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Lifecourse, wellbeing and public policy in developing countries 22 May 2006

Life course, wellbeing and public policy in developing countries There is a need to develop new frameworks which facilitate analysis of demographic and epidemiological change in developing countries. No substantial research, publication or meeting has sought to explore the potential of life course frameworks to this end. Bringing together academics from a range of discipline and backgrounds, this conference will provide a platform for a significant shift in understandings of wellbeing and health in developing countries. The conference will be divided into four sessions. The first of these will explore different approaches to conceptualising the life course and will consider their specific applications to developing countries. Different speakers will explore life course from clinical, sociological, anthropological and demographic perspectives. The second session will focus on aspects of life course which relate to fertility, reproduction and demographic change in developing countries. The third session will consider how life course frameworks can enhance our understanding of issues relating to health and wellbeing in developing countries, and will pay particular attention to policy implications. The meeting will conclude with a roundtable and a discussion of research and publication plans. It is planned that the workshop will lead on to an academic network on life course, health and wellbeing in developing countries, which will take the form of an electronic discussion forum as well as future meetings and projects.

Amount: £3,000
Funder: The Wellcome Trust
Recipient: University of East Anglia

Mitochondrial probes for oxidative stress. 08 Feb 2006

Mitochondrial probes for oxidative stress Interest has recently been focused on the damage caused to mitochondria by reactive oxygen species (ROS) such as hydroxyl (HO·), peroxyl (HO2·) and superoxide (O2·) radicals. Such damage appears to be causal in the universally experienced, but poorly understood, process of ageing. Thus, the extension of lifespan when there is calorie restriction in the diet of rats appears to arise at least in part from reduced oxidative damage to mitochondria. Furthermore, murine life span can be extended by overexpression of catalase targeted to mitochondria, where the increased removal of hydrogen peroxide will reduce ROS production and consequent damage. Oxidative stress is also important in a range of pathologies including the accelerated atherosclerosis associated with diabetes. Mitochondria are particularly susceptible to oxidative stress because much of the intracellular production of ROS arises in these organelles, particularly when a large proton motive force is generated by mitochondria respiring, but not producing ATP. Understanding the role and significance of ROS generated in mitochondria in ageing and pathologies where oxidative stress appears important has been hampered by a lack of mitochondria-targeted probes that specifically detect radicals. The aim of this research is to develop such generally useful probes and to use them to test the hypothesis that increased production of ROS in mitochondria is a major contributor to oxidative damage during hyperglycaemia (important in diabetes). The only technique that observes radicals directly and to the exclusion of all non-radical species is electron paramagnetic spectroscopy (EPR). The technique is very versatile and is useful in studies extending from simple chemical reactions in the test tube to the observation of radicals in vivo. Thus, the probes to be developed are for use with EPR spectroscopy. The specific objectives are to: (i) Design and synthesise new hydroxylamine H-atom transfer probes for EPR spectroscopy. (ii) Characterisation of their chemical reactivity with radicals and the longevity of the EPR signal produced in the presence of ascorbic acid. (iii) Determination of uptake into isolated mitochondria and whole cells. (iv) Application of probes to investigate the role of mitochondrial dysfunction in oxidative damage in hyperglycaemia (and to protect cells against cellular ageing).

Amount: £2,060
Funder: The Wellcome Trust
Recipient: University of Glasgow

'Exploiting Medical History: a practical approach' conference to be held at the University of Birmingham from 23rd to 24th October 2006. 30 Aug 2006

Exploiting Medical History: a practical approach To support Librarians, Archivists and researchers by reviewing and analysing projects intended to support research in the History of Medicine. What's happening in the History of Medicine? Research Resources in Medical History Digitisation Preparing a preservation proposal The Queen's College Oxford Medical Collections Raising money Overview of lottery funding for archives Designation scheme Cataloguing and listing Collaborative working Designation - how we did it. Choice 4 out of 6 of these workshops: a. Techniques of Conservation b. Digitisation Principles c. Benchmarks d. Digitisation in Practice e. Grant writing f. Preservation Care

