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Recipients:
University of Oxford

Results

Exploring the potential of Open Source solutions to deliver Clean, Clear Information for Health Service Improvement. 25 Mar 2015

This mixed-methods health systems research project aims to use semi-structured interviews with managers and clinicians involved in Electronic Health Record (EHR) system implementation. Interviewees will be identified through a snowballing technique until saturation of new information from interviewees is reached. A specific case study will be performed of an individual EHR implementation project in Machakos County that uses open-source EHR software (OpenMRS) to identify the barriers and opportunities of using open-source EHR software in the county public health system in Kenya. The results of the case study will inform the development of an innovative in-silico simulation of the Machakos County health system as it would be envisaged in the planned roll out of open-source technology to support clinical care, centralised data collection and on-demand registry services (such as the Master Patient Index and a Master Facilities Index). Finally, a co-design workshop will be held with key EHR stakeholders in Kenya (including policy-makers, researchers, hospital administrators, clinicians, patients, EHR vendors, IT companies, programmers and consultants). The workshop will aim to bring together the results of the survey, case report and simulation with experience from across Kenya to develop a set of research objectives to inform the development of the next stage of research aimed at development and re-use of clean, clear information from data gathered by EHR systems to improve health systems broadly while fostering growth of innovative health services research.

Amount: £32,367
Funder: The Wellcome Trust
Recipient: University of Oxford

Health Services that Delivery: Improving care for sick newborns (HSD-N) 28 Oct 2014

Neonatal mortality now accounts for over 40% of all child mortality in many countries. Yet prior research in low-incomesettings suggest that sick newborns often do not receive the interventions they need to ensure their disability free survival.Sick newborns require multiple interventions, given repetitively for multiple days and so their care is especially sensitive tothe major deficit in the nursing workforce found in the majority of low-income countries. To reduce this deficit and constrainworkforce costs task-shifting, moving responsibility for delivering interventions from professional to lower level workers,may be a solution. Particularly as the interventions delivered may be time consuming but not complex (eg. assistedfeeding). Yet such apparently rational approaches may be poorly designed or implemented leading to their rejection inpolicy or practice.Our overarching objective, employing frameworks to guide development of complex interventions, is to undertake researchMR/M002772/1 Page 3 of 7 Date Saved: 14/01/2014 14:57:31Date Printed: 14/01/2014 15:36:21SummaryIn simple terms please describe your proposed research in a way that it could be publicised to a general audience [up to4000 characters].with key Kenyan stakeholders to design a contextually appropriate and feasible task-shifting intervention to improvedelivery of essential neonatal interventions in facilities. This new arena for research on task-shifting in low-income settingswill demand use of innovative methods and an integrated, multi-disciplinary approach. In parallel we will focus on buildingcapacity for health systems research in Kenya enhanced by the creation of new academic partnerships spanning businessschools to clinical epidemiology. Learning lessons from this approach we aim to develop this participatory research modelfor work on other questions and in other settings.We will develop 4 broad areas of work that inform each other during design, conduct, analysis and interpretation. These willspan: stakeholder engagement and analysis; assessing existing capacity and future needs for interventions for a populationof 5 million; exploration of what is actually required of the workforce to deliver interventions and opportunities for taskshifting;and examination of the regulatory, professional and social context within which task-shifting might be introduced.This programme of work will strengthen researcher - policy maker engagement, result in at least 3 Kenyan PhDs, developinnovative methodological approaches through new partnerships, and generate considerable generalisable knowledge. Ourspecific objectives (indicative of planned outputs) are:1. To examine the regulatory environment and position and influence of key stakeholders on task-shifting debates inneonatal care at the start of the project and explore how such positions change with participation over the lifetime of theproject2. To define with government and key stakeholders a core package of services for sick newborns requiring facility basedcare in Kenya3. To assess current capacity to provide this package in Nairobi County facilities (in all sectors) and to estimate current useof services and contrast this with estimated need derived from epidemiological models at a population level (Gap 1)4. To quantify which interventions needing delivery by nurses are provided safely in representative facilities (Gap 2)5. To characterise neonatal nursing task frequency and duration and the skill level required for delivery to identify thosesuitable for task-shifting6. To explore workplace contexts and managers', professionals' and parents' perspectives to further inform design of anacceptable task-shifting strategy7. To develop illustrative models of the human resource costs of delivering agreed interventions for Nairobi County (closingGap 1 and Gap 2) while varying coverage and task-shifting options to inform stakeholder discussions on design of a taskshiftingintervention that considers affordability, feasibility, access and equity8. To draw lessons on how researchers can engage in a dynamic collaboration to inform improvements in health systems

Amount: £329,756
Funder: The Wellcome Trust
Recipient: University of Oxford

The cross-reactivity of human humoral and cellular immune responses to Burkholderia pseudomallei and avirulent Burkholderia species. 17 Jun 2015

