within and beyond our walls. By sharing our resources, knowledge and research culture, and through initiatives with our UCL, UK and international partners, we will collectively advance global efforts to understand the neural underpinnings of behaviour.

The Sainsbury Wellcome Centre

one

Centre

UCL

UK


We aim to create a multi-user micro-imaging platform that is designed to benefit scientists at the Institute of Infectious Disease and Molecular Medicine (IDM), the University of Cape Town (UCT), and other research institutions in South Africa as well as the broader southern African region. Therefore, we seek funding for the procurement of a state-of-the-art confocal microscopy system, suitable for the multi-user environment of the UCT Confocal and Light Microscope Imaging Core Facility. This s ystem must be capable of a large variety of multi-modal and cutting-edge applications in advanced live-cell and tissue analysis, deep tissue imaging, and physiology. Together with a new super-resolution microscope for live pathogen imaging (recently approved for funding by the South African National Research Foundation [NRF]), the proposed equipment will establish the capacity within a single research campus to image non-infectious and infectious biological samples routinely, thereby placing UC T among a very limited number of institutions worldwide with this research capability. Critically, the new equipment will serve the needs of high-priority biomedical research projects, many of which are funded by the Wellcome Trust, in the Southern African region and beyond, while providing an important platform for undergraduate and post-graduate training and research capacity building.

IDM

the University of Cape Town

UCT

South Africa

African

NRF

UC T

the Wellcome Trust

the Southern African region


This thesis will investigate the impact of illness and infirmity on the lives of older people and their families in England, c.1570-1730. At this time, approximately twenty percent of the adult population was aged over sixty, and yet the health conditions of this demographic have attracted little attention. There are two key goals: the first is to ascertain how medical providers and laypeople understood and treated the diseases and disabilities of older people, and whether this constituted a concept of elderly medical care. The second aim is to uncover the personal experiences of ageing sufferers themselves, together with their carers and relatives, investigating what it was like to suffer or witness pain, sensory loss, ‘dotage’, and the prospect of death. Drawing on a range of printed and archival materials, the project will transform understandings of both old age and disease in early modern England, revealing the hitherto unnoticed importance of 'state of health' in definitions of old age. The project is of vital relevance to an array of historiographical areas, including bodies, emotions, pain, senses, religion, death, gender, and family and community relationships. It also has modern-day significance, and may spark debates about the wellbeing of an expanding ageing population.

England

approximately twenty percent

sixty

two

first

second

England

modern-day


Trypanosoma brucei and related tsetse-transmitted parasites cause significant morbidity and mortality in humans and other animals in sub-Saharan Africa. Thedevastating human disease, African sleeping sickness, threatens millions of people in some of the poorest, most remote areas of the world, and the relatedcattle disease is of huge economic importance. Together these diseases significantly impact on the economy and development of affected countries. There is a desperate need for a deeper understanding of the biology of these parasites, which can then be exploited for the development of novel approachesto combat these diseases. Here I propose to examine the nature of the parasite's metabolism for a number of reasons: (1) there are several unique features of trypanosome metabolism, (2) metabolism can underpin phenotypic variation, (3) currently little is known about how trypanosomes control their metabolism and (4) metabolic pathways can be novel drug targets. The approach I propose is to combine genome-wide forward genetics with metabolomics analysis. This approach will allow me to ascertain how genetic variation

sub-Saharan Africa

African

millions


Immunity to nematode parasites requires sequential activation of innate and adaptive immunity in a concerted Type 2 response dependent on the cytokines IL-4, IL-13 and IL-25. Our work, and that of others, has identified a novel epithelial cell type that is critical to initiation of this response, known as tuft (or brush) cells. Most significantly, tuft cells are a major source of IL-25 during gastro-intestinal nematode infection, which induces IL-13 production from innate lymphoid cell type 2 (ILC2s), to activate further innate and adaptive cell populations. They also express high levels of the enzymes that produce acetylcholine and lipid mediators implicated in immunity. Tuft cells are found in other mucosal locations, including the lungs, and are highly conserved across the Mammalia, including in ruminants where intestinal nematodes are a major problem. A fascinating aspect is their expression of taste receptors suggesting that they may chemically ‘sense’ the presence of nematodes. In this proposal we seek to (i) determine the immune effector functions of  tuft cell mediators; (ii) identify molecules from parasites that may activate tuft cells; and (iii) establish whether tuft cell functions are conserved in ruminants and may lead to new strategies for control of nematode infection in sheep.

Mammalia

iii


Innovative approaches are needed to assess quality and institutionalize quality improvement in private facilities, but rigorous evaluation of such interventions is very limited, with a particular lack of controlled designs. This study will provide new evidence on the PharmAccess model of quality improvement. The research is based on a well-articulated theory of change, linking PharmAccess activities to outputs, outcomes and impacts, and draws on both quantitative and qualitative data:- to examine changes in adherence to SafeCare standards in participating facilities to date, we will analyse the PharmAccess database which contains SafeCare scores across multiple dimensions, facility characteristics and implementation measures for at least two time points for 300 facilities in Kenya and Tanzania, using panel regression methods to identify factors associated with improvements in scores.- to evaluate the impact of PharmAccess on process quality of care we will conduct a prospective randomised controlled trial in Tanzania. Intervention facilities will receive the full PharmAccess package, while control facilities receive SafeCare assessments only with no further action. The primary outcome will be technical process quality at follow-up, with secondary outcomes of SafeCare scores, perceived quality, and business performance. The primary outcome will be measured using standardised (covert) patients and clinical role-playing vignettes.- to understand experiences and perceptions of participating facilities we will conduct in-depth interviews with staff from 30 purposively selected intervention facilities, and 8 implementing staff.- In addition to improving quality in participating facilities, PharmAccess aims to make the broader market and policy environment more conducive to the operation of a high performing private sector. We will investigate these potential effects through 30 key informant interviews with stakeholders in Kenya and Tanzania

PharmAccess

PharmAccess

SafeCare

PharmAccess

SafeCare

at least two

Kenya

Tanzania

PharmAccess

Tanzania

PharmAccess

SafeCare

SafeCare

PharmAccess

Kenya

Tanzania


By bringing GOARN Research and ISARIC partners together in the LMIC setting during COVID-19 we hope to strengthen the clinical, social science  and operational research response.