Amount: £3,000
Funder: The Wellcome Trust
Recipient: Royal Society of Medicine

Children and hospitals in eighteenth-century provincial English and Scottish towns. 30 Aug 2006

'Children and hospitals in eighteenth century provincial English and Scottish towns' The pilot project will establish the feasibility of a larger scale investigation into child health and the hospital movement in eighteenth century English and Scottish provincial towns. This is a significant topic given the almost total neglect of children as a category of the sick population in this period, and especially outside London. Clearly a growing interest in child health from medical practitioners, and the beneficence of individual subscribers over-rode the blanket exclusion of the young. An examination of how children were catered for in hospitals will be a valuable addition to our understanding of hospital aims and functions, as well as attitudes towards child health. The project has three immediate aims: To establish how far and how uniformly hospital admission records recorded patients' ages, and how commonly children were treated in hospitals in different towns. This will enable me to analyse how far the young were integrated into the growing system of general hospital care. To investigate how far the treatment of children was related to the aims and interests of specific doctors or benefactors, or to the ideals of individual institutions at their foundations. This will be accessed via the hospitals' own literature, and any surviving case notes. By casting the geographical net widely (using all extant registers), I will be able to assess whether and how far ideals and practices differed at different institutions, or whether we can discern a common trend in the treatment of sick children. To address how far it is possible to draw distinctions, between in-patient and out-patient care, as it has proved to be for Northampton, and how far child patients were treated differently from adults, both socially and medically. How far were children admitted on the basis of 'interesting' conditions, and how far were they treated solely on medical need? Were they housed with adult patients, and were expectations of their behaviour the same?

Amount: £1,990
Funder: The Wellcome Trust
Recipient: Misc England

Implementing interdisciplinarity in the life sciences and society: what does it mean and how do we do it? 22 May 2006

Implementing Interdisciplinary in the Life Sciences and Society: What does it mean and how do we do it? Postgraduate students, by virtue of their positioning at the boundaries of some of these disciplines as well as their position of junior academics, often find themselves negotiating anew with established theories and methodologies as well as employing them in new ways. Events like this are important because they allow postgraduates, as junior members of the academy, to present their nascent research and conceptual frameworks in a collegial and productive environment. It is increasingly being recognised that the things that we study are best understood from an interdisciplinary methodology that combines empirical evidence and an engagement with on the social, ethical and legal implications of developments within the life sciences. How do we forge these interdisciplinary relationships? What can we expect to learn from them? How is the concept of interdisciplinarity misused? What is 'best interdisciplinary practice'? These and other questions are at the heart of what 'interdisciplinarity' means in the context of social study of the life sciences. The challenge of interdisciplinarity is one of the most important areas requiring our attention at this crucial time in the emergence of a new field, and thus an extremely timely topic for the Post Graduate Life Sciences and Society Symposia to address. The topics to be covered will attempt to engage with these questions both theoretically and practically in terms of gaining access to literatures and sites located outside of one's discipline. Gaining access and negotiating sites Inter-literacy Interdisciplinary dissemination of findings Ethical practice through multiple sites

John Gorham (1814-1899) General Practitioner. Medicine in Victorian Tonbridge. 26 Apr 2006

-        John Gorham (1814-1899) General Practitioner. Medicine in Victorian Tonbridge. This study is the story of John Gorham's education and the medical life in Tonbridge between 1836 when Gorham started in practice in the town, and his death in 1899. Aims of the study: To chronicle the life of a small town doctor who practiced almost throughout the whole Victorian era - probably the century that saw the greatest growth in population and the greatest changes in medical practice. To describe the education of the doctor, initially at the local grammar school and then as an apprentice to a local surgeon apothecary, William West, who was celebrated in his own right. To describe Gorham's education at Guys Hospital through pupil registers, casebooks, admission registers, minute books, published works of his teachers and medical journals, and so to assess his medical training there. To describe the examinations at the end of his training through archives at Royal College of Surgeons and the Society of Apothec

