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Results

Assessment of Exeter Partnership NHS Trust records. 20 Sep 2006

The Devon Partnership NHS Trust, providing mental health and learning disability services for Devon has decided to discard a substantial number of individual patient records, together with at least two different card indices. These materials appear to date mainly 1930s - 1960s and are to be destroyed unless archived. They represent an important resource for researchers and for the engagement of scientific and historical scholarship with the wider public. The Devon Archivist has accepted the need to house these materials on a temporary basis until an effective means of sampling and retention can be found. The rationale for retaining these materials and developing a clear model for sampling what is a collection of some ten thousand patient files can be simply stated. Earlier deposits of health records, in particular those relating to mental health, have provided a foundation for major research initiatives at the Centre, including detailed studies of mental services in south west England before 1939. Relatively few collections of patient records for the post-1918 period have survived, though they complement studies of the nineteenth century which have drawn largely on such materials. The present proposal is for a brief (approximately 3 months) investigation of the medical records to assess their scope and organisation, and to identify an appropriate strategy for future sampling. The proposal envisages funding for one member of staff (a Research Assistant) under the direction of Dr Jo Melling (the applicant), in collaboration with the Devon Archivist, but housed in the Devon Record Office. John Draisey (Devon County Archivist) has agreed to the Research Assistant using office space, telephone facilities and associated resources at the Devon Record Office. Management will be arranged by monthly meetings, with reports prepared by the Research Assistant.

Amount: £8,823
Funder: The Wellcome Trust
Recipient: University of Exeter

The performance of medicine : researching the historical writings on the ritual of tarantism. 13 Jul 2008

The project for which this grant is being sought, is for proposed archival research into specific aspects of medical history relating to the phenomenon of tarantism. The grant will allow for detailed examination of documents and sources contained within two libraries, the Wellcome Trust Library, London, and the Bodleian Library, Oxford, both of which hold significant material relating to the historical study of the medical writings concerning tarantism, which date from the 15th Century through to the present. The key goals of this archival research are that it will contribute toward the writing of a monograph, Ritual, Rapture and Remorse: the dance of the spider in Salento, under contract with Peter Lang, which is a study of the history of tarantism through different disciplinary perspectives, and includes discussion of the extensive amount of documentation within the field of the history of medicine. This will make an important contribution to dissemination of these writings, each of which demonstrates the shifts in approaches to the body, medicine and scientific and philosophical paradigms, most particularly in Renaissance and Early Modern Italy, but also moving through to the developments in psychiatric medicine during the 20th Century.

Amount: £1,297
Funder: The Wellcome Trust
Recipient: University of Exeter

MA in Medical History. 31 Aug 2007

The mind and its inexorable relationship to the early modern body caught my imagination specifically, and my dissertation was influenced as such. 'Lovesickness' became the core focus of my thesis. Not only did I discover a historiographical lacunae in this field of medical history, but, surprisingly, an incredible amount of source material relating to this disease in both popular and medical tracts of the seventeenth century. Through my research I began to establish the hypothesis that it was this period that witnessed the articulation of the female body as that primarily affected by this disease. Discovering that it was associated with sexual appetite and mental instability, I concluded that lovesickness was grounded deliberately in the fundamental characteristics of the female anatomy in order to posit her gender as sexually and mentally volatile. As such, a diagnosis of 'lovesick' served perfectly to validate a young women's exclusion from the public and intellectual domains, thus supporting the common early modern paradigm of female subjection. Yet while this may have implied the historical fiction of lovesickness, I believe that my analysis also elucidated a genuine disease that may have inspired the invention. Indeed diary entries, newspaper articles, and the predominance of the lovesick maid in popular ballads inferred that real women experienced the tumults of love both physiologically and psychologically. If permitted what I would like to investigate is the disparity in representation between the male and female versions of the disease. Was male lovesickness as much of a cultural phenomenon as the female version, or was it simply a literary relic deriving from the Middle Ages (when the term Amor Heroes implied the masculinity of the disease, as attested by the historian Mary Wack)? Did male lovesickness reside in a different area of the body to that of female lovesickness, and did love enter the body through the same channels? Was the male less, and the female more susceptible to the disease due to their humoral characteristics? Was female lovesickness more innately sexual that male? In medical accounts of authors such as Jacques Ferrand, he seats the disease potentially in the testicles, yet does not link this explicitly to sexual appetite, whilst with the seating of the disease in the womb, he does. Was the male sufferer, therefore, more prone to the melancholic rather than the erotic stage of lovesickness? And as in female accounts of the disease, was the male sufferer always young? And finally, I would like to investigate whether genuine cases of lovesickness inspired the fictive accounts of the male malady, as they did the female. Thus there are an incredible number of avenues to research in this field, if indeed I am granted the opportunity to do so.

