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Funders:
The Wellcome Trust

Results

Exploring the relationship between the quality and availability of primary care services and demand for emergency care. 02 May 2017

Despite the implementation of a number of programmes, crowded accident and emergency (A&E) departments and increasing unplanned hospital admissions are now two of the biggest challenges facing the NHS. There is currently a focus on policies to reduce A&E attendances through changes in primary care, despite limited evidence of a relationship between the availability and quality of primary care services and the demands placed on secondary care. The focus of this PhD is to utilise a newly available and underutilised administrative dataset of all A&E attendances in England to examine the relationship between the volume and composition of A&E attendances and the accessibility and quality of primary care services. Firstly we will develop methodology to identify A&E attendances which could be avoided with better quality primary care and attendances which would be more appropriately treated within a primary care setting. This will establish the extent of the problem and potential scope for interventions. Once we have identified the potential scope for interventions, we will assess where best to target interventions by analysing if, and how, factors of primary care services influence the demand for emergency care. Finally we will assess the potential cost-effectiveness of current interventions.

Amount: £85,721
Funder: The Wellcome Trust
Recipient: University of Manchester

The evaluation of effective healthcare delivery in China using electronic medical records for 10 years in 0.5M participants in the China Kadoorie Biobank 02 May 2017

This DPhil project will assess the social determinants and equality in hospital care delivery and use, in 0.5 million participants who have been followed up for 10 years in the China Kadoorie Biobank. The first goal of this research is to evaluate differences in the annual rates of people hospitalised, the annual rates of hospital admissions per person, and the average length of stay (ALOS) overall and for 10 of the most frequent causes of hospitalisation (5 mostly unavoidable and 5 mostly avoidable causes) over the last 10 years and by region, hospital-tier, type of health insurance (HI) package and socioeconomic characteristics. Another goal is to study the variation in hospital care costs in China, considering LOS, and use of specialised procedures and major treatments, overall and for the 10 most frequent causes of hospitalisation over the last 10 years, by region, hospital-tier, HI package, and socioeconomic characteristics. Finally, the inequalities behind the variation in use and costs of hospital care will be investigated across regions, HI package and socioeconomic characteristics. This will provide the reliable quantitative evidence to evaluate operational defects and plan initiatives to improve healthcare delivery by individual hospitals, HI organisations and the wider community in China.

Amount: £95,184
Funder: The Wellcome Trust
Recipient: University of Oxford

Water resistance: a study of environmental justice, resilience and citizen science activism in Mexico City 02 May 2017

This research will explore resilience in the context of environmental justice, with a focus on water insecurity in Mexico City. The concept of resilience is central to public health and climate change discourse, but is rarely critiqued. Addressing this omission is crucial: resilience frameworks can conceal social inequalities, uphold political status quo, and overlook local experience. Equally, few anthropological studies have examined resilience and urban water insecurity. In Mexico City these gaps are especially prescient. The third most water-stressed city in the world, low-income neighbourhoods have limited access to water. Communities often protest in response. Drawing together an ethnographic study with the digital participatory methods of citizen science, the goals of this research are to: Understand the meaning and practices of resilience amongst people who experience water insecurity. Investigate the role of digital technology and citizen science in this space. Inform future uses of resilience in environmental justice research, design and policy. Through these objectives, the research acts at the intersection of social inequality, public health and the environment. The outcomes will contribute to anthropological theory and knowledge, open the potential for trans-disciplinary collaborations, and bring a more sensitive and ethical perspective to the overlap of climate change and health.

Amount: £96,532
Funder: The Wellcome Trust
Recipient: University College London

Central nervous system compartmentalisation and drug resistance in HIV-1 sub-type C infection 30 Sep 2017