Amount: £3,000
Funder: The Wellcome Trust
Recipient: Misc England

Ethical Issues Relating to Contagious Disease Control. 26 Apr 2006

Title of meeting: Ethical Issues Relating to Contagious Disease Control Key issues to be discussed will focus around two core themes as follows: 1. Contagious diseases: possible barriers to effective control Given recent outbreaks of SARS, avian flu, and the possibility of an influenza pandemic, it is of utmost importance to reflect on the effectiveness and justification of outbreak management policies and protocols. Speakers from different cultural contexts will briefly present specific examples of outbreaks and focus on cultural or social barriers to effective disease control that actually did occur or that are likely to arise in the future. Examples of such barriers might be: strict rules of respect for privacy or autonomy; fear of stigmatisation; shame (e.g. for apparently failed control); lack of trust; lack of preparation; priority given to family obligations over professional obligations etc. Speakers will be invited to outline their experience of these issues, particularly in relation to SARS. For this reason, participants will be sought from China, Hong Kong, Taiwan, Singapore, Vietnam, Philippines and Canada (the worst affected countries in relation to SARS). 2. Freedom limiting measures for contagious diseases control: moral controversies and justifications We propose to have several short presentations by commentators from around the world focusing on specific controversial features of a national policy or protocol. Examples are: mandatory isolation or quarantine procedures; compulsory vaccination or treatment; allocation procedures for scarce vaccine or antiviral drugs. Each presentation will be followed by in-depth discussion of possible justifications or problems with the particular intervention. These talks will be presented mainly by experts in ethics and law from around the world, building upon the actual experiences as relayed in the first part of the seminar.

Amount: £4,800
Funder: The Wellcome Trust
Recipient: Keele University

Student electives for Krupal Shah and Ipsita Sinha. 19 Jul 2006

Epidemiological investigation into risk factors associated with acute suppurative parotitis caused by Burkholderia pseudomallei in Thai children Melioidosis is a major cause of paediatric morbidity and mortality in north east Thailand. Acute suppurative parotitis is the presenting clinical feature in one third of cases. The mechanisms by which this occurs are poorly understood. We hypothesise that bacteria gain direct entry into the parotid gland via the mouth, and that risk factors include. B. pseudomallei contamination of the mouth. The aim of this study is to develop an epidemiological tool to identify risk factors for acute suppurative parotitis in children living in north east Thailand. This will subsequently be applied during a prospective study at Sappasithiprasong Hospital.

Amount: £3,200
Funder: The Wellcome Trust
Recipient: Mahidol University

Student elective for Edward Prior. 19 Jul 2006

Despite effective therapeutics and detection strategies, the prevalence and incidence of leprosy is still a public health concern across parts of Africa, Asia and South America. There is also much that remains unknown about its transmission and pathophysiology. Importantly it is not yet understood why some people are able to contain the infection and remain healthy whereas others succumb to the disease because they are unable to mount an effective immune response. The host response to this disease ranges along an immunological spectrum. T helper cell type 1 leprosy responses, distinguished by IFNg expressin, result in paucibacillary (tuberculoid) leprosy where bacteria re contained and destroyed. Multibacillary (lepromatous) leprosy is characterised by Th2 cells expressing IL4 which are unstable and can switch from protective to susceptible depending on the immunological status of the host. Leprosy is caused by Mycobacterium leprae. It infects primarily Schwann cells and macrophages. Host responses to infection involve the formation of granulomata, an attempt by the host to contain and destroy the bacteria. Those with tuberculoid leprosy mount an effective cell mediated immune response with T cell activated macrophages killing the bacteria. There is an absence of an effective T cell response in lepromatous granulomata and macrophages are unable to kill their bacterial load. However, in an attempt to control infection there is further macrophage recruitment. It is the role of these fresh cells that my host laboratory are currently investigating as part of their efforts to establish an in vitro granuloma model. Work published by Dr Adams' laboratory has shown, in mice, that activation of freshly recruited macrophages is able to reduce the viability of M. leprae even in the absence of T cells. During my elective period we would like to further investigate the role of human macrophages using an in vitro model.