Amount: £20,153
Funder: The Wellcome Trust
Recipient: University of Exeter

Rewriting the System of Nature: Linnaeus's Use of Writing Technologies. 13 Nov 2008

Although the cultural turn in the history of science and medicine has considerably raised awareness for the contextual importance of material artefacts and practices, medical and scientific knowledge itself is still largely seen as something which is exemplified by cognitive entities: the concepts, theories, and methodologies that scientists hold and use. This project would start from a different perspective by assuming that any form of socially organized knowledge is essentially written knowled ge, and proceeds through the development, deployment and dissemination of writing technologies. While the project focuses on the corpus of manuscripts and publications of a single scientist, Carl Linnaeus (1707 1778), I conceive it as a pilot project that will serve to develop both a terminology and a methodology that is attentive to the materiality of writing, and will have ramifications for how the history of science and medicine is done in general. In particular, it will bring historiography closer again to the defining mark of modern science and medicine: their reliance on forms of inductive reasoning operating on a social and global scale, and the concurrent emergence of ontological concepts of collective entities like species, disease categories, and human types .

Amount: £119,746
Funder: The Wellcome Trust
Recipient: University of Exeter

MA History of Medicine 29 Aug 2008

Not available

Amount: £21,442
Funder: The Wellcome Trust
Recipient: University of Exeter

An investigation of genes in key beta-cell pathways following the type 2 diabetes WTCCC genome wide association study. 31 Oct 2007

We will test the hypothesis that common variation in beta-cell genes predisposes to type 2 diabetes. We will aim to a) identify the most strongly associated SNPs in five new gene regions already identified, and b) investigate in more detail ~730 genes expressed in key beta-cell pathways. We will first genotype a panel of 768 SNPs that increase coverage in selected beta-cell genes in the 2000 cases and 3000 controls already covered by the 500K chip. This will result in information from approxi mately ~31,000 SNPs from across these beta-cell genes. We will then take the 384 SNPs with the best P values (~P80% power to detect odds ratios of 1.15-1.2 at p<1x10-7. We will work with collaborators from the two other largest type 2 diabetes genome scans and UK epidemiological based collections to further increase the confidence of our findings. Finally we will assess the role of newly associated and replicated type 2 diabetes risk variants in pre-diabetic traits including insulin secretion, fasting glucose and birth weight and growth.

Amount: £868,678
Funder: The Wellcome Trust
Recipient: University of Exeter

Monogenic diabetes in Iran. 01 May 2015

The aim of this seed project is to establish a collaboration with hospital-based researchers in Iran to understand monogenic diabetes in this Middle Eastern country. This study is important: (i) The prevalence of diabetes and obesity is high in Iran; family history and clinical criteria used in Europe may not be useful in diagnosis. Correct diagnosis is important because monogenic forms can often be treated with oral agents rather than insulin. (ii) The rate of consanguinity is high; identificat ion of new recessive mutations/genes is easier in consanguineous families, which will inform us about the underlying mechanism and diagnostic tests for monogenic diabetes. (iii) This will be the first study of the genetics of monogenic diabetes in Iran using next generation sequencing and whole-exome sequencing. I work with one of the leading groups in monogenic diabetes (led by Professors Hattersley and Ellard). I aim to (i) Establish a collaboration with Iranian clinicians and set up cohorts of monogenic diabetes. (ii) Use advances in DNA sequencing to assess the role of known and novel genes in the pathogenesis of monogenic diabetes. (iii) Use known genetic variants and non-genetic biomarkers to help classify young patients into type 1 diabetes or likely monogenic diabetes.