My research proposes to study HIV compartment shifts from the CNS to the peripheral blood, the evolution of drug resistance in the CNS and the relationship between CNS co-infection with other neurotropic organisms and CNS compartmentalisation in HIV-1 subtype C. Within a longitudinal cohort I will conduct a proof-of-principle study with the aim of testing the hypothesis that the CNS is a reservoir for HIV, where independent replication with the possibility of developing drug resistant mutations that may seed into plasma on treatment interruption. I will track the dynamics of compartment shifts and the evolution of drug resistance in paired plasma and CSF before and during the course of ART over 2 years. I will follow-up patients in this cohort initiating first-line therapy, and go on to repeat paired sampling of plasma and CSF in those with low level viraemia (LLV), where I expect 20% to have CNS compartmentalised HIV. Finally, I will capitalize on collaboration with an ongoing therapeutic clinical trial of cryptococcal meningitis (CM) (the ACTA trial) to examine HIV CNS compartmentalisation and the emergence of ART resistance in the brain in patients with CM. I will benefit from having access to stored samples of paired CSF and plasma from 680 patients in this multi-centre trial in Africa. Phenotypic drug susceptibility using pseudotyped viruses with patients’ derived gag-pol in a single cycle infection assay system and genotypic assessments of compartmentalised viruses will be performed, using next generation sequencing and single genome amplification. The project builds upon the continuing close collaboration between Dr Ravi Gupta’s group at UCL and Professor Deenan Pillay at the Africa Health Health Research Institute in KZN, South Africa. The proposal complements and extends the research programs in both centres. I will have access to superb experimental science facilities in Durban where there is a major focus on HIV drug resistance and with clinical and population based research excellence at the epicentre of the HIV epidemic. The Gupta laboratory at UCL specializes in HIV drug resistance, HIV reservoirs, particularly within macrophages, with complementary skills and interests in Durban.

Amount: £291,661
Funder: The Wellcome Trust
Recipient: University College London

Signalling pathways that control T cell metabolism and T cell fate 30 Nov 2016

The laboratory will map how antigen receptor, cytokine and environmental signals integrate to control the function of T lymphocytes. We will comprehensively define signaling pathways that maintain T cell metabolism, transcriptional and proteomic landscapes. Specifically, we will comprehensively delineate the molecular details of how changing the supply of oxygen, glucose and iron impact on T cell signal transduction pathways and T cell phenotype. We will explore the ability of the Prolyl hydroxylase domain protein PHD2 and the transcription factor NFIL3 to link oxygen sensing to the control of T cell function. We will define how glucose fueled signaling pathways including those mediated by AMP-activated Protein Kinase alpha1 (AMPKa1) and the O-GlcNAc transferase (OGT) control T cell fate. We will comprehensively map how the protein tyrosine phosphatases SHP-1 and SHP-2 regulate protein phosphorylation networks in T cells and how they modulate T cell proteomes and T cell function. We will also characterize signaling pathways mediated by Phosphatidylinositol 3,4,5-trisphosphate PI-3,4,5-P(3) and define how the lipid phosphatases PTEN and SHIP1 shape T cell metabolism and T cell function. These experiments will map and define the molecular processes that determine T cell fate outcomes.

Amount: £3,954,769
Funder: The Wellcome Trust
Recipient: University of Dundee

Role of ATP in Chronic Cough 11 Jul 2017

The cough reflex is triggered by ion channels present on vagal nerve termini which can be activated by a wide variety of irritants. Utilising a P2X3 antagonist we have identified ATP as a driver of chronic idiopathic cough which is treatment refractory. However, the mechanisms are not known and it is not clear whether similar efficacy will be observed in chronic cough associated with common respiratory diseases. We have identified different neurophenotypes in patients with chronic cough associated with different lung diseases suggesting that a single therapeutic may not address cough across all indications and that mechanistic information will be required. Furthermore, upstream targets, involved in the release of ATP, may provide a broader efficacy profile as ATP has been shown to have a range of disease relevant biological effects in the lung mediated by purinoceptors. We will identify (1) whether ATP is a biomarker of treament sensitivity; (2) upstream targets involved in the release of ATP; (3) the contribution of the upper airway to ATP-induced sensations; (4) the role of ATP in mediating chronic cough across other airway diseases? This project will identify novel targets, biomarkers and the patient phenotypes that will respond to treatment.

Amount: £166,005
Funder: The Wellcome Trust
Recipient: University of Manchester

Understanding mechanisms that drive pain perception in early human development 11 Jul 2017

Pain in infancy has negative long-term consequences and its prevention is a clinical priority, but adequate treatment requires mechanistic understanding of the structural and functional development of human nociceptive circuitry. Recent scientific and technological advances provide insights into how noxious information is transmitted to the infant brain, providing a platform to ask how intrinsic brain network connectivity and the environment affect noxious-evoked brain activity, behaviour and ultimately pain perception in the developing infant nervous system. The fellowship goal is to understand the mechanisms that drive and modulate pain perception in early human development. I will ask whether inherent differences in how the brain behaves at rest influence variability in noxious-evoked activity, and will determine how this relationship is altered by environmental factors and pathology. I will establish how the development of structural and functional network connectivity alters noxious-evoked brain activity, and influences the dynamic relationship between brain activity and behaviour. I will translate this mechanistic understanding into clinical practice by conducting a clinical trial of an analgesic (fentanyl) during a minor surgical procedure, and will establish whether our newly-developed measures of noxious-evoked brain activity are suitable for use in infant analgesic dose-finding studies.