Amount: £1,200
Funder: The Wellcome Trust
Recipient: University of Nottingham

Student elective for Rosalie Douglas. 19 Jul 2006

Knowlesi malaria infections among humans in the Kapit Division of Sarawak, Malaysian Borneo. Malaria in humans is commonly caused by 4 species of Plasmodium: P. falciparum, P. vivax, P. malariae and P. ovale. It was recently reported that more than half of 208 hospital admissions for malaria in the Kapit Divison of Malaysian Borneo that were studied were due to P. knowlesi (Singh et al., 2004), a malaria parasite of long-tailed and pig-tailed macaque monkeys. Due to the morphological similarities between P. knowlesi and P. malariae, these infections were misdiagnosed by microscopy mainly as P. malariae. Correct identification required the use of newly developed P. knowlesi -specific primers in a nested PCR malaria detection assay. This assay can detect between 1-6 parasites per µ1 blood and is more specific and sensitive than microscopy, which has a limit of detection of approximately 100 parasites per µ1 blood. The Kapit Division of Sarawak is the largest of the administrative divisions with an area of 38,934 m2 and a population of 101,120. The people of the divisions are served by one district hospital at Kapit Town and 22 health clinics. People that are found to be positive for malaria by microscopy at the Kapit Polyclinic are admitted into Kapit Hospital. Those that are negative by microscopy for malaria are usually not admitted into hospital unless their medical condition is serious. It is not known whether a number of patients with malaria, particularly knowlesi malaria, are not diagnosed with malaria by microscopy due to low parasite counts and return to their communities and are potential source of human infections. Preliminary data has indicated that monkeys in Kapit are infected with P. knowlesi but it is not clear whether monkeys are the source of the infections or whether the parasite has switched hosts and transmission is human-to-human. Clustering of knowlesi malaria cases within longhouse communities, particularly among children, would suggest that human-to-human transmission is occurring. In order to examine whether clustering of knowlesi malaria cases occurs, it is essential that all malaria infections be detected. The main aims of the project are to accurately determine the number of outpatients at Kapit Polyclinic that are infected with malaria parasites, determine the sensitivity of detection of malaria by microscopy at Kapit Polyclinic and determine whether clustering of cases occur within longhouse communities.

Amount: £1,600
Funder: The Wellcome Trust
Recipient: Queen's University Belfast

Psychiatric Discourse, Colonization and Social Representation of Insanity in the British Colony of Grenada, West Indies 1900-1950. 12 Jun 2006

The social history of madness in the British West Indies to date has not yet been examined. Very little scholarship has been undertaken about madness in the colonial context. Colonisation, colonial psychiatric medicine and colonial ideologies have shaped the dissemination of knowledge. West Indian society has therefore been constructed as a society devoid of any cultural past and defined as a dualistic society, African and European. In any analysis of insanity in the British West Indies it is critically important to understand on a broader basis the social, political and economic influences that shaped complex day-to-day interactions within the West Indies. Psychiatric medicine illuminates the overlapping of layers of attitudes, suffering and dehumanization of people under colonialism, a system in which race is a key factor for conflict. Under such a system psychiatry is a complex area to analyse and study. This complexity is a result of social, political, economic, medical and administrative factors that have determined rates of admission, of release and readmission, length of stay and diagnosis, etc. In Grenada specifically, many factors therefore needed to be considered in examining the psychiatric discourse, colonization and the social representation of insanity 1900 - 1950. This study will therefore be the first of its kind to research and analyse the social history of psychiatry in Grenada between 1900 - 1950. Psychiatry offers a new direction through which the interpretation of historical text and patient records in Grenada can be understood.

