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Results

Transformations: Encountering Gender and Science 16 Jun 2018

The Rethinking Sexology team’s historical research has uncovered important material on the relationship between medical authority and ‘patient’ experience and the development of diagnostic categories/treatment protocols. We propose a public engagement programme that invites young trans people (age 16-25) to explore this material, co-conduct new research, including an oral history project, and develop an ambitious programme of creative responses leading to a performance and exhibition in four relevant high-profile venues across the UK. The plan of action has been developed during an extensive consultation period with key stakeholders, in which ideas and methodologies have been fully tested. The programme is led by the Rethinking Sexology (RS) team who has an outstanding track record in field-leading engaged research and public engagement. The team’s experience will be complimented by collaborating with a uniquely qualified group of writers, performers and youth-facilitators, known for their pioneering and award-winning work with the trans community, with whom the RS team already has long-standing collaborative relationships. The programme will deliver a set of exceptionally innovative activities that will empower young people to: contribute to and enhance health and humanities research and public engagement practices; investigate clinical and diagnostic protocols and transform clinical dialogue; shape public debate through high-quality creative outputs (exhibition/performance) that promise to be intellectually, artistically and emotionally powerful and stimulating. The co-production model at the heart of the programme will feed systematically and continually into ongoing research activities, enabling the project to stand as a beacon of good practice in engaged research and public engagement.

Amount: £147,315
Funder: The Wellcome Trust
Recipient: University of Exeter

Macromolecular Mechanisms of Microsporidia Infection Investigated by Cryo Electron Tomography 21 May 2018

Microsporidia are eukaryotic, intracellular parasites that infect most animals, including humans. They cause debilitating disease in immunocompromised individuals and are partly responsible for the global decline in honeybee populations. To infect a host cell, microsporidia employ a harpoon-like apparatus called polar tube (PT) that rapidly ejects from the spore, penetrates the membrane of a target tissue cell and transports the spore content (sporoplasm) into it. I propose to investigate the so-far unknown macromolecular architecture and mechanism of the PT using state-of-the-art cryo electron tomography (cryoET). The key goal is to examine the cellular machinery that facilitates PT release, sporoplasm transfer and target membrane penetration. This research will provide 3D molecular maps of the PT in action and thus detailed and dynamic understanding of the microsporidian infection pathway. The research will enrich our knowledge of fundamental cell biology, establish microsporidia as a eukaryotic model system for cryoET, inform new medical approaches to treat microsporidiosis and help fight the decline in honeybee populations. Seed Award funding will pave the way for my career as new independent group leader in the UK, with a high impact biomedical profile and will offer a plethora of opportunities to collaborate with academia and industry downstream.

Amount: £98,680
Funder: The Wellcome Trust
Recipient: University of Exeter

The development of insulin resistance and anabolic resistance during muscle disuse: what is the role of fuel integration? 08 Nov 2017

Skeletal muscle atrophy, which occurs during short-term disuse, is thought to be due to the development of anabolic resistance of protein metabolism and insulin resistance of glucose metabolism, although their cause is currently unknown. The primary research aim of this fellowship is to establish the role of muscle fuel availability and integration in disuse-induced insulin and anabolic resistance. In collaboration with the Medical School, I will perform two randomized, placebo-controlled studies in which young, healthy participants undergo 2 days of forearm immobilisation with placebo, Acipimox (to decrease plasma lipid availability), Formoterol (to stimulate glycolytic flux), or dietary branched-chain amino acid (BCAA) manipulation, to alter substrate availability. I will combine the arteriovenous-venous forearm balance technique, that I have recently established in Exeter, with stable isotope amino acid infusion and repeated forearm muscle biopsies to quantify muscle glucose, fatty acid, and BCAA balance, oxidation, and intermediary metabolism (including muscle protein synthesis), both fasted and during a hyperinsulinaemic-euglycaemic-hyperaminoacidaemic clamp. Two periods of research at the University of Texas Medical Branch will enable me to develop skills in mass spectrometry tracer analyses and develop a network of collaborators in the USA, both crucial for my future career investigating disuse-induced muscle atrophy.