Aim: to support the roll out of the ISARIC WHO natural history protocol (known as the Clinical Characterisation Protocol - CCP) across LMICs:

Overarching goals:

 Support the roll out/uptake of the CCP across 5 countries per region, where feasible* (across four ISARIC regions of S America, Africa, S Asia  &  SE Asia).

 Support the set up and running of local dynamic clinical data dashboards in at least 10 sites per ISARIC region

 Share the aggregate data with WHO to assist with providing a global picture on the incidence and presentation of moderate to severe cases across a representation of the LMICs to inform clinical management and public health planning and control.

 Support the establishment of follow up modules and programmes for discharged hospitalised cases in 5 sites per region to evaluate longer term health impacts of COVID-19 on individual, health services and society to inform prevention and care planning.

*Brazil are in an intense first wave and reaching out to another 4 S. American countries would be challenging at the time of writing.

GOARN Research

ISARIC

four

ISARIC

S America

Africa

S Asia

SE Asia

ISARIC

WHO

first

American


Breast cancer is the second most common cancer to affect women in Ireland. Approximately 15% of breast cancers are described as triple negative breast cancer (TNBC), a subtype of breast cancer which lacks the receptors for oestrogen and progesterone and do not overexpress HER2. This renders hormone treatment and the monoclonal antibody Herceptin/Trastuzumab ineffective.

TNBC is a particularly aggressive and invasive form of breast cancer which has recently been shown to have its own unique microbiome. These microbiome may contribute in driving the pathogenic process. It is also suggested that cancer microbiomes may play a significant role in chemoresistance.

Our objective is to determine the association of the breast cancer tumour microbiome with tumour proliferation and chemotherapeutic drug efficacy. Importantly for this study, bacteria have been shown to be potentially involved in the degradation of chemotherapeutic drugs.

In summary, tumour microbiome is beginning to gain recognition as one of the hallmarks of cancer. If our research were to show a link between the microbiome and the cancer cells’ proliferation and innate resistance to treatment, it could pave the way for further investigation into possibilities of treating cancer patients with antibiotics in addition to chemotherapeutics to improve clinical outcome.

second

Ireland

Approximately 15%

Herceptin/Trastuzumab


Macropinocytosis is an evolutionarily conserved yet ill-studied endocytic process. It is characterised by the formation of Rac1-actin-dependent membrane ruffles and shares the same core machinery with the process of cell migration. Macropinocytosis can be utilised by professional antigen-presenting cells like macrophages to sample their surrounding environments for signs of infection or by cancer cells to fuel their proliferation. Despite its important roles in many pathophysiological conditions, factors that regulate macropinocytosis remain largely unclear.

Traditionally, it is believed that growth factors play a central role in triggering macropinocytosis. However, recent in vitro evidence suggests physical cues such as hydraulic pressure and membrane tension also significantly impact this process. Nevertheless, an in vivo model that intercalates physical factors in the regulation of macropinocytosis is still lacking.

This proposal looks at the highly macropinocytic macrophages and aims to combine the advantage of the mechanically tunable Xenopus embryos with the high-resolution imaging capability of zebrafish embryos and larvae to address three key questions:

 Can tissue mechanical properties affect the migration and macropinocytosis of macrophages?
 Establishing a Xenopus ex vivo primitive myeloid-derived macrophage model for macropinocytosis study.
 Can substrate stiffness affect bacterial clearance by macrophages during wounding and inflammation?

Keywords: Macropinocytosis, mechanosensing, macrophages, Xenopus, zebrafish.

Xenopus

three


After elections in Kenya in March 2013, decentralisation of management and financing of public health facilities from central to county level will begin to be implemented.  The proposed study will take place a year and a half later.  It will explore how the design and implementation of the Health Sector Services Fund (HSSF - a direct facility funding mechanism for primary healthcare facilities) varies across counties following implementation of Kenya's new constitution, and look at the perceived  impact of different HSSF designs and implementation strategies on health facility performance in three counties. These goals will be achieved through a mixed methodology, primarily qualitative, study which will: i. Describe different approaches to incorporating HSSF into the county level. ii. Explore key stakeholders perceptions of the implementation and impact of HSSF on priority setting, utilization, structural quality (availability of supplies, equipment and infrastructure), accessibili ty, adherence to user fee policies, staff motivation and community engagement. iii. Document health centre and dispensary income sources and levels, and if and how direct facility funds are included in facility income and expenditures. The study findings will contribute to on-going health sector reforms in Kenya and in other similar settings.

Kenya

March 2013

a year and a half later

the Health Sector Services Fund

Kenya

HSSF

three

ii

iii

Kenya


Are mental illnesses and the core concepts in the psychiatric toolkit universal and identical across cultures, ethnic groups and 'civilisations'? This research will offer the first substantial historical analysis of the roots of the current global mental health movement and transcultural psychiatry. It challenges the idea that the concept of a global psyche is a recent development, and aims to demonstrate that it emerged in the aftermath of WWII and during decolonisation, when Western psychiatry endeavored to leave behind its colonial legacies, and lay the foundation for a new union of Western and non-Western concepts of mental illness and healing. In this period, leading psychiatrists across the globe set about identifying and debating the universal psychological characteristics and psychopathological mechanisms shared among all cultures. My research will explore this psychiatric, social and cultural search for a new definition of 'common humanity', and analyse the core medical-historical forces behind it. The International Pilot Study of Schizophrenia will serve as a case study.