Amount: £60,000
Funder: The Wellcome Trust
Recipient: University of Oxford

Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850-2000. 30 Apr 2017

Our project investigates health risks, medical interventions and health care in English and Irish prisons between 1850 and 2000. The two systems were interconnected in terms of administrative development and the high number of Irish prisoners in English prisons, yet varied in terms of the size of their respective populations, the impact of religious bodies on reform and in the role of political prisoners in shaping health. The largest research strand explores the high incidence of mental illness amongst prisoners and the impact of the prison system on the mental health of inmates, adults and juveniles, key issues which have preoccupied prison medical services and reformers from the early nineteenth century to the current day. Further strands examine the management of medical care and disease; responses to HIV/AIDS in prisons; the impact of political prisoners on medical regimes and prisoners' rights; the health of women prisoners; and the campaigns of lay and religious reformers in see king to improve facilities. The project interrogates inherent tensions as medical staff grappled to maintain healthy and hygienic practices, while devising regimens to discipline and rehabilitate prisoners in the context of poor conditions, official disinterest and intermittent overcrowding. Our case studies also consider the categories of gender, sexuality, class, age, religion, race, migration and ethnicity and how these influenced medical interventions. Alongside the production of scholarly o utputs, and a wide range of public engagement activities, our project will address current policy debates on prison systems, medical ethics and the management of prisoners' health.

Amount: £88,465
Funder: The Wellcome Trust
Recipient: University of Warwick

Toddlers and Touchscreens: Establishing an evidence-based dialogue 31 Mar 2017

Toddlers and Touchscreens: Establishing an evidence-based dialogue

Amount: £22,828
Funder: The Wellcome Trust
Recipient: King's College London

CANDO Engagement Grant 30 Sep 2017

CANDO Engagement Grant

Amount: £256,580
Funder: The Wellcome Trust
Recipient: Newcastle University

Cell Block Science & Beyond the Walls 07 Sep 2017

Cell Block Science will build on our successful programme of delivering informal science learning in HMPs Shotts and Low Moss. By expanding the programme into HMP Perth and HMPYOI Polmont we will include women prisoners and young offenders in the programme as well as piloting integrated delivery for family learning through HMP Perth’s established family programme. To enhance this family delivery we will create a virtual school with the Childrens’ University to encourage the uptake of informal learning opportunities beyond this project. For researchers this will provide an opportunity for developing interactive, accessible activities linked to their research and, through training and delivery, to gain confidence in delivery and insight into their research. We will open this programme to researchers from all Scottish universities as well as participants from community organisations such as science centres and Zoos. The programme will be evaluated for best practice and disseminated through all possible stakeholders and interested parties, including a wider European network of prison learning providers who have already expressed an interest. In addition we aim to highlight the value of science learning in the prison curriculum to present to policy makers as evidence for including formal science learning.

Amount: £147,354
Funder: The Wellcome Trust
Recipient: University of St Andrews

Marked (Working Title) 07 Sep 2017

Marked, will be an experimental art film, an adult-oriented cartoon hoping to create a greater awareness and acceptance of the psychological impact of disfigurement, post-surgical trauma: with particular reference to the wearing of mastectomy tattoos by people with breast cancer. Featuring Alicia, who, after undergoing mastectomy surgery, declines breast reconstruction but instead decorated her scars with a tattoo. The fantastical, open-ended nature of cartoon animation itself allows Alicia to tell her story, to represent her very real, extreme, exaggerated states of being. Marked will ask/raise various complex questions and ideas about disfigurement body-image, symmetry, and subsequent post-surgical trauma: What role does symmetry play in our physical and psychological understanding of ourselves? What are the boundaries of both physical and psychological loss? What does it mean to live as a woman with a tattoo where her breasts once were? What happens to our identity/bodies after surgery? The visual manifestations of myths, folktales, personal narratives, ideas, desires and/or histories, the locations of the tattoos, the act of tattooing and the tattoos themselves are powerful responses to disfigurement that mark the sites of trauma, while marking the survival of breast cancer.