Amount: £93,819
Funder: The Wellcome Trust
Recipient: University of Exeter

Applying the power of genetics to increase knowledge of underlying mechanisms of recessively inherited congenital hyperinsulinism. 29 Oct 2014

This project will search for novel genetic causes of recessively inherited congenital hyperinsulinism in patients born to consanguineous parents in whom all the known genetic causes of HI have been excluded 1. Using genetic approaches to localise the genetic location of the aetiological gene I will use genome-wide SNP analysis to identify large (>3cM) homozygous segments, which are identical by descent in all 187 subjects. To refine gene localisation I will: a. Genotype additional affecte d and unaffected family members b. Search for shared haplotypes across families in ethnically matched apparently unrelated individuals c. Combine analysis of unrelated individuals with shared extra- pancreatic features d. Combine analysis of multiple families with isolated hyperinsulinism to identify shared regions of homozygosity. 2. Next generation sequencing to identify potential variants Potential aetiological variants in coding and non-coding regions will be detected within the refin ed regions of linkage by genome sequencing in key family members. 3. Confirming aetiological role of variants To define a novel aetiological gene needs replication in multiple families and finding different variants in the same gene. Therefore potential aetiological genes will be sequenced in the larger cohort. When there is clear genetic evidence we will go on perform appropriate functional studies to investigate disease mechanism(s).

Amount: £773,545
Funder: The Wellcome Trust
Recipient: University of Exeter

A Pseudo-Aristotelian Medical/Magical Arabic Manuscript. 20 Apr 2015

This project will produce a preliminary transcription and an article describing the contents of a manuscript containing an influential, previously unedited work of Arabic Hermetic magic, The Book of Venus. It will elucidate its reliance on the concept of man-as-microcosm, and other ideas central to medieval medical, philosophical, and scientific literature. By describing the relation of this manuscript to other similar manuscripts, this article will help scholars navigate an important but poorly -understood body of texts that survive mainly in manuscript form. It will also explore the decisions of the manuscripts compiler in presenting these medical-magical texts and their intriguing illustrations.

Amount: £3,189
Funder: The Wellcome Trust
Recipient: University of Exeter

Open access publishing costs 2014/15. 15 Sep 2014

Not available

Amount: £36,560
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

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

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 Cross-Disciplinary Invention of Sexuality: Sexual Science Beyond the Medical, 1890-1940. 20 Jan 2015

This project represents a fundamental rethinking of the emergence of the scientific study of human sexuality in the c19th and reconsiders how modern understandings of sexuality were constructed. We critique the hitherto dominant assumption that 'sexology' existed as a clearly understood and primarily medical field of knowledge. We present a new account of the rise of a cross-disciplinary 'sexual science' driven by dissatisfaction with exclusively medical approaches. From the 1890s, medical docto rs argued that a properly scientific understanding of sexuality required input from additional areas of knowledge (e.g. anthropology, sociology, history, literature). This project offers the first full investigation of the conceptual and cultural factors driving the evolution of a cross-disciplinary sexual science: the desire to understand the global variety of sexual behaviour; an interest in historical and cultural variation; and a new focus on the 'normal' and 'healthy' alongside the 'path ological' and 'abnormal'. We examine the ways in which these studies challenged biological explanations of sexuality, raising questions about the 'nature/nurture' divide, and brought imperially-shaped debates about race, the primitive, civilization and degeneration into the heart of sexual science. Thus the project sheds new light on the evolution of a range of categories that are central to understandings of human behaviour in the modern world. Interdisciplinary collaborations will produce m onographs, journal issues and edited collections. A stakeholder-led engagement programme will raise broader questions about the relation between medical and non-medical forms of knowledge in the past and present to address contemporary challenges surrounding sexual health and wellbeing.