The project will involve the scoping of archives in Europe, Africa, Asia and the US, the employment of four research assistants, organisation of an international conference, and the creation of a network of researchers and practitioners in global psychiatry.

first

WWII

Western

Western

non-Western

Europe

Africa

Asia

US

four


To host a ground-breaking discussion in the UK on the relationship between brain death and organ transplantation, ~which includes all relevant perspectives and stakeholders (including critics of brain-centred definitions of death). Produce collection of papers to be published as a special issue of a medical ethics journal (willingness of the editor of Clinical Ethics (RSM Press) has already been agreed). Establish a network of philosophers, clinicians, and policymakers and others interested to inform future policy and practice.

UK

Clinical Ethics

RSM Press


Lab_13 Ghana is part of a network of Lab_13s founded on the principles of creating a space where children can explore the science questions which matterto them; where curiosity is encouraged and experiment driven by imagination. We want to inspire the next generation of passionate scientists harnessing theskills they, and their countries, need for success There are 3 (soon to be 9) Lab_13s in the UK. Lab_13 Ghana is the first to open in Africa. The lab is run by a management committee of young people, supported by a team of Scientists in Residence (SiRs), who are not teachers act as guides to the students in their investigations. For many students Lab_13 will be their first and only school experience of practical science. Lab-13 Ghana is a partnership between Lightyear Foundation, with many years experience of running participatory science sessions in Ghana schools, and Ignite!, who developed the concept of Lab_13 in the UK. The ultimate aim is for the programme to be managed locally. A Ghana Advisory Board (GAB) has beenset up to facilitate this process. A 5 month pilot is under way, taking its first students in March 2015. 22 schools have already signed up to participate. The next stage of the programme is to open a second lab alongside the pilot for 12 months. In addition to doubling the reach we will monitor the academic benefit over a longer period and work with the GAB to move towards a sustainable locally owned operation.

Lab_13 Ghana

UK

Lab_13 Ghana

first

Africa

first

Lightyear Foundation

many years

Ghana

Ignite

UK

A Ghana Advisory Board

5 month

first

March 2015

second

12 months

GAB


The study will utilize a cluster randomized controlled trial design in which a stepped-care management program is compared with care as usual (CAU) for depression in primary care. We expect the intervention program will significantly increase rate of recovery from depression than CAU at the primary end point of 6 months of trial. Among secondary hypotheses to be tested the intervention package will 1) reduce disability; 2) improve quality of life; and 3) be more cost-effective than CAU. The stud y will be conducted in urban and rural primary care clinics around Ibadan, Nigeria, serving predominantly poor people. The intervention program will consist of psychoeducation, problem solving treatment as well as pharmacotherapy to be delivered by non-physician primary health providers. Supervision and support from scarce medical and specialist personnel will be gained by the structured use of mobile telephony.  The study is designed to test the effectiveness of an evidence-based intervention p ackage for depression that is contextualized for possible scaling-up in settings with extremely low human resources as is characteristic of much of Sub-Sahara Africa.

6 months

Ibadan

Nigeria

Sub-Sahara Africa


My research explores how understandings of food allergy have changed during the twentieth century.  Despite the clinical, cultural and political significance of food allergy, there has been little historical investigation of the subject.  Although food allergy is now the subject of intense medical research, lobbying and legislation, it was considered witchcraft, a fad, or a racket  for much of the twentieth century, and an area of clinical practice that was certain to discredit those who resear ched and treated it.   The aim of this project is to examine how food allergy was transformed from a marginalised, ridiculed subject to a medical phenomenon which has changed the ways in which food is processed, marketed and consumed.  My sources will include the medical literature in which the debates about food allergy occurred, encompassing both published and archival material found in the UK and North America.  I will also use newspaper, magazine and online sources, and conduct interviews of  patients, allergists and activists who have engaged in and been affected by the debates about food allergy.  My goal will be to publish a monograph and journal articles on the subject, and to contribute to informed public debate about food allergy.

the twentieth century

the twentieth century

UK

North America


The Health Law & Regulation Unit at The University of Liverpool, would like to host an interdisciplinary conference in Liverpool to mark the ten year anniversary of The Mental Capacity Act 2005 a visionary piece of legislation for its time, which marked a turning point in the statutory rights of people who may lack capacity. As such, it is both an apt and opportune time to revisit the statute, reflecting upon its provisions and exploring how it has been operating in practice. The conference will allow for the building and sharing of interdisciplinary knowledge between law, ethics and practice in the domain of mental health regulation. It will create research collaborations that develop understanding of interactions between mental health and endeavours to regulate, govern and assist those in society who may lack capacity. The conference has the confirmed participation of academics, mental health practitioners, policy-makers and the judiciary. It is hoped it will facilitate dial ogue, knowledge exchange and the possibility of future research collaborations. Research from the conference will be disseminated; a Special Issue of The Medical Law Review has been secured. Papers from the conference will be published in 2016, in Volume 3 of the journal.

The Health Law & Regulation Unit

The University of Liverpool

Liverpool

ten year

The Mental Capacity Act

a Special Issue

The Medical Law Review


In this project, I want to understand whether the ways in which responses to migration and health are limited at a regional level in Southern Africa resonates in the Asia and the Pacific context.

Using an analysis of existing literature and original research with the International Organisation for Migration (IOM), this research will do three things:

 Suggest ways in which the newly established Migration Health and Development Research Initiative (MHADRI) network, as part of the Migration Health Research Portal committed to the development of early career researchers, could strengthen and respond to gaps in the existing literature around the roles that are and can be played by supranational, specifically regional, organisations in around issues of migration and health;
 Start to develop an understanding of intraregional migration management in Asia and the Pacific, in relation to that of intraregional migration management in Southern Africa; and
 Reflect on lessons learnt by the IOM, as a non-state organisation, in working with regional structures and actors, to better inform understandings of the working relationships between state and non-state actors across contexts.