Amount: £250,000
Funder: The Wellcome Trust
Recipient: University of Exeter

Neurobiological mechanisms of emotional relief in adolescents with a history of sexual abuse 06 Dec 2017

Adolescents who experienced childhood sexual abuse (CSA) engage in non-suicidal self-injury (NSSI) more frequently than peers exposed to other forms of abuse or no abuse. NSSI serves an important function of relief from acute negative affect. Despite providing temporary relief from distress, NSSI is also linked to higher rates of suicide and hospitalisations and the effectiveness of current clinical interventions is limited. This may be attributed to a lack of understanding the neurobiological and behavioural mechanisms that underlie NSSI as a relief function in particular in youth who experienced CSA. To address this gap, the study aims (1) to model brain activity during distress and emotional relief (i.e., NSSI) in adolescents with and without a history of CSA using functional magnetic resonance imaging and (2) to examine if adolescents with CSA select actions to 'escape' an aversive context more quickly and often compared to non-abused peers. The ultimate goal of this translational research is to understand the neurobiological and behavioural mechanisms that confer vulnerability to NSSI following CSA (Stage 1) in order to develop effective intervention and prevention strategies to keep vulnerable teenagers safe (Stage 2) . Keywords: sexual abuse, non-suicidal self-harm, relief, functional magnetic resonance imaging, translational research

Amount: £230,048
Funder: The Wellcome Trust
Recipient: University of Exeter

Open Access Awards 2017/18 30 Sep 2018

Not available

Amount: £58,344
Funder: The Wellcome Trust
Recipient: University of Exeter

The filamentous phage assembly system as a therapeutic tool 04 Dec 2017

Antibiotic resistance is a growing healthcare concern worldwide. The rise in the number of resistant bacteria is not being matched with an increase in new antibiotics or treatments. Novel ideas harnessing modern technology therefore need to be applied to address this problem in a timely manner. In this work, a phage encoded assembly system will be assessed for its potential application as a "switch" to control bacterial proliferation. By genetic manipulation of cells and viruses, protein expression, purification and high-end electron microscopy, the structure of a virus-encoded machinery in its host bacterial cell membrane will be determined in different conformational states. Furthermore, pilot experiments will be carried out to express and purify individual protein components for downstream mechanistic and high-resolution structural studies. The knowledge gained will provide many further avenues for research on our quest to develop advanced bactericides and synthetic cell-based treatments, and will deepen our understanding of bacterial pathogenicity in crops and animals, including humans. Funding for this proposal will also open up a multitude of downstream opportunities for collaboration with academia and industry, and importantly will provide me with the means to launch the crucial next stage of my career as an independent investigator.

Amount: £99,386
Funder: The Wellcome Trust
Recipient: University of Exeter

A Healthy Interest: diets, exercise, and ideal bodies in England and Holland, 1650-1800. 08 May 2018

My thesis will analyse diet and exercise advice and practices to investigate attitudes to ‘healthy bodies’ in Dutch and English printed medical literature, physician’s casebooks, patient-physician correspondence, and recipe books between 1650 and 1800. With modern concerns around increasing obesity rates and an ever-growing body of dietary advice in both medical and popular literature, a study of diets and exercise in the past can help us understand where our current ideas and ideals concerning body and health originate. The key goals of this project are to locate the health values and practices that were being promoted at this time; to assess to what extent dietary advice and ideals reached lay society; to analyse to what extent patients followed advice and made dietary and exercise considerations part of their ‘lifestyle’; and to examine attitudes to ‘healthy’ or ‘unhealthy’ bodies and bodily ideals in late seventeenth and eighteenth-century Dutch and English society. Examining manuscript and printed sources in a geographically comparative study will provide a rich and in-depth understanding of contemporary ‘health cultures’ and bodily ideals. In so doing the thesis will analyse how far we can identify the development of a modern ‘health culture’ in this period.

