- Total grants
- Total funders
- Total recipients
- Earliest award date
- 09 Mar 2006
- Latest award date
- 30 Sep 2018
- Total GBP grants
- Total GBP awarded
- Largest GBP award
- Smallest GBP award
- Total Non-GBP grants
I plan to conduct cross sectional surveys in five demographic surveillance sites across sub-Saharan Africa, to identify cases of active convulsive epilepsy (ACE). This cohort will be used to determine the prevalence of ACE and the extent of the number of people not receiving treatment (treatmetn gap) in these sites, identify the causes (particularly parasitic diseases that could be prevented) and establish cohorts of people with epilepsy, from which the magnitude and causes of excess mortality a ssociated with epilepsy can be determined. In addition, a community based intervention will be tested through a randomised cluster trial in one of the sites, to reduce the treatment gap and improve the quality of life of people with epilepsy in this area.
Using new evidence synthesis techniques to explore health and care inequalities among Lesbian, Gay, Bisexual and Transgender people 24 May 2017
This proposal will utilise a developing approach to synthesising existing quantitative data in order to substantially enhance the evidence-base around health, wellbeing and care inequalities among Lesbian, Gay, Bisexual and Transgender (LGBT) people. The aims of this project are to: Review the potential of nationally representative UK datasets for individual participant data meta-analysis on the health, wellbeing and care states of LGBT people in the UK Apply individual participant data meta-analysis, to develop robust estimates around LGBT health, wellbeing and care needs and inequalities. The analysis will first focus on four target measures of general health, alcohol consumption, mental wellbeing, and provision and receipt of social care among older LGBT people. Develop policy and research recommendations arising from the modelling. By combining evidence from multiple datasets we expect to show representative findings for LGBT outcomes (including statistically significant differences) that we would otherwise not have sufficient power to detect if modelling within individual datasets alone. Develop a network collaborators to expand the approach trialled above, creating a stronger evidence base of LGBT health and care needs across different age groups, intersectionalities, and also across international settings including low and middle income countries.
Management and rehabilitation of patients with socially incompatible personality disorders at Broadmoor Hospital. Secondly an audit into the outcomes of people bought into the emergency department by police who are under the influence of methamphetamine and have suicidal ideation, at St Vincents Hospital in Sydney.
The Congress for Curious People. 30 Aug 2013
We are seeking support for a trans-disciplinary series of lectures and performances, The Congress for Curious People, which is addressing popular variants of scientific knowledge and its social, historical and cultural dimensions. From August 30th to September 8th 2013 this event will be held in multiple venues in London, exploring more specifically relationships between the sciences and spectacle in contemporary society. Beginning with a series of evening lectures and performances and culminati ng in a two-day symposium, the Congress will feature the work of historians of art and science, museum professionals, performers and artists as well as problematise this field and specifically ethical issues around spectatorship. The Congress will create not only a forum for discussing but also for experiencing spectacle, entangling the academic with the popular spheres. Its structure is trans-disciplinary, meaning it is mixing performances, discussions and academic papers in order to question t he abyss between academic reflection and spectacular practices.
My current and previous Wellcome Trust Fellowships (Henry Wellcome, 2009-13; Henry Dale 2014- present) focus on important aetiological questions about psychotic disorders, using epidemiological data. Psychotic disorders are a debilitating set of mental health disorders, characterised by hallucinations, delusions and cognitive deficits. My research demonstrates that these disorders have a robust, replicable social aetiology, with higher incidence rates observed in young people,1–3 men,1–3 ethnic minorities2–7 and people exposed to greater social disadvantage.8–11 In my previous fellowship, I established the largest epidemiological study of first episode psychosis [FEP] in England since 1999, to demonstrate that these substantial mental health inequalities also exist in more rural populations (East Anglia)3,12; rates are over twice as high as expected,3,13 with deprived rural communities experiencing the highest psychosis incidence. This study has generated new Page 5 of 18 aetiological clues, for example by showing that people at "ultra-high risk" of psychosis are exposed to similar social and spatial markers of social disadvantage as FEP patients,14 implicating an aetiological role for social adversities prior to onset. I have also demonstrated that migrants face greatest FEP risk when immigrating in childhood,15 an important period of sociocognitive development. I am attempting to replicate this in my current Fellowship, in a larger longitudinal cohort using Swedish national register data. Using this data, I have already shown that refugees are at elevated psychosis risk compared with other migrants from the same region of origin,7 providing further insights into the possible social determinants of psychosis. Epidemiological data can also inform mental health service planning. In England, Early Intervention in Psychosis [EIP] services assess and treat people with suspected FEP, offering evidence-based multidisciplinary care to