Southern Africa

Asia

Pacific

IOM

three

MHADRI

the Migration Health Research Portal

Asia

Pacific

Southern Africa

IOM


 The MSc in Global Health within the Faculty of Social Science at the University of Southampton is a multi-disciplinary programme designed to equip students with the necessary skills to understand and respond to global health challenges. Our previous award from the Wellcome  Master's Programme Award in Humanities and Social Science enabled three talented students from low- and middle-income countries to attend this highly successful programme.  They have gained an extensive understanding of key issues in Global Health from a social science perspective as well as strong quantitative skills that provide a firm basis for a successful career in research.  They have also established enduring links with Global Health academics within the University who will continue to support and advise them.

We are now requesting funding for a further five studentships.  Three will again be ring-fenced for students from low- and middle-income countries, while the other two will be open to UK students in order to build further capacity in global health research within the UK.  In addition to gaining subject knowledge, quantitative expertise and transferable skills for the workplace, they will also be supported in planning their future careers and offered opportunities for networking and gaining specific training and experience.

MSc

the Faculty of Social Science

the University of Southampton

the Wellcome  Master's Programme Award

three

Global Health

five

Three

two

UK

UK


X-ray mammography is the most common technique for breast cancer screening, a leading cause of death in the UK, but it is often inaccurate and causes damage due to ionising radiation. Photoacoustic imaging is a promising new technique for mammography that measures ultrasound waves created by laser light absoption in structures such as blood vessels in human tissue. However, it is challenging to design an imaging system with a large penetration depth because the detection sensitivity is a complex function of many different factors. This research project will compare different ultrasound detectors to be applied to human breast imaging (photoacoustic mammography) in order to help determine what kind of detector is most promising when designing imaging systems. The detectors will be tested using phantom imaging experiments that consist of blood vessel-like tubes placed in an optically scattering liquid to represent human biological tissue. By pulsing the system with a laser, ultrasound waves will be produced and the sensor will detect them. The goal of the research is to evaluate the performance of different ultrasound sensors. In the future, this will enable the selection of an optimal ultrasound sensor for designing new photoacoustic imaging systems.

UK


Little is known about the impact of cardiovascular disease (CVD) healthcare costs on household care-seeking behaviour and risk of impoverishment in low-and middle-income countries (LMIC). Nested within PURE, an 18-country study on CVD, the goal of this project is to develop and implement standardised instruments for measuring the impact of CVD healthcare costs on patient households, and to pilot these instruments in three LMIC (Tanzania, Zimbabwe and South Africa). Data on healthcare exp enditure and utilisation collected from over 1500 household surveys will be analysed and compared against data from pictorial diaries filled out by the same households. The impact of CVD healthcare costs on catastrophic spending and likelihood of forgoing care will be analysed and the relative appropriateness of either data collection method will be assessed for subsequent research. Qualitative interviews will be conducted to examine long-term effects of distress financing (e.g. borrowing money  to finance healthcare) on household healthcare-seeking decisions and risk of impoverishment, and to identify CVD healthcare costs not captured by quantitative data collection. Tools developed by this project will subsequently be applied in all PURE countries and evidence generated will be of major importance for global health policy.

PURE

three

Tanzania

Zimbabwe

South Africa

over 1500


DESIGN- pre and post observational cohort study - a continuation of existing pilot Pulmonary rehabilitation (PR) programme with collection of quantitative data and detailed qualitative study on the optimisation of the programme contents, deployment and evaluation to inform the development of a large trial. PARTICIPANTS: Three cohorts yielding 30-40 people who have completed the PR programme. QUANTITATIVE: Details of those identified, invited, accepted and completed will be recorded. For all participants, we will record demographics, medical history and clinical features as before with new detailed evaluation of chest pains and haemoptysis. Outcome measures include incremental shuttle walking test, Clinical COPD questionnaire, MRC dyspnoea scale, spirometry and biometrics. Descriptive statistical analysis will assess the performance of the outcome measures QUALITATIVE: Semi-structured interviews with 25 participants who have completed the programme will be conducted by experienced qualitative researchers. They will be recorded in native languages, fully transcribed and translated to English. The interviews will be flexibly guided by a list of topics including: (i) facilitators and barriers to attending the programme (ii) the impact of their respiratory disease on their lives before and after the programme (iii) problems caused by attending PR (iv) improvements in the PR or its assessment (v) maintenance after PR. Five semi-structured interviews will be conducted with people who did not take part or complete PR, focusing on barriers to attending or completing PR. A focus group and upto 5 in-depth interviews with stakeholders (clinicians, administrators, community representatives and the PR team) will explore practical issues of running and extending PR in Africa. Thematic analysis will be performed by Ugandan researchers in local languages initially with further framework analysis of the translated transcripts in collaboration with the UK team

Three

English

Five

Africa

Ugandan

UK


Non-typhoidal Salmonella (NTS) such as Salmonella Typhimurium and Salmonella
Enteritidis generally cause self-limiting gastroenteritis. However, in sub-Saharan Africa,
clones of these Salmonella serovars cause invasive disease particularly in infants and
toddlers. Our overall goal is to develop vaccines to provide broad protection against
invasive non-typhoidal Salmonella (iNTS) disease. The main goal of the project is to
show that we can develop live oral Salmonella vaccines with improved safety due to
reduced transmission, designated here as Live Attenuated Non-Transmissible (LANT)
vaccines. We will complete pre-clinical safety and efficacy studies assessing the in vivo
persistence, immunogenicity, and protective efficacy of candidate S. Typhimurium and
S. Enteritidis LANT vaccines in mice. At the conclusion of this project, we anticipate
demonstrating that iNTS LANT vaccines are only shed in feces for a short duration but
are still immunogenic and can protect animals against challenge with wild-type iNTS. If
we are successful, these results will pave the way for initiating future Phase I clinical
trials using safe, live attenuated Salmonella Typhimurium and Salmonella Enteritidis
vaccines.