Amount: £99,441
Funder: The Wellcome Trust
Recipient: University of Exeter

Care, the great human tradition: A multi-disciplinary collaborative exploration of family care across time and culture 27 Jun 2018

There are 7 million family carers in the UK and their unpaid work has been valued at more than £132 billion per year. The demand for family care, however, is rapidly exceeding supply and carers experience serious physical and mental health problems as a result of their role. Novel approaches to supporting family carers are urgently required to ensure the sustainability of family care into the future. Archaeological, anthropological, and historical accounts of care may help carers to contextualise their role, enhancing wellbeing through connection with positive accounts of care across time and cultures. The aims of this project are to (1) bring scholars from archaeology, anthropology, and history together with contemporary care researchers, carers, and partner organisations, to develop the Collaboration for Applied Archaeological, Anthropological, and Historical Research and Engagement (CARE) Network and, (2) undertake scoping research for a large Collaborative Award application. The Collaborative Award will be used to develop a comprehensive account of family care across time and cultures, and create an evidence-based intervention for contemporary carers that can be delivered by a range of arts, education, and outreach organisations.

Amount: £29,050
Funder: The Wellcome Trust
Recipient: University of Exeter

Decolonising madness? Transcultural psychiatry, international order and the birth of a global psyche 07 Mar 2018

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.

Amount: £28,155
Funder: The Wellcome Trust
Recipient: University of Exeter

Waiting Times 01 Feb 2017

This project brings together an interdisciplinary team to investigate waiting as a cultural and psychosocial concept, and an embodied and historical experience, in order to understand the temporalities of healthcare. It represents a fundamental rethinking of the relation between time and care through a critical analysis of waiting in the modern period. Working across Medical Humanities and Psychosocial Studies, we will uncover the history, cultural representation, and psychosocial organisation of delayed and impeded time, from 1860 to the present. This work will underpin focused investigations of ‘watchful waiting’ in current general practice, psychotherapy, and end of life care. We ask which models of time operate within healthcare practices and develop new models of durational temporality to conceptualise how waiting can operate as a form of careful attention, historically and in the present. Contextualising these healthcare practices within broader social organisations of time, we open up the meanings, potentialities, and difficulties of waiting in current times. Through academic publications and extensive public engagement, we will reframe debates about waiting in and for healthcare, moving beyond the urgent need to reduce waiting times in the NHS, towards a more comprehensive understanding of the relation between waiting, care, and changing experiences of time.

Amount: £674,829
Funder: The Wellcome Trust
Recipient: University of Exeter

The Animal Research Nexus: Changing Constitutions of Science, Health and Welfare 01 Feb 2017

This five-year collaborative programme will develop approaches for understanding laboratory animal research as a nexus, asking how reconceptualising connections and generating communication across different perspectives can contribute to improving the future of animal research. New research will draw attention to historical independencies between science, health and welfare; identify challenges emerging at the interfaces of animal research and create opportunities for informing policy and public engagement. We suggest collaborative approaches are essential for understanding how rapid transformations across science and society are changing the patterns of responsibility, trust and care which hold together, or constitute, this nexus. We will deliver new: integrated research across the social sciences and humanities, using historical research to inform understanding of present challenges and create new engagement opportunities for the future; interactive research projects, co-produced with researchers, animal suppliers, veterinarians, publics and patients, to investigate the contemporary dynamics of animal research; interfaces for generating cultures of communication with publics, policy-makers and practitioners across the animal research nexus. This programme brings together five leading researchers on the social and historical dimensions of animal research, uniting the strengths of five institutions, engaging creative practitioners, and advancing the work of five early career researchers and three PhD students.