Amount: £1,500
Funder: The Wellcome Trust
Recipient: Oxford Brookes University

'Self-destruction': Suicide, lunacy and the asylum in nineteenth century England. 22 May 2006

'Self-destruction': Suicide, lunacy and the asylum in nineteenth century England Influenced by an important article by Shepherd and Wright, which pointed out the paucity of research on the asylum's response to suicide, I focused on the issue of suicide prevention during the era of 'Non-restraint' for my MA dissertation. That work is being developed with a much broader investigation of the relationship between insanity, suicide and the asylum during the nineteenth century. My intention is that the project's findings should contribute to the historiography both of psychiatry and institutions. The central question to be addressed is how the admission, treatment and management of suicidal patients in the asylum altered and adapted during the course of the century. Changes in practice will are being assessed in the context of the changing nature of the asylum and its management, and the transformation of 'mad-doctoring' into the emerging psychiatric profession. Alongside these broader changes is an in-depth consideration of how gender, social class, and cultural attitudes impacted upon the asylum's handling of the suicidal insane. The key research issues are to be addressed using qualitative data gathering and analysis. Administrative and medical records are being drawn from a rural/urban cross-section within the Midlands region, concentrating particularly, on Birmingham and the counties of Leicester and Worcester. This comparative study is based largely on detailed examination of patient records including certificates of insanity, casebooks and annual reports. The study will consist of six chapters, encompassing discussion and consideration of suicidal behaviour, the public, professional and institutional response to the suicidal insane, treatment and management of patients, and finally, the 'official' role of the Commissioners in Lunacy.

Amount: £1,500
Funder: The Wellcome Trust
Recipient: Misc England

Slippery slopes in the history of in vitro fertilisation and therapeutic cloning: the influence of ethical argument on the development of law and policy. 26 Apr 2006

IVF and embryo research have been the subject of controversy for more than thirty years and have been attacked on the basis that allowing them is the beginning of a 'slippery slope' towards eugenics, state control of reproduction and reproductive cloning. Debates about these technologies have been characterised by fears of the 'uncontrollability' of science and the consequences of uncontrolled scientific development Robin Henig argues in her history of the reproductive revolution that many of the slipper slope ethical arguments initially raised against IVF are now being used against human cloning and genetic engineering. However, she points out that many of the predictions made in arguments have not occurred. This project will test this conclusion by examining the influence of slippery slope ethical arguments on the historical development of legislation regulating IVF - a technology that is now widely accepted - and therapeutic cloning technologies. The project will: Produce empirical findings on the influence of slippery slope arguments on policy development; Examine how slippery slope concerns in public and academic ethical discourses affect policy development; Compare the outcomes predicted in these arguments, with the actual outcomes of the development of these technologies to examine the concept of fallacy within slippery slope arguments; and Consider the ethical validity of resulting legislative measures given the actual outcomes.

Amount: £3,700
Funder: The Wellcome Trust
Recipient: University of Oxford

"Signalling Sound" to be held at the University of Warwick on 7th March 2009 16 Sep 2008

International Symposium, 'Signalling Sound'

Amount: £4,967
Funder: The Wellcome Trust
Recipient: University of Warwick

Psychiatry, murder and M'Naghten in colonial context: The place for forensic psychiatric knowledge in East Africa 30 Jun 2008

This research aims to complement some work I did in Africa in January 2008 on the role and status of psychiatry in the insanity defence in colonial East Africa. The aim of this research is to evaluate the treatment of psychiatric knowledge in murder trials in which insanity defences were raised. This research will include examining trial transcripts, (especially that of Charles Ross; National Archive, CO/533/427/5), as well as medical sources (East African Medical Journal), the press (including trial reports in the East African Standard), and legal sources (especially the East African Law Reports). In addition, there is some archival correspondence at the Wellcome Library (Eugenics Society papers) about a prominent insanity trial from colonial Kenya (Ross, 1932) by the leading East African psychiatrist, HL Gordon, which encapsulated some of his eugenic arguments concerning feeble-mindedness in relation to criminal responsibility. Such sources are not available in Scotland. This research will be presented at both medical history and socio-legal studies conferences, and published in a number of academic journals and in an edited collection. It will form the basis of a larger project on this topic for which I will be seeking funding.

Amount: £3,000
Funder: The Wellcome Trust
Recipient: University of Edinburgh

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