sub-Saharan Africa


The 1958 Birth Cohort (1958BC) recruited 17,416 British newborns 3-9 March 1958. A BiomedicalResource (58BMR) was later created by the biomedical survey (Strachan, Power, Bynner[2002/3]) to include extensive questionnaire data, physical measures and biosamples on 1958BCparticipants. The biosamples, stored in ALSPAC laboratories at the University of Bristol, includeblood, urine and saliva (9,000+ participants), DNA (8000+), lymphoblastic cell lines (7,500+). Mostparticipants providing DNA have been genome-wide-genotyped (data held at European-Genome-Phenome-Archive). Other data are held at UK-Data-Archive, managed by Centre for LongitudinalStudies. The 58BMR is used widely by biomedical, social and population scientists nationally andworldwide. 58FORWARDS will maintain and develop the infrastructure for managing, linking andreleasing biosamples/data from 58BMR, facilitating scientific exploitation by makingbiosamples/data readily available for sharing. 58FORWARDS has three aims: (1) Fund andsupport pre-existing procedures and systems that have underpinned the 58BMR for  > 10 years; (2)Ensure targeted development of key systems and procedures to meet rapid, and understandable,changes in the strategy of national funders regarding infrastructural support for major UK cohorts;(3) Ensure that access to data and biosamples from the 58BMR remains streamlined and securethrough all maintenance and development work.

British

3-9 March 1958

Strachan, Power, Bynner[2002/3

ALSPAC

the University of Bristol

European-Genome-Phenome-Archive

UK-Data-Archive

Centre for LongitudinalStudies.

three

UK


Increasing urbanisation has created epidemic incubators, fuelling infectious diseases and often increasing susceptibility to them. Longitudinal perspectives on the socio-environmental conditions which shape the emergence and 're-emergence' of infectious diseases can help to mitigate and prevent epidemics in rapidly urbanising nations. Regrettably, human health experiences throughout much of (pre-)history of urbanisation remain clouded by a lack of reliable data on disease exposure and transmissi on. This project will develop an innovative new approach, which recovers evidence for infectious disease exposure directly from the mouths of skeletons.  We have recently discovered that archaeological dental tartar (mineralized plaque) entraps and preserves DNA and proteins from multiple oral and systemic infectious disease pathogens. Uniquely, this can provide insight into past microbial landscapes and disease exposure rates  information not previously available through historical or archae ological analyses. The objectives of this project are: 1) to develop new molecular pilot data on disease exposure in the historically well-documented context of Industrial England; 2) interrogate and corroborate these pilot data drawing upon multi-disciplinary expertise in York; and 3) to forge a multi-institutional network investigating historic disease environments and the dynamics of human-pathogen co-habitation throughout the history of urbanisation. Please consider for cross-trust fundin g

Industrial England

York


Asian Bioethics Colloquium (ABC): Inaugural Meeting. The basic aim of the ABC is career development of early career bioethics scholars in Asia. This aim will be met by having all the papers delivered at the Colloquium authored by such scholars (for example by PhD candidates or junior academics). The role of the senior scholars attending will be mentoring, feedback and detailed advice on how to achieve publication in high quality journals. Asian Bioethics Review will be one outlet for publication , subject to normal peer review. The Colloquium is a collaboration between several academic bioethics centres in Asia. This inaugural meeting is being hosted by the Centre of Biomedical Ethics, NUS. Future meetings will be held in other centres in Asia. Scholarships will be provided for junior scholars whose papers have been accepted. Senior scholars will be asked to find their own funding if possible.

Asian Bioethics Colloquium

ABC

ABC

Asia

Colloquium

PhD

Asian Bioethics Review

one

Colloquium

Asia

the Centre of Biomedical Ethics

NUS

Asia


In 2012, 20,000 adults in the UK had a tonsillectomy making it one of the 20 most commonly performed operations. There is large variation in national tonsillectomy rates and it is unclear whether this disparity is warranted or unwarranted. Investigation of paediatric tonsillectomy has shown variation related to surgeon preference. I hypothesise variation in adult tonsillectomy rates is related to unwarranted factors and aim to investigate the disparity through assessment of primary care referral  and secondary care surgical listing patterns, after controlling for warranted risk factors for variation. Data will be extracted from Fluwatch, Clinical Practice Research Datalink and Hospital Episode Statistics databases.  There is no disease specific patient reported outcome measure (PROM) for adults with recurrent tonsillitis. As a result it has not been possible to compare national standards of service provision for this condition or to definitively assess the clinical effectiveness of  tonsillectomy. I aim to evaluate the psychometric properties of a German PROM (TOI-14) on a UK adult population to assess its validity in this role. The key goals are to understand the variations in management and develop a tool that accurately measures treatment for adults with recurrent tonsillitis.

UK

Fluwatch

Clinical Practice Research Datalink

German

UK


The drought that is currently affecting Cape Town has driven the implementation of maximum level water restrictions. To meet these requirements, city residents are experimenting with various water saving methods, including harvesting rainwater and recycling grey water for household use. Bucket Loads Of Health responds to the multiple health risks that are associated with these approaches to reusing water.