Burkholderia pseudomallei is the Gram negative bacterial cause of melioidosis, a sepsis disease with 40% in-hospital mortality in Northeast Thailand and surrounding regions. Seroconversion to positive indirect haemagluttination assay has traditionally been considered a marker of exposure to B. pseudomallei, and has been used in diagnostics, but the role of avirulent environmental bacteria such as B. thailandensis and B. thailandensis CPS variant in positive serology and protection from disease a nd death is unknown. Samples from two clinical studies offer a unique opportunity to measure cross-reactivity of humeral and cellular responses to the three bacterial species. In the first study samples from approximately 100 rice farmers in three regions of Thailand are paired with bacterial isolates from fields associated with each farmer, to evaluate the relationship between responses and environmental prevalence. In the second study samples from 100 patients with culture-confirmed melioid osis in Northeast Thailand at Weeks 0, 12 and 52 where available will be studied alongside healthy controls. Cross-reactive responses will be characterised by IHA, ELISA, functional antibody assays, multiparameter flow cytometry, cytokine stimulation assays and interferon-gamma ELIspot assay. The results will advance B. pseudomallei specific diagnostics and effective vaccine design.

Amount: £113,244
Funder: The Wellcome Trust
Recipient: University of Oxford

Improving ultra-high field MRI using parallel transmit technology. 11 Jun 2015

Parallel transmit technology is a recent innovation in magnetic resonance imaging (MRI) that enables the sensitivity benefits possible in ultra-high field (7 Tesla) scanning to be achieved across the whole brain. The equipment requested is a parallel-transmit RF head coil. Oxford's 7 Tesla MRI scanner is already enabling researchers to study the function, structure, connectivity and metabolism of the human brain in greater detail and with higher sensitivity than had previously been possible. Ho wever, one of the greatest challenges to achieving these benefits in the broadest range of neuroscience applications is that it is difficult to obtain this high sensitivity uniformly across the brain. Some regions of the brain are essentially inaccessible at 7 Tesla due to the inhomogeneity of the RF transmission field. The most promising approach for overcoming this challenge requires parallel transmit hardware, which enables us to sculpt the transmission field. The new hardware requested will allow researchers to expand the set of brain regions and MRI modalities that can benefit from the exquisite sensitivity offered by the 7 Tesla scanner, opening up the methods to a greater range of clinical conditions and neuroscience questions.

Amount: £176,400
Funder: The Wellcome Trust
Recipient: University of Oxford

OPen access award 2015/16 21 Sep 2015

Not available

Amount: £85,000
Funder: The Wellcome Trust
Recipient: University of Oxford

Open access award 2015/16 MoP 21 Sep 2015

Not available

Amount: £75,000
Funder: The Wellcome Trust
Recipient: University of Oxford

Open access award 2015/16 MoP. 21 Sep 2015

Not available

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

Open access award 2015/16. 21 Sep 2015

Not available

Amount: £540,000
Funder: The Wellcome Trust
Recipient: University of Oxford

Vaccine microencapsulation for single dose delayed release delivery. 25 Aug 2015

Dr Anita Milicic at Oxford University has recently received Pathfinder Award funding to study alternative delivery methods for multiple-dose vaccines. The project aims to develop a new technology for vaccine delivery that would allow multiple (prime-boost) immunisations to be combined into a single-dose vaccine while retaining full efficacy. The boost dose(s) would be encapsulated into polymer microcapsules, for a delayed delivery at predetermined time intervals within the body, and administered together with the priming vaccine thus mimicking the conventional prime-boost immunisation. This innovative technology could allow patients to achieve protection from a disease after just a single dose thus minimising sub-optimal vaccine coverage of the population.

Amount: £98,932
Funder: The Wellcome Trust
Recipient: University of Oxford

Oxford, Structural Biology. 22 Jun 2015

Not available

Amount: £161,673
Funder: The Wellcome Trust
Recipient: University of Oxford

Oxford, Cellular Structural Biology. 22 Jun 2015

Not available

Amount: £161,673
Funder: The Wellcome Trust
Recipient: University of Oxford

Oxford, Cellular Structural Biology. 22 Jun 2015

Not available

Amount: £161,673
Funder: The Wellcome Trust
Recipient: University of Oxford
Amount: £161,673
Funder: The Wellcome Trust
Recipient: University of Oxford

Oxford, Cellular Structural Biology. 22 Jun 2015

Not available

Amount: £161,673
Funder: The Wellcome Trust
Recipient: University of Oxford

Oxford, OXION. 22 Jun 2015

Not available

Amount: £161,673
Funder: The Wellcome Trust
Recipient: University of Oxford

Oxford, OXION. 22 Jun 2015

Not available

Amount: £161,673
Funder: The Wellcome Trust
Recipient: University of Oxford

Oxford, OXION. 22 Jun 2015

Not available

Amount: £161,673
Funder: The Wellcome Trust
Recipient: University of Oxford

Oxford, OXION. 22 Jun 2015

Not available

Amount: £161,673
Funder: The Wellcome Trust
Recipient: University of Oxford
Amount: £161,673
Funder: The Wellcome Trust
Recipient: University of Oxford