Amount: £420,315
Funder: The Wellcome Trust
Recipient: University of Exeter

The evolutionary and mechanistic basis of virus host shifts. 21 Oct 2015

Despite host shifts being a major source of emerging infectious disease, we have much to learn about why hosts vary in their susceptibilities to novel pathogens and how viruses evolve in new hosts. The first goal of this fellowship is to understand what factors affect the ability of a virus to infect a novel host. I will break the infection process down into different steps to test whether differences in susceptibility are due to the ability of the virus to: bind, enter, replicate in, and exit h ost cells. I will then examine whether the ability of the virus to suppress the host immune response can determine whether it can infect novel hosts. I will investigate the relative importance of environmental versus host-genetic factors in determining the success of host shifts by determining how susceptibility changes with temperature. Next I will use viruses experimentally evolved in different species to examine how viruses adapt to host species, and what consequences this has on their abilit y to infect further hosts. Finally, I will evolve viruses in alternating hosts, using closely or distantly related species, to examine how host breadth affects the potential of a virus to infect a range of novel hosts.

Amount: £1,019,797
Funder: The Wellcome Trust
Recipient: University of Exeter

Masters in the History of Medicine 13 Jul 2010

Not available

Amount: £23,185
Funder: The Wellcome Trust
Recipient: University of Exeter

MA History of Medicine 30 Nov 2009

Our key objective is to expand and sustain a critical mass of researchers exploring three inter-related themes. 1. Environments, bodies and boundaries. Research will focus on the impact of domestic, occupational, and urban environments on medical understandings and patient experiences of disease. Revolving partly around research on stress, this strand will also focus on `sick building syndrome', child health, and the relationship between environmental change and health. 2. Sexual knowled ge, sexual experiences and health. This strand explores theories of sexuality, sexual practice and health from ancient to modern worlds. It encompasses projects on impotence and infertility, bodies, sex and health, and how representations of sexual practices in `other historical contexts have shaped modern debates. 3. Transmission and boundaries of medical knowledge. Much of our research analyses the construction and transmission of medical knowledge across time and space and exchanges betw een expert understandings and lay experiences of disease. We aim to develop these themes into a designated strand that encompasses work on the reception and dissemination of Galen s physiology and research on the cultural history of heredity. Seminars, joint conferences, staff exchange schemes and collaborative research projects will be used to disseminate research findings, strengthen international links, and facilitate comparative research.

Amount: £22,553
Funder: The Wellcome Trust
Recipient: University of Exeter

Mental illness and returning patient care in the early National Health Service: a comparative study of the admission and treatment of multiple-entry patients in English mental hospitals, c.1948-1970. 12 Nov 2009

The project addresses complex research problems of mental health care in the post-war years by concentrating on admissions, and more particularly multiple-admission patients who used mental hospitals after 1948. By examining their entry to hospital, the previous social environment of the patient as well as their clinical diagnosis can be ascertained. In addition to considering the influence of kinship and other relations, the role of medical professionals as well as inside hospital is evaluate d. The re-admission patients are examined in depth, including pattern of treatment in hospital and the circumstances of discharge. Particular attention is paid to drug dosages and specific treatments such as ECT. A chronology of admission patterns will be established to track changes affecting the patient population at large as well as the particular experience of readmissions. Control groups will be established among single-admission patients and a detailed comparison is undertaken of two s imilar but distinct regions of England, compiling a comprehensive data set of patients in each area with three levels of specific information. Contemporary rhetoric and societal changes are identified as contexts, institutional practices and patient experiences being monitored to consider the significance of therapeutic and policy initiatives.

Amount: £96,668
Funder: The Wellcome Trust
Recipient: University of Exeter