The project will engage residents from three communities that vary significantly in water availability. Through a series of participatory audio-visual workshops, the community participants will explore their individual and collective experiences of water shortage and water saving. The workshop outputs - including body maps, personal stories, musical narratives and short films - will create platforms for co-learning between the community participants, water scientists, government representatives and other community members. These engagements will enable the exchange of knowledge about how water saving efforts can compromise health, and generate new thinking about practical measures to make these efforts safer.

This work will emphasize the importance of public engagement in making scientific research more accessible and relevant to communities and policy makers. It will also enable policy makers to draft guidelines underlining the health-related aspects of water saving and reuse in different contexts.

Cape Town

Bucket Loads Of Health

three


Three work streams will address participatory local action (outcomes 1-3), national media (outcome 4), and global communication (outcome 5). After two years, we will have stimulated local discussion and co-designed and implemented public engagement interventions for urban environmental sustainability and health – centred on waste management - with residents of informal settlements in Kisumu, will have equipped Kenyan journalists to increase and improve scientific reporting, and will have shared case studies and interactive models as the foundation of an ambitious web presence.

Outcome 1: Both quantity and quality of public discussion of urban health and environmental sustainability will have increased, led by residents of informal settlements, with mutual learning through visits by representatives of other partner cities.

Outcome 2: Local waste management solutions – benchmarked against scientific evidence and simulations - will have been co-developed by residents of informal settlements, community-based organisations, and researchers.

Outcome 3: Visual, audio, and text materials documenting activities and solutions will have been developed through participatory processes led by Kenyan researchers and creatives, and will be available to decision-makers and local and global publics as attractive, intelligible knowledge products.

Outcome 4: Media coverage around environment and health will have increased in quantity and verified scientific quality as a result of engagement with journalists.

Outcome 5: As a springboard for work in other cities, a set of case studies including art, narratives, infographics, and interactive simulations will be available and accessed through our website. The package will be a model for public engagement in other cities.

Three

two years

Kisumu

Kenyan

Kenyan


The   Plasmodium falciparum genome contains large multigene families that code   for    hypervariable antigens, which are exported to the surface of the infected   host erythrocyte and    represent targets of naturally acquired immunity to malaria. These variant   surface antigens    (VSA) act at the host-parasite interface, ensuring parasite survival   without inducing a sterilizing    host immune response. With the exception of the well-demonstrated roles of   var-encoded P.    falciparum erythrocyte membrane protein (PfEMP)1 in virulence and immune   evasion, the    biological significance of other VSA and their role in the acquisition of   antimalarial immunity in    endemic regions is largely unknown. Here we propose to determine whether   two other VSA,    RIFINs and STEVORs, encoded by the rif and stevor multigene families   respectively, are    targets of natural immunity and whether the hypervariable regions of these   structurally-related    proteins are exposed to antibody-mediated immune selection at the   erythrocyte surface. We will    define the expression patterns and measure the naturally acquired antibody   responses to these    antigens in wild isolates of P. falciparum from coastal Kenya. By   identifying and characterising    the molecular targets of naturally acquired immunity, this research will   advance current    understandings of P. falciparum antigenic variation and the mechanisms of   natural acquisition    of protective immunity against malaria.

two

Kenya


Community engagement (CE) for biomedical research is increasingly promoted internationally. Important studies at the KEMRI-Wellcome Trust Research Programme (KWTRP) for which CE is essential but complex are those involving Most-at-Risk- Populations (MARPs) for HIV-1, including Female Sex Workers and Men who have Sex with Men (MSM). Although MARPs are a priority intervention group for the Ministries of Health, sex work and male-same-sex behaviour is illegal in Kenya. These populations can therefore face a double stigma of HIV-1, and being criminalised, stigmatised and discriminated against, including in health care. These challenges underscore the importance of research focused on these groups. However, in this context,research and even CE activities can have unintended adverse outcomes both those the research is aimed at benefiting (through increased unwanted attention), and for the broader KWTRP. A range of MARPs studies (interventional and observational; clinical, epidemiological, immunological and socio-behavioural) have been conducted in three urban areas along the Coast of Kenya: Mtwapa, Kilifi and Malindi. Many studies have been linked to cohorts of HIV-1 negative and positive volunteers (250 and 165 respectively). CE activities to date have focused on sensitizing local key stakeholders, including community leaders, district health authorities, religious leaders, partner organizations and researchers. The proposed project will be an action researchactivity aimed at strengthening locally appropriate forms of community engagement through documenting, evaluating and amending the current communication structures and activities. As is typical for action research projects, this will be a cyclic process with action and critical reflection taking place in turn.

the Ministries of Health

Kenya

three

the Coast of Kenya

Mtwapa

Kilifi

Malindi


Unlike other childhood cancers genomic abnormalities are currently not used in the clinical management of aggressive Burkitt lymphoma (BL) and we cannot predict which children will or will not respond to therapy. There is huge disparity between outcome for children with BL in high- and low-income countries ( > 90% vs 50%) and BL remains a substantial global health challenge. For those patients who do not respond to front-line treatment or who relapse, outcome is dismal in both settings. There is, therefore, a clear clinical need to identify biomarkers and new therapeutic targets. Knowledge of the key genetic defects driving the pathogenesis of BL and disease progression is essential to develop rational targeted therapies suitable for both low- and high-income countries. In this project we will use cutting-edge next-generation sequencing approaches to fully characterise the genome complexity of patients with relapsed disease. Analysis of matched diagnostic and relapse samples from children diagnosed with BL in the UK and Malawi will enable the key abnormalities associated with disease progression to be identified. Our overall aim is to identify the specific abnormalities which could be targeted by novel drugs to improve survival for children diagnosed who are currently not cured by frontline treatment.