Amount: £352,781
Funder: The Wellcome Trust
Recipient: University of Exeter

Expanding the capabilities and use of the South West Regional Facility for High-Resolution Electron Cryo-microscopy 07 Dec 2016

State-of-the-art direct electron detectors (DEDs) and new image processing strategies enable electron cryo-microscopy (cryoEM) routinely to achieve near-atomic resolution of biological samples. CryoEM has thus become a primary imaging technique, increasing the need for research institutions to provide cutting-edge cryoEM equipment. The Living Systems Institute (LSI) at the University of Exeter is a brand new interdisciplinary research centre, which will develop strategies to study diseases and their prevention. As part of the GW4 group (also including Bristol, Bath and Cardiff), we seek to develop regional research infrastructure on a scale beyond the capabilities of the single institutions. Within this remit, the Wellcome Trust-funded South West Regional Facility for High-Resolution Electron Cryo-microscopy will be established in Bristol, with a 200kV cutting-edge cryo electron microscope at its core. To support this venture and significantly increase the capabilities of the facility for all users within GW4, we plan to contribute a state-of-the art K3 DED with energy-filter. We also plan to establish an entry-level multiuser cryoEM facility at the LSI, supporting the research needs of local users in order to provide samples for further high-resolution analysis in Bristol and at the Wellcome Trust-funded electron Bio-Imaging Centre (eBIC) at Diamond.

Amount: £1,000,000
Funder: The Wellcome Trust
Recipient: University of Exeter

MA History 30 Jul 2017

My project researches associations between fat bodies and gender in the medical literature of early modern Europe. While modern concerns with increasing rates of obesity are reflected by a growing historical scholarship on this topic, much remains to be examined, especially concerning the link between cultural ideas about fat bodies and the medical understandings of these bodies. The purpose of this research is to assess gendered ideas in early modern medical discussions on obesity. I will do so by examining European medical texts between 1650 and 1750, particularly comparing English medical debates with those occurring in the Netherlands in the same period. The goal of this comparison is to locate and explain differences in the extent to which gendered assumptions about obesity informed medical debates in each country, in different schools of thought, and even between individuals. I will assess the nature and causes of different explanations and treatments of obesity within the context of cultural, as well as medical developments, unique to period, place, and practitioner. I will demonstrate how and why gender played a role in the diagnosis and prescriptions for cures of obesity.

Amount: £22,440
Funder: The Wellcome Trust
Recipient: University of Exeter
Amount: £63,702
Funder: The Wellcome Trust
Recipient: University of Exeter

Socialist Medicine: an Alternative Global Health History 10 Nov 2016

The aim of this Seed Award is to develop an Investigator Award application for a project on the role of socialism as concept, and socialist internationalism as practice in shaping global health history, focusing primarily on the Cold War era. The project to be developed with the help of this grant will investigate socialism and socialist internationalism simultaneously from within and from without. First, it will track how ideas of public health and medicine circulated among socialist countries and welfare states, which practices and concepts were adopted as opposed to others, and how local solutions fed back to the overall idea of health in national and international contexts. Second, it will explore how socialist medicine engaged with Western and non-aligned health systems and global health programs. The project in this sense provides a significantly new perspective on histories of global health. Key goals: develop an Investigator Award application conduct archival scoping on four continents identify research questions, concepts and methods through workshops build local research capacity and create network of research assistants, experts and scholars in key research sites develop an academic network in which the project can be embedded establish Advisory Board for research project

Amount: £47,082
Funder: The Wellcome Trust
Recipient: University of Exeter

A community approach to accelerate the discovery of the molecular basis of neurodevelopmental disorders 05 Sep 2017

The molecular causes of the majority of inherited neurodevelopmental disorders remains largely poorly understood, presenting an immense healthcare burden worldwide. The cause of such disorders in rural Pakistan typically relates to founder mutations that have accumulated due to historical ancestral population bottlenecks, followed by population expansion. Together with expert clinical input, this enables greatly empowered phenotypical, genetic and functional studies to discover the molecular causes of autosomal recessive diseases that would otherwise elude discovery, benefiting medical science and aiding disease diagnosis globally. This seed proposal will cement new collaborative relationships established by the applicant and develop infrastructure in four Pakistani Research Centres enabling invaluable new opportunities for novel neurodevelopmental disease gene discoveries. These will unravel important new biomolecular developmental processes for future exploration using stem cell and animal models that will be developed alongside this program. This project also provides opportunities to improve local knowledge of the spectrum and causes of inherited neurodevelopmental disease, greatly facilitating development of diagnostic services in Pakistan. By consolidating these collaborative relationships, while further developing the applicant’s skill set and experience, the proposal will lay foundations for long term future molecular studies to enhance scientific knowledge and define new therapeutic avenues for these devastating disorders.