improve downstream clinical and social outcomes, shown to be highly costeffective.16 Unfortunately, original policy implementation guidance17 made no provision for the heterogeneity in incidence described above, with services commissioned on a uniform expectation of 15 new cases per 100,000 people-per-year. This was at least half the true incidence,1,3 and over three times lower than the overall referral rate for all suspected FEP, including "false positive" (nonFEP) referrals,3 who still require appropriate psychiatric triage and signposting, and consume additional EIP resources not factored into original guidance. In response, I demonstrated that epidemiological estimates of psychosis risk could be used to better predict the expected FEP incidence in the population at-risk in England,13 nationally and regionally. The tool, known as PsyMaptic, has had substantial impact on policy and commissioning since it was freely-released in 2012 (www.psymaptic.org).16,18–22 Most recently, it has been used to inform national EIP workforce calculations23 following the introduction of Access and Waiting time standards,19 as part of the Department of Health’s commitment to achieving parity of esteem between mental and physical health by 2020.24 Whilst I have demonstrated, via PsyMaptic, that it is possible to translate epidemiological data into effective public mental health,25 some vital methodological limitations require empirical attention. I therefore seek Wellcome Trust enhancement funding to answer four empirical questions to develop and apply novel statistical prediction methodologies to generate sustainable, dynamic populationbased models of future mental health need.
Young people in sub-Saharan Africa are central to ending the HIV epidemic. However, uptake of proven protective interventions is low and evidence on who does/does not engage is limited. Theory predicts that behaviours and intervention uptake cluster within social networks. Interventions in other settings have successfully leveraged social ties to improve intervention impact. I aim to: (1) use novel methods to identify how social networks pattern risk for HIV acquisition; and (2) test the feasibility of using such knowledge to improve intervention uptake. I will undertake this work at the Africa Health Research Institute in rural KwaZulu-Natal, South Africa. Following qualitative interviews with young people exploring their social networks and social norms, we will then quantitatively follow 600 15-24 year-olds, together with their close friends and family, for three years. Using these longitudinal data, we will statistically model how social contacts influence behaviour and HSV/HIV acquisition. We will then quantitatively and qualitatively evaluate the feasibility of using network-selected peer-educators to promote uptake of HIV self-tests and subsequent treatment. We will compare how influential peer-educators differ from randomly selected ones in terms of willingness to be involved, training dynamics and health impact.
Investigating prevention of cervical cancer, disease burden, and opportunities for improvement in inclusion health women (IHW) 30 Sep 2018
Cervical cancer is preventable due to screening and vaccination against human papillomavirus (HPV), the main cause of cervical cancer. However, there were 3,224 new cases and 890 deaths in the UK in 2014. By 2035, this is predicted to rise by 43% due to screening non-attendance. Living in a deprived area increases cervical cancer rates and non-attendance at screening. Inclusion health addresses needs of groups frequently underserved by health services who have worse overall health than people in deprived areas. These include homeless people, migrants, substance misusers, prisoners, and sex workers. It is likely that they engage the least with cervical cancer prevention and have the greatest need for intervention. Unfortunately, they are rarely included in cervical cancer prevention research. This fellowship will fill this knowledge gap. I will measure disease levels, engagement in prevention, and find ways to improve outcomes in inclusion health women. This is needed to eliminate cervical cancer. I will achieve this in three ways: (1) a review of existing studies on inclusion health and cervical cancer (2) a study linking information on 1.6 million migrants to cervical screening and vaccination data and (3) a survey and HPV testing of inclusion health women attending outreach services.
The Neuroscience of Nudge 01 Apr 2016
Nudges are simple behavioural methods designed to influence decision making by taking advantage of people’s implicit biases. One important type of nudge is known as "anchoring." The simple presentation of an irrelevant number affects people’s decisions by shifting estimations towards that number. This behavioural effect is well understood although the mechanism behind the unconscious bias remains unclear. The brain bases of this effect has received surprisingly little attention in the literature. One study found that the medial prefrontal cortex played a crucial role in anchoring theory-of-mind decisions in a social context, suggesting that activity within cortical networks intrinsic to the task is shaped by this extrinsic information. I propose to initiate this investigation by piloting an fMRI experiment to investigate the neural correlates of anchoring in reasoning about uncertainty. The aim is to collect a preliminary data set from a small sample of healthy adults (n=12) to explore whether the experimental paradigm: yields robust behavioural anchoring effects, identifies brain regions whose activity is affected by these anchoring effects, and tests whether these effects are parametric modulated. I predict that within prefrontal regions engaged by the task, I will observe parametric modulation based on the amplitude of the behavioural anchoring effect.