> 90%

UK

Malawi


The project draws together collaborators with particular interests in the relationships between pornography and sexual health to examine the empirical evidence base on forms of mediated sexuality, enabling better understanding of the kinds of interventions most useful to young people. Increasingly prominent in discussions of sexual health pornography is often portrayed as a public health issue, addictive, a factor in erectile dysfunction, loss of sexual desire, changes to brain functioning, as well as worries about wellbeing and ‘healthy’ relationships. Sex and relationship education will be compulsory in the UK from 2019, and pornography will be included  but what form such ‘porn ed’ will take is not clear. Our project takes as its starting point a review of the disjuncture between dominant framings of pornography and the bodies of knowledge about pornography, health and sexuality emerging from critical forms of humanities and social sciences. In particular, as media become central to sexual practices, experiences, identities and lifestyles, we will investigate how these may be significant to sex education and sexual health interventions. These findings will contribute to networking and scoping activities which will lead to a larger funding application to develop educational resources which are deliverable, effective and useful.

UK


There has been growing interest in developing and shaping Medical and Health Humanities (MHH) in Africa. While still a nascent field on the continent, in the last six years, through conferences and meetings, the increasing visibility of MHH has resulted in discussions about what the field is; how it can shape understandings, provision, and research related to health; and how artists, academics, activists, and health care seekers and providers based in Africa can contribute to its local development and international evolution. Our project seeks to support existing, local MHH networks; foster the growth of new regional networks; and connect regional networks through the creation of a MHH Africa hub and working group.

Starting with southern and east Africa, this project will build a community of MHH researchers and practitioners and bring together people to collectively identify future projects, and to strengthen and develop formal, collaborative MHH structures. The intention is to foster a community of people involved in MHH and actively engage them in contributing to the future of the field and the network on the continent. Our vision is to build a south-led, south-to-south collaboration, which by 2025 will be an internationally recognised MHH Africa hub and working group.

Medical and Health Humanities

MHH

Africa

the last six years

MHH

Africa

MHH

MHH Africa

Africa

MHH

MHH

MHH

MHH Africa


Type 2 diabetes increases the risk of vascular disease, with co-morbid hypertension and hyperlipidaemia increasing risk further. UK studies have identified substantial ethnic differences in the risk of vascular outcomes amongst individuals with type 2 diabetes. Whether these inequalities stem from differences in healthcare usage, quality of care, or differences in treatment efficacy remains unknown.
The aim of this fellowship is to identify modifiable determinants of ethnic inequalities in vascular outcomes of type 2 diabetes in order to generate an evidence base for clinical management of diabetes tailored to the UK population.
Objectives:
1. To identify determinants of ethnic differences in access to health services and quality of preventive care for patients with type 2 diabetes using electronic health databases.
2. To examine whether patients identified as having uncontrolled cardio-metabolic risk factors are treated appropriately and equitably across ethnic groups.
3. To identify ethnic differences in trajectories of risk factor control following initiation of treatment and achievement of control to recommended targets.
4. To explore whether pharmacological treatment reduces the risk of vascular events equally across ethnic groups.
5. To develop recommendations for treatment strategies based on real world evidence of ethnic differences in risk factor profile and pharmacological treatment.

UK

UK


In 2016-2017, the "Talking Trees Project" - 'A public health/forum research addressing maternal deaths prevalent among pastoralists’ communities of Kenya’ was launched and implemented in Narok, and Kajiado Counties by the Enduring Voices Foundation (EVF).

The EVF through its Wellcome Trust’s - International Public Engagement Award, organized the ‘Talking Trees Project" around the following modules: Maternal healthcare, FGM/C, alternative rites of passage, women’s health (sexuality, pregnancy management, HIV/Aids and mortality), human rights, child development and early child-marriage. This second-project-phase will mobilize the Somali communities in Garissa and Wajir Counties, to participate in open-public-health-engagement and research forums, which will lead to voluntary public declarations on the abandonment of FGM/C.

This project will bring together researchers, health experts and the Somali communities to discuss and develop an understanding of the discrepancies between modern science and traditional practices, and to share best practices culminating from the phase-one of the ‘Talking Trees Project’ that would help minimize maternal deaths resulting from FGM/C complications. It will also help the research team in identify challenges and support gaps in research dissemination to the general public, so as to develop appropriate information materials in Somali language that actively contributes to Somali community outreach and FGM/C awareness.

the "Talking Trees Project

Kenya

Narok

Kajiado

the Enduring Voices Foundation

EVF

EVF

Wellcome Trust’s

second

Somali

Garissa

Wajir

Somali

Somali

Somali


King's College London (KCL) and its partners the Guy's and St Thomas' Foundation Trust (GSTT), King's College Hospital (KCH) and South London and Maudsley (SLAM) NHS Trusts propose a Clinical Research Facility (CRF) to support research into neuroscience and psychiatry, cell therapy, immunology and the regulation of inflammatory and immune responses. In addressing the strategically important area of mental health, the design of the KCL CRF permits us to examine the possibility that inflammatory immune responses significantly exacerbate neuropathology. Thus, optimised cell infusion therapies in a context of immunological tolerance may play a major role in the treatment of neurodegeneration, developmental disorders, and unwanted immunity against allergens, self, and cell and organ transplants. Importantly, this proposal is possible because it builds on internationally competitive research in neuroscience and in immunology that is collectively supported by several MRC and Wellcome Trust Programme Grants, and that involves three of the four MRC Centres awarded to KCL. To optimally align basic and clinical research strengths the CRF will compose a hub and spoke structure. The hub adjacent to the Institute of Psychiatry (IOP) at Denmark Hill (DH) will focus on neuroimaging and the development of novel therapeutics for mental health. The spoke at Guy's Hospital will drive the clinical application of advances in immune regulation being made in the adjacent immunological research laboratories, and will include a GMP facility for cell production. The two units will be run under a single management structure based at DH, which has established experience in GMP licensing and other major logistical aspects of clinical research. This is possible because of a strategic alliance already established between KCL, KCH and GSTT in clinical trial training, administration and delivery which is funded in part by the London Development Agency. Moreover, the focus of the CRF is aligned to the local Trusts' strategic priorities and to their long term commitment to excellence in clinical care. The CRF will play a local and regional role in training new generations of clinical researchers and support staff, and by its nature will enhance cross-disciplinary scholarship that can put UK clinical research at the leading edge. The cost of construction and equipment is estimated at £8m of which £4m is requested here; matching funding will be provided by KCL, its partners and from other sources secured through fundraising (£3m secure already).