Amount: £100,000
Funder: The Wellcome Trust
Recipient: University of Exeter

Quantifying the impact of the Eurasian Beaver on multiple environmental ecosystem Services 19 Mar 2017

There is limited understanding of the impact that Eurasian Beavers might have on the wide range of ecosystem services that the River Otter supports and provides. Indeed it is not understood whether any impacts might be detrimental to the river channel structure and function, or the wider landscape in the riparian zone of the river and the agro-ecosystem on the floodplain. Objectives are therefore: 1. Characterise the existing structure of the River Otter riparian zone and quantify any changes during the 2015-2019 period, relating these to Beaver activity or other processes taking place in the catchment. 2. Quantify the impact of beaver activity on water flow at a range of scales in the Otter catchment. 3. Evaluate the impact of beaver activity on water quality both in terms of water chemistry: including sediment and macronutrient (N, P, C) retention and also in terms of ecological status, as described by the macroinvertebrate assemblages in-river, at a range of scales in the Otter catchment. The PhD will deliver against all of the objectives outlined above, over a program of 3 years research.

Amount: £40,000
Funder: The Wellcome Trust
Recipient: University of Exeter

Cultures and Environments of Health 30 Oct 2016

Our vision is to create and sustain cultures and environments that enable health and well-being across the life course. Combining expertise from the humanities, social sciences and biomedical sciences, the Centre will provide a unique opportunity to work together to address health challenges facing socially and culturally diverse populations. We aim to: a) determine how health and well-being are shaped by cultural contexts, environmental conditions and social relations; b) extend the evidence base for cross-sectoral policies and interventions that help to create and sustain `healthy publics’. Building on the methodological approaches, expertise and interests of existing research groups, research will explore four core interdependent areas of enquiry that traverse disciplinary boundaries and generate innovative methods for investigating and addressing contemporary health and environmental challenges: 1. Enabling health - investigating changing experiences and meanings of health and developing methods for addressing health inequalities; 2. Health across the life course - studying patterns of emotional well-being and cognitive health in children, families, and older people; 3. Relational approaches to health - assessing the value of social relations and identities in promoting resilience and enhancing health; 4. Environmental and cultural engagement - exploring how cultures and environments can be used to promote health.

Amount: £4,094,682
Funder: The Wellcome Trust
Recipient: University of Exeter

Institutional Strategic Support Fund 07 Sep 2016

Not available

Amount: £900,000
Funder: The Wellcome Trust
Recipient: University of Exeter

MA History – Medical Pathway 03 Jul 2016

Life in Glamorgan County Lunatic Asylum 1864–1914. Research Problem: To investigate the interaction between the perspectives, practices and responses of professional staff and incarcerated patients within the Glamorgan asylum, in order both to recover the silent voice and lived experience of patients and to reveal the implementation of professional medical theories within the daily life of the asylum itself. Key Goals: To use the archival records of an individual asylum (Glamorgan County Lunatic Asylum) to ask wider questions and challenge traditional generalised narratives of asylum history. To exploit the archival asylum records in new and dynamic ways in order to recover the ‘patient voice’ and understand patients as active agents in their asylum patient experience. To consider interactions between professional staff and patients in the interpretation of the relationship between the body and the mind within the asylum To investigate how physical ‘symptoms’ were used to demonstrate mental illness, and the use of photography in casebooks to consider the idea that madness had a ’face’

Amount: £21,839
Funder: The Wellcome Trust
Recipient: University of Exeter