Amount: £198,900
Funder: The Wellcome Trust
Recipient: Royal College of Art

SMASHfestUK: 2018/19 - consolidation application 30 Sep 2017

SMASHfestUK is at a critical juncture: Having established a successful family festival in Deptford, specifically engaging underserved audiences, we seek to consolidate learning, deepen, embed and extend our community engagement and develop sustainability plans. Our purpose is to increase STEAM engagement for people in Deptford and their families, ultimately leading to increase STEAM study/career choices, increased engagement with research and research outcomes, and increased biomedical knowledge. Increasing science and social capital will increase opportunities for young people in STEAM careers, thus increasing social mobility and future investment in the local Deptford economy. We seek to develop a business strategy for sustainability. A manager and community outreach team will be employed throughout 2018 and 2019 to underpin the development of community clubs and workshops, with outputs culminating in SMASHfestUK delivery. The manager will focus on diversifying our income portfolio: (we have 1 established commercial sponsor, Vound, and are negotiating with Air Products and Tideway, and are also developing a commercial arm) We will continue our community-embedded hyperlocal approach measuring science-capital outcomes, whilst continuing to build our interdisciplinary community of practice, by engendering intra and inter dialogues between publics and industry, and continuing to explore innovative methods and strategies for engagement.

Amount: £60,000
Funder: The Wellcome Trust
Recipient: Refinery Productions Ltd

Objectified 30 Sep 2017

The Museum of Homelessness (MoH) is a unique initiative in the UK. The organisation and all its projects are developed by people with lived experience of homelessness, working alongside cultural professionals. MoH uses museum objects as the catalyst for verbatim theatre storytelling to explore and discuss testimonies about homelessness. For this project, Objectified, we want to investigate whether a museum object – and its story - has the power to change motivations and perceptions around the complex subjects of homelessness and health. We will use existing research around homelessness and health to underpin curatorial exploration and sharing with the public. Dr Lasana Harris (UCL), a leading social neuroscientist, will advise on the construction of the stories, drawing on his social cognition research. He will also support MoH to evaluate whether the storytelling changes people’s perceptions. MoH will partner with Groundswell, a GSK award winning homelessness health charity, Professor Kate Hardy (University of Leeds), Dr Tom Gillespie (University of Sheffield), and Dr Harris, to deliver a public engagement programme in Manchester which focuses on health and homelessness, and which engages three audiences: members of the (housed) public, people experiencing homelessness and professionals who work with homeless people in healthcare settings.

Amount: £75,000
Funder: The Wellcome Trust
Recipient: Museum of Homelessness

Cuttin' It Secondary Schools Tour 30 Jul 2017

Cuttin’ It is a multi-award winning new play about Female Genital Mutilation (FGM) by Charlene James first staged at the Royal Court in 2016. In January 2018, the Royal Court aims to revive the play for a younger audience, in collaboration with experts on the impact of FGM. We will tour the show and an accompanying workshop programme to 15 secondary schools in London and five schools in Birmingham. Through targeting schools in economically deprived areas, Cuttin’ It will reach a new, under-served audience who have little opportunity to engage with professional theatre. Key advisors will be Louise Williams- a specialist nurse in paediatric FGM at UCLH and Lorraine Anderson of Solace Women’s Aid. They will ensure medical accuracy within the play and inform about mandatory reporting and the referral process should young participants wish to disclose that they have been affected by FGM. Their expertise will help us to engage young people in the issue of FGM from a robust but culturally sensitive standpoint in a supported environment. Up to 1,800 young people aged 14-18 from across Greater London and the West Midlands will benefit and engage in the debate around the ethical, medical, and cultural issues of FGM.

Amount: £69,539
Funder: The Wellcome Trust
Recipient: Royal Court Theatre

Rare Disease Priority Setting Partnerships 30 Sep 2017

We will engage rare disease patients/carers and clinicians to identify their research priorities, in order to influence the research agenda in a way that benefits patients: we will use the established and esteemed James Lind Alliance model of Priority Setting Partnerships (PSPs), administering two PSPs for groups of related diseases. Selection of the disease areas will be made following consultation with our membership, ensuring that the project is democratic and is driven by motivated patient groups. Wellcome Trust funding will allow economies of scale through running two simultaneous PSPs, and will enable very small patient groups with restricted resources to participate. We will make the process as accessible as possible: for example, delivering surveys in accessible formats; and will facilitate the involvement of teenagers and young people. Our membership is highly motivated to take part in research - together with our own experience in steering two existing rare disease PSPs, and our policy and public affairs expertise, we are in a strong position to facilitate successful PSPs that will influence research funding and policy for the benefit of rare disease patients. By disseminating learning from the process we hope to support the establishment of further successful PSPs for rare diseases.