King's College London

KCL

GSTT

King's College Hospital

KCH

South London and Maudsley

SLAM

KCL

MRC

Wellcome Trust Programme Grants

three

four

MRC Centres

KCL

CRF

the Institute of Psychiatry

Denmark Hill

DH

Guy's Hospital

two

DH

KCL

KCH

GSTT

the London Development Agency

CRF

CRF

UK

KCL


We aim to create an intergenerational longitudinal population study of chronic conditions in rural and urban Malawi, leveraging substantial existing research infrastructure, to address the lack of high-quality longitudinal-data on chronic conditions in low income sub-Saharan Africa (LI-SSA).

Our prospective cohort data will provide age-specific incidence and survival estimates for multiple chronic conditions, and improve understanding of determinants (socioeconomic, psychological, nutritional, microbial and inflammatory) of health-related trajectories over the life-course, from poor pregnancy outcomes to multimorbidity in adulthood. Understanding how early-life exposures interact with later-life factors to mediate disease risk will indicate when and how to intervene effectively.

Within rural and urban populations (110,000 individuals) we hold detailed non-communicable disease risk factor and HIV-test data in adults, plus an extensive biorepository. Procedures for longitudinal tracking, community surveillance and birth capture are well-established in rural Karonga and have been piloted in urban Lilongwe. Wellcome LPS support will enable;

1_Longitudinal tracking of 110,000 urban/ rural individuals.

2_Repeat biomarker and clinical assessments of chronic conditions.

3_Establish novel, effective migrancy tracking within/between rural/urban settings.

4_Recruit/follow 7,500 nested families (grandparents-parents-siblings-pregnancy-birth-cohort);  pregnancy, early-life and intergenerational effects.

5_Health facility linkage; low-cost longitudinal health-care/outcomes data.

This resource will be shared with the global research community to best-practice guidelines.

Malawi

sub-Saharan Africa

Karonga

Lilongwe


This project aims to answer the primary research question: Will the projected impacts of environmental changes on terrestrial food production and food quality have a demonstrable influence on nutrition and health outcomes over the next 20-30 years? The project will establish an interdisciplinary approach encompassing environmental, agricultural, nutrition, health, mathematical and social sciences to enable the mapping and quantification of the multiple pathways between environmental change and population-level food availability, food quality, dietary intake, nutrition and health outcomes over the coming decades. By taking a broad, interdisciplinary analytical approach, and applying it to country case studies, this project aims to test whether current projections of changes in agricultural production, food availability and food quality are likely to result in quantifiable impacts on nutrition and health outcomes. Key goals: 1. Define an evidence-based analytical framework linking environmental change with nutrition and health outcomes. 2. Apply the framework to three countries (UK, Mexico and Ethiopia) to identify critical nodes where policy-level action may influence nutrition and health. 3. Establish a method and analytical baseline for future modelling and scenario testing and make an inter-sectoral dataset on agriculture, food prices, nutrition and health available for public use.

the next 20-30 years

the coming decades

three

UK

Mexico

Ethiopia


Dengue fever is a major public health problem [1-3] which basically relies on vector control through the use of insecticides, larvicides [4] and Wolbachia-infected mosquitoes in Australia [5].  These control strategies are challenged by the emergence of insecticide resistance, biting time and financial constraints [6-10].  Attractive toxic sugar bait (ATSB) is an intervention that I believe may have the potential to be developed into a new tool against Aedes mosquitoes. This strategy has shown to reduce other disease transmiting mosquitoes such as Anopheles gambiae and Anopheles sergenti [11-13]. Our previous work [14] showed that by combining an ATSB with a resting place increased the bait-fed Anopheles arabiensis number compared to non-resting place. This tool (attractive toxic sugar-baited resting place (ATSB-RP)) is a new method exploiting sugar feeding behaviour of disaese vectors.
I intend to determine the Ivermectin concentration capable of killing 90% of  Aedes. Aegypti  and investigate if Ae.aegypti  will sugar feed even if the host is constantly available. Finally I will determine the percentage of wild Ae.aegypti  attracted by ATSB-RPs in the field.
My findings will introduce ATSB-RPs as a potential control tool against Ae.aegypti and may be further investigated to determine the epidemiological impact on dengue transmission.

Australia


We will test the hypothesis that mitophagy and mitochondrial biogenesis are tightly balanced, and that uncoupling this balance contributes to cellular dysfunction and disease. Errors in mitochondrial quality control lie at the heart of several important human diseases, and we intend to translate knowledge gained from our dynamic cell biology approaches to the genetically-tractable Drosophila system in order to elucidate the pathways linking mitochondrial dynamics, clearance (mitophagy) and biogenesis with the progress of neurodegenerative disease. We also plan to identify novel players in the mitophagy pathway by screening for factors required for Parkin-mediated mitophagy using a cell-based model of mitochondrial clearance. Our specific aims will be to: Describe the itinerary of a damaged mitochondrion with its exile from the mitochondrial network to its sequestration within an autophagosome. Identify and characterize new signaling pathways linking mitochondrial dysfunction with localized autophagosome formation. Explore the relationships between mitochondrial quality control and mitochondrial biogenesis in Drosophila models of neurodegenerative disease.

Drosophila