Created Out of Mind will shape public and professional perceptions of dementia through a dynamic fusion of scientific and creative experimentation. Our Hub residency will support the active connection and collaboration of previously disparate cultures (scientists, artists, commissioners/policymakers) and infuse the insights and skills of people living with dementia, communications professionals and collaboration experts. Common (mis-)conceptions of dementia will be challenged through integrated artistic and scientific investigation of less recognised symptoms associated with typical and rare dementias. The project will investigate the neuroscientific, artistic and social bases of artistic engagement, enjoyment and change across multiple art forms. Interdisciplinary discussion, disagreement and creativity will also challenge and develop thinking regarding the principles, priorities, practice, health benefits and methodologically-robust evaluation of arts in dementia. Our inspiration comes directly from the intriguing experiences, heart-rending questions and puzzling uncertainties of people living with dementia. Team members will become creative collaborators whilst maintaining their professional ‘essence’, yielding a richly and meaningfully interconnected network of multi-skilled science/arts researchers, practitioners and communicators. We will also enrich understanding about dementia by raising provocative questions about the healthy brain, our emotional reactions to change in ourselves and others, and the attributes by which we value and define humanity.
Although schizophrenia affects more than 500,000 people in the UK, its neural basis remains poorly understood. What is increasingly clear is that the diverse range of symptoms associated with the disorder are linked by a pervasive problem with the appropriate processing of context. We have reported that people with schizophrenia are largely immune to a visual illusion that relies on suppressive contextual interactions (contrast gain control). The first series of experiments examine contrast gain control in schizophrenia in some depth. We will modify an established combined fMRI-psychophysics paradigm to (a) measure Threshold-versus-Contrast (TvC) functions and so determine if reduced inhibition confers better detection performance in the test group and (b) relate this to the BOLD contrast response function in test and control groups. The second series of psychophysical experiments will determine if gain control deficits extend into domains other than contrast, such orientation and moti on-direction. Finally we will use fMRI and psychophysics to investigate gain-control in another sensory modality: tactile perception. These findings will contribute both to understanding sensory abnormalities associated with schizophrenia and, we hope, in the potential to diagnose it, using psychophysical and fMRI measures.
The pathogenesis of tuberculous meningitis 30 Sep 2018
Tuberculosis is an infection affecting people in many countries throughout the world. In some cases the infection can occur in the lining of the brain (the meninges) leading to a condition called tuberculous meningitis. This is particularly dangerous when the immune system is also suppressed by infection with Human Immunodeficiency Virus (HIV) which is also a common problem worldwide. In this context 40% of patients with tuberculous meningitis will die. When tuberculous infects the brain, the body’s own immune system is activated to fight the bacteria. This is usually helpful, but often the immune system goes into overdrive, causing more damage to the brain than the bacteria itself. This research aims to find out exactly what happens when the immune system works hard to fight the bacteria. The experiments will isolate the building blocks within the blood which dictate which molecules are involved in fighting the infection. We will discover what happens in the immune system at different points during the patient’s illness and treatment. In doing so we hope to find targets for new medicines to control the immune response therefore in the future reducing the number of people who die or are disabled due to tuberculous meningitis.
Shared equipment application for a NIRx Near Infrared Spectrometer (NIRS) system for functional measurements (fNIRS). 11 Jun 2015
We request a Near Infrared Spectrometer (NIRS) to be shared primarily by researchers in speech, hearing and language to make functional NIRS measurements (fNIRS). NIRS is a non-invasive method that measures the absorption of near-infrared light through the intact skull. Similar to fMRI, fNIRS provides an indirect measure of neural activity based on changes in blood oxygenation due to metabolic processes within the cortex. The equipment will be used in research that involves hypotheses that can b e tested based on activations near the cortical surface where the procedures or participants make it difficult or impossible to use fMRI. It can be used with children, people with cochlear implants, and people with conditions or in experiments that make it difficult to remain stationary whilst speaking or listening. The equipment will help extend established research programmes and there are plans in place to permit junior PIs to share and develop new research in a way that will make the facilit y self-sustaining. The research falls within Wellcome Trusts vision statement to improve health.