Amount: £60,000
Funder: The Wellcome Trust
Recipient: Genetic Alliance UK

Arting Health for Impact: Botswana, South Africa and India 30 Jun 2017

The project will explore the potential and efficacy of using street art and colllaborative design to engage the public on science and health matters in Botswana, India and South Africa. It will forge collaborations between biomedical communities and artists to install culturally-relevant and sensitive arts installations as science-health engagement in these countries. The generic hypothesis is that biomedical professionals, artists or community members, in isolation, are not capacitated to design or manage a pre-emptive health communication strategy focused on engagement. In essence, artists will be the intermediary between biomedicine and communities/public, these 3 bodies of knowledge are considered to be complimentary and necessary in the context of public health. Residency programmes between these 3 groups will allow artists to perform a visual art performance with better understanding of specific illnesses/science to incorporate in real-time art installations. The project will track immediate and retained knowledge of a sample of the audience members in each country as measure of evaluation. It will explore best practice in each country, as the premptive step to scaling the project to additional countries. Outputs: 1. Art residencies 2. Street art installations in public spaces 3. Publication 4. Photography and videography documentation 5. Online media platforms

Amount: £100,000
Funder: The Wellcome Trust
Recipient: Infers Group

Poplar Wellbeing Pavilion 30 Jun 2017

Partners: Poplar HARCA Housing, Trees for Cities, UCL Urban Sustainability & Resilience PhD research, community architects: AzuKo and Rural Studio USA. Through a 4-month programme of inspiring public activities and events, this ground-up initiative explores the complex relationship between wellbeing and the built environment. Sited around a purpose-built pavilion on the Lansbury Estate, Poplar, weekly activities will animate and influence a new community-owned urban space. Dialogue, dancing, fitness, horticulture, literacy and design events, will catalyse exchange and make collaborations visible. Bookended by two major architecture festivals, this project will reach over 2,000 participants and visitors and promote a dialogue between community networks and decision makers in design and health. The project’s scope and ambition is underpinned and made possible through its key partnerships. It aims to: - challenge embedded behaviours, attitudes and beliefs about wellbeing in the city - make local initiatives visible, extending their reach - create inspirational and inclusive activities with and for the public - engage and influence design and healthcare professionals by connecting decision-makers to community action The work will have an extensive reach and legacy. Its impact will be continuously documented and tracked, shared online and folded back into HARCA’s projects and networks.

Amount: £20,000
Funder: The Wellcome Trust
Recipient: No Organisation

Bits - A new play exploring myths about the vulva 30 Jun 2017

We are applying for funding to develop Bits, a new play for 15-25 year old women exploring the myths, anxieties and confusions that surround the vulva. Women, particularly young women, are not talking about their bits. Sex education has only just been made compulsory in England and is yet to be made compulsory in Wales, Scotland and Northern Ireland. Athletes who talk about their periods, writers who write about their vaginas and actors who show their vulvas (real ones, with hair and bits that hang) are deemed radical. This stifling silence has become a breeding ground for confusion and unrealistic aspirations that could explain disturbing patterns in female behaviour such as the significant rise in requests for labiaplasty, particularly amongst adolescents. Using a cabaret style, Bits will feature singing and stand up with a story about a mother and a daughter at its heart. We will conduct interviews and collaborate with medical health professionals to create a truthful and inclusive play that asks: what is normal? What are you worried about? How can you change that? How did we get here? The project is being supported by The Yard Theatre, London and will culminate in a sharing in the autumn.

Amount: £8,000
Funder: The Wellcome Trust
Recipient: Papermash Theatre Limited

Sick(er) R & D and Production 30 May 2017

I’m making feature film, Sick(er). I’m seeking research and development funding for companion documentary shorts of £30k, and £50k for the feature. Over three months of R&D, I’ll draw on my extensive network of scientists, psychiatrists and academic experts to create three documentary shorts with different participants who’ve had EDs beyond the stereotypical subjects. I’ll integrate a level of science and individual social-cultural context in the films. The complex intersection of lived experience and science will be transformative for audiences. The shorts will support the feature development. Sick(er) explores EDs’ impact on family life through an engaging human story. It builds on my success as a novelist and short filmmaker. I’m keen to bring my filmmaking voice to this vital subject now, as it is such an important issue. The companion documentary shorts will function independently but also support the dramatic feature film, in that they’ll connect with audiences through websites; Nowness and Little White Lies. The feature will have appeal to arthouse audiences with potential at international film festivals, followed by crossover to theatrical distribution and home entertainment release. As a BBC Films feature we are guaranteed a screening across their channels and BBC iPlayer.

Amount: £30,000
Funder: The Wellcome Trust
Recipient: